Monkeypox: A Little-Studied Biological Threat to Russia

Monkeypox is a natural focal zoonosis of rodents and monkeys living in the Congo Valley (clade CB) and West Africa (clade WA). The special interest in monkeypox is due to its pandemic spread, which began in May 2022. The aim of this article is to consider the danger of monkeypox due to the lack of knowledge about its nature, as well as existing achievements in the treatment and prevention of this disease. The information was collected mainly from English­language sources available through the PubMed and Google Scholar databases. The study was conducted in the following areas: the epidemiology of monkeypox outbreaks until May 2022; taxonomy and origin of monkeypox virus (MPV); morphology and life cycle of poxviruses; ecology and epidemiology of MPV; the clinical picture of monkeypox in humans with natural infection; monkeypox clinic in European homosexuals; clinical picture and pathomorphology of monkeypox in animals with artificial infection; immunoprophylaxis and therapy of monkeypox. It has been established that until May 2022 the appearance of MPV into non­endemic countries was limited to single cases of the disease. Because of that, the monkeypox pandemic that began in May 2022 looks atypical. The low­contagious MPV (WA) that caused it did not occur in Nigeria until 2017. Its spread was facilitated by a new mechanism of infection through organized homosexual contacts. Therefore, monkeypox should no longer be considered a rare disease geographically limited to the countries of West and Central Africa. It is also necessary to take into account the possibility of activating the natural reservoirs of other poxviruses, as well as the realization of their epidemic potential through immunodeficient human populations, which reach 20% of the total population in the developed countries. At present, there are no vaccines or drugs whose efficacy and safety have been confirmed in epidemic foci of MPV with immunodeficient populations. Serious efforts should be made to identify man­made outbreaks of monkeypox; to the identification of possible zoonotic hosts of MPV in Russia; factors that support MPV in ecosystems; host factors that determine the severity of the disease, as well as facilitating animal­to­human and human­to­human transmission.

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