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Emerg Infect Dis 2019 May 17;25(5). Epub 2019 May 17.

We note the reemergence of human monkeypox in Sierra Leone following a 44-year absence of reported disease. The persons affected were an 11-month-old boy and, several years later, a 35-year-old man. The reappearance of monkeypox in this country suggests a need for renewed vigilance and awareness of the disease and its manifestations. Read More

Emerg Infect Dis 2019 Feb;25(2):281-289

Monkeypox, caused by a zoonotic orthopoxvirus, is endemic in Central and West Africa. Monkeypox has been sporadically reported in the Republic of the Congo. During March 22-April 5, 2017, we investigated 43 suspected human monkeypox cases. Read More

J Travel Med 2019 Jan 18. Epub 2019 Jan 18.

Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA.

Infect Genet Evol 2019 Jan 8;69:8-11. Epub 2019 Jan 8.

Virology Service, Centre Pasteur of Cameroon, Yaounde, Cameroon. Electronic address:

A monkeypox virus was detected from a human clinical case in 2018 in Cameroon; a country where no human cases were reported since 1989. The virus exhibited close genetic relatedness with another monkeypox virus isolated in Nigeria during the 2017-2018 outbreak. Although our molecular findings argue in favor of an extension of the monkeypox outbreak from Nigeria into Cameroon, the possibility that the monkeypox virus detected could be indigenous to Cameroon cannot be ruled out. Read More

Expert Rev Anti Infect Ther 2019 Feb 21;17(2):129-139. Epub 2019 Jan 21.

a US Centers for Disease Control and Prevention, Poxvirus and Rabies Branch , Atlanta , GA , USA.

Introduction: Monkeypox is a re-emerging viral zoonosis that occurs naturally in heavily forested regions of West and Central Africa. Inter-human transmission of monkeypox virus, although limited, drives outbreaks, particularly in household and health-care settings. But the available evidence suggests that without repeated zoonotic introductions, human infections would eventually cease to occur. Read More

PLoS Negl Trop Dis 2018 12 20;12(12):e0007034. Epub 2018 Dec 20.

Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

Endemic to the Democratic Republic of the Congo (DRC), monkeypox is a zoonotic disease that causes smallpox-like illness in humans. Observed fluctuations in reported cases over time raises questions about when it is appropriate to mount a public health response, and what specific actions should be taken. We evaluated three different thresholds to differentiate between baseline and heightened disease incidence, and propose a novel, tiered algorithm for public health action. Read More

Cell Rep 2018 Nov;25(9):2369-2378.e4

Department of Molecular Microbiology and Immunology, Saint Louis University, Saint Louis, MO 63104, USA. Electronic address:

Tracking antigen-specific T cell responses over time within individuals is difficult because of lack of knowledge of antigen-specific TCR sequences, limitations in sample size, and assay sensitivities. We hypothesized that analyses of high-throughput sequencing of TCR clonotypes could provide functional readouts of individuals' immunological histories. Using high-throughput TCR sequencing, we develop a database of TCRβ sequences from large cohorts of mice before (naive) and after smallpox vaccination. Read More

Health Secur 2018 ;16(S1):S44-S53

Pia D. M. MacDonald, PhD, CPH, is a Senior Epidemiologist, Biostatistics and Epidemiology, RTI International, Durham, North Carolina.

High-functioning communicable disease surveillance systems are critical for public health preparedness. Countries that cannot quickly detect and contain diseases are a risk to the global community. The ability of all countries to comply with the International Health Regulations is paramount for global health security. Read More

Int J Infect Dis 2019 Jan 16;78:78-84. Epub 2018 Nov 16.

Division of Infection and Immunity, Center for Clinical Microbiology, University College London, United Kingdom; The National Institute of Health Research Biomedical Research Centre at UCL Hospitals, London, United Kingdom. Electronic address:

The identification of monkeypox in 3 separate patients in the United Kingdom in September raised media and political attention on an emerging public health threat. Nigeria, whose last confirmed case of monkeypox was in 1978, is currently experiencing an unusually large and outbreak of human monkeypox cases, a 'One Human-Environmental-Animal Health' approach is being effectively used to define and tackle the outbreak. As of 13th October 2018, there have been one hundred and sixteen confirmed cases the majority of whom are under 40 years. Read More

Antiviral Res 2019 Feb 14;162:171-177. Epub 2018 Nov 14.

U.S. Centers for Disease Control and Prevention, Atlanta, USA.

Healthcare-associated transmission of monkeypox has been observed on multiple occasions in areas where the disease is endemic. Data collected by the US Centers for Disease Control and Prevention (CDC) from an ongoing CDC-supported program of enhanced surveillance in the Tshuapa Province of the Democratic Republic of the Congo, where the annual incidence of human monkeypox is estimated to be 3.5-5/10,000, suggests that there is approximately one healthcare worker infection for every 100 confirmed monkeypox cases. Read More

Medchemcomm 2018 Oct 19;9(10):1746-1753. Epub 2018 Sep 19.

Novosibirsk Institute of Organic Chemistry , Siberian Branch of the Russian Academy of Sciences , Lavrentjev Avenue 9 , 630090 Novosibirsk , Russia . Email:

The genus belongs to the Poxviridae family and includes variola virus (smallpox), cowpox virus, monkeypox virus and vaccinia virus (VV). Smallpox is considered one of the great epidemic disease scourges in human history. It has currently been eradicated; however, it remains a considerable threat as a biowarfare or bioterrorist weapon. Read More

New Microbes New Infect 2018 Nov 30;26:S104-S108. Epub 2018 Aug 30.

Microbes, Evolution, Phylogeny and Infection (MEФI), UMR Aix-Marseille Université, IRD, APHM, IHU Méditerranée Infection, Marseille, France.

The genetic and morphologic similarities between primates and humans means that much information obtained from primates may be applied to humans, and However, habitat loss, hunting and the continued presence of humans have a negative effect on the biology and behaviour of almost all nonhuman primates. Noninvasive methods such as stool collection are among the safest alternative ways to study the multiple aspects of the biology of primates. Many epidemiologic issues (e. Read More

J Med Virol 2019 Apr 19;91(4):533-540. Epub 2018 Nov 19.

Virology, Microbiology and Infectious Diseases Research Group, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.

Since the eradication of smallpox approximately 39 years ago, monkeypox virus remains the most pathogenic poxvirus, being mainly restricted to Central and West Africa. Before 1970, there were no reports of human monkeypox in Nigeria, while between 1971 and 1978 there were three cases, with none having been reported thereafter. However, in September 2017, a case of contagious skin rash disease, typical of monkeypox, was observed in an 11-year-old boy from the southern part of the country and confirmed to be associated with the monkeypox virus. Read More

Viruses 2018 10 6;10(10). Epub 2018 Oct 6.

National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, via Portuense 292, 00149 Rome, Italy.

(OPVs) are diffused over the complete Eurasian continent, but previously described strains are mostly from northern Europe, and few infections have been reported from Italy. Here we present the extended genomic characterization of OPV Abatino, a novel OPV isolated in Italy from an infected Tonkean macaque, with zoonotic potential. Phylogenetic analysis based on 102 conserved genes (core gene set) showed that OPV Abatino is most closely related to the Ectromelia virus species (ECTV), although placed on a separate branch of the phylogenetic tree, bringing substantial support to the hypothesis that this strain may be part of a novel OPV clade. Read More

Curr Protoc Microbiol 2018 Nov 3;51(1):e65. Epub 2018 Oct 3.

School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Australia.

Ectromelia virus (ECTV) is an orthopoxvirus that causes mousepox in mice. Members of the genus orthopoxvirus are closely related and include variola (the causative agent of smallpox in humans), monkeypox, and vaccinia. Common features of variola virus and ECTV further include a restricted host range and similar disease progression in their respective hosts. Read More

BMJ 2018 Oct 2;363:k4132. Epub 2018 Oct 2.

The BMJ.

Lancet 2018 09 20;392(10152):986. Epub 2018 Sep 20.

Euro Surveill 2018 Sep;23(38)

Emerging Infections and Zoonoses Section, National Infection Service, Public Health England, Colindale, London, United Kingdom.

In early September 2018, two cases of monkeypox were reported in the United Kingdom (UK), diagnosed on 7 September in Cornwall (South West England) and 11 September in Blackpool (North West England). The cases were epidemiologically unconnected and had recently travelled to the UK from Nigeria, where monkeypox is currently circulating. We describe the epidemiology and the public health response for the first diagnosed cases outside the African continent since 2003. Read More

MMWR Morb Mortal Wkly Rep 2018 Sep 21;67(37):1040-1041. Epub 2018 Sep 21.

Front Public Health 2018 4;6:241. Epub 2018 Sep 4.

Laboratory of Clinical Virology, Department of Microbiology & Immunology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium.

Monkeypox is an emerging zoonotic disease recognized as the most important orthopoxvirus infection in humans in the smallpox post-eradication era. The clinical presentation of monkeypox is similar to the one of smallpox. The case fatality rate of monkeypox (10%) lies between the case fatality rate of variola major (30%) and variola minor (1%). Read More

Influenza Other Respir Viruses 2018 11 6;12(6):695-705. Epub 2018 Sep 6.

Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia.

Background: Estimates of influenza-associated outpatient consultations and hospitalizations are severely limited in low- and middle-income countries, especially in Africa.

Methods: We conducted active prospective surveillance for influenza-like illness (ILI) and severe acute respiratory illness (SARI) at 5 healthcare facilities situated in Kinshasa Province during 2013-2015. We tested upper respiratory tract samples for influenza viruses using a reverse transcription-polymerase chain reaction assay. Read More

J Infect Dis 2018 Sep;218(9):1490-1499

SIGA Technologies, Inc, Corvallis, Oregon.

Background: Tecovirimat (ST-246) is being developed as an antiviral therapeutic for smallpox for use in the event of an accidental or intentional release. The last reported case of smallpox was 1978 but the potential for use of variola virus for biowarfare has renewed interest in smallpox antiviral therapeutics.

Methods: Cynomolgus macaques were challenged with a lethal dose of monkeypox virus (MPXV) by aerosol as a model for human smallpox and treated orally with 10 mg/kg tecovirimat once daily starting up to 8 days following challenge. Read More

N Engl J Med 2018 07;379(1):44-53

From SIGA Technologies, Corvallis, OR.

Background: Smallpox was declared eradicated in 1980, but variola virus (VARV), which causes smallpox, still exists. There is no known effective treatment for smallpox; therefore, tecovirimat is being developed as an oral smallpox therapy. Because clinical trials in a context of natural disease are not possible, an alternative developmental path to evaluate efficacy and safety was needed. Read More

Anal Bioanal Chem 2018 Sep 22;410(23):5817-5823. Epub 2018 Jun 22.

Institute of Chemical Biology and Fundamental Medicine, Siberian Branch, Russian Academy of Sciences, pr. Lavrentieva 8, Novosibirsk, 630090, Russia.

A variant of the hybridization oligonucleotide microarray, utilizing the principle of many probes-one spot (MPOS-microarrays), is proposed. A case study based on Orthopoxviruses (Variola, Monkeypox, and Ectromelia viruses) demonstrates a considerable increase in the fluorescence signal (up to 100-fold) when several oligonucleotide probes are printed to one spot. Moreover, the specificity of detection also increases (almost 1000-fold), allowing the use of probes that individually lack such high specificity. Read More

PLoS Negl Trop Dis 2018 06 21;12(6):e0006581. Epub 2018 Jun 21.

United States Army Medical Research Institute of Infectious Diseases, Virology Division, Fort Detrick Maryland, United States of America.

Concerns regarding outbreaks of human monkeypox or the potential reintroduction of smallpox into an immunological naïve population have prompted the development of animal models and countermeasures. Here we present a marmoset model of monkeypox and smallpox disease utilizing a relevant poxvirus via a natural exposure route. We found that 1000 plaque forming units (PFU) of Monkeypox virus was sufficient to recapitulate smallpox disease, to include an incubation period of approximately 13 days, followed by the onset of rash, and death between 15 and 17 days. Read More

Emerg Infect Dis 2018 06;24(6):1158-1160

Reports of 10 suspected cases of monkeypox in Likouala Department, Republic of the Congo, triggered an investigation and response in March 2017 that included community education and surveillance strengthening. Increasing numbers of outbreaks suggest that monkeypox virus is becoming a more prevalent human pathogen. Diverse approaches are necessary for disease control and prevention. Read More

Viruses 2018 05 12;10(5). Epub 2018 May 12.

Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers of Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.

Annotated whole genome sequences of three isolates of the Akhmeta virus (AKMV), a novel species of orthopoxvirus (OPXV), isolated from the Akhmeta and Vani regions of the country Georgia, are presented and discussed. The AKMV genome is similar in genomic content and structure to that of the cowpox virus (CPXV), but a lower sequence identity was found between AKMV and Old World OPXVs than between other known species of Old World OPXVs. Phylogenetic analysis showed that AKMV diverged prior to other Old World OPXV. Read More

Med Clin (Barc) 2018 Oct 7;151(8):320-322. Epub 2018 May 7.

Facultad de Medicina, Universitat de Girona, Girona, España.

Open Forum Infect Dis 2017 3;4(4):ofx168. Epub 2017 Nov 3.

Unité Environnement et Risques Infectieux, Cellule d'Intervention Biologique d'Urgence.

An outbreak of familial monkeypox occurred in the Central African Republic in 2015/2016 by 3 transmission modes: familial, health care-related, and transport-related. Ten people (3 children and 7 adults) were infected. Most presented with cutaneous lesions and fever, and 2 children died. Read More

J Gen Virol 2018 Jun 20;99(6):790-804. Epub 2018 Apr 20.

1​Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands.

Poxviruses comprise a group of large dsDNA viruses that include members relevant to human and animal health, such as variola virus, monkeypox virus, cowpox virus and vaccinia virus (VACV). Poxviruses are remarkable for their unique replication cycle, which is restricted to the cytoplasm of infected cells. The independence from the host nucleus requires poxviruses to encode most of the enzymes involved in DNA replication, transcription and processing. Read More

Emerg Infect Dis 2018 06 17;24(6):1149-1151. Epub 2018 Jun 17.

In Nigeria, before 2017 the most recent case of human monkeypox had been reported in 1978. By mid-November 2017, a large outbreak caused by the West African clade resulted in 146 suspected cases and 42 laboratory-confirmed cases from 14 states. Although the source is unknown, multiple sources are suspected. Read More

Med Mal Infect 2018 Jun 21;48(4):263-268. Epub 2018 Mar 21.

Institut Pasteur de Bangui, Central African Republic.

Background: Monkeypox is a zoonosis caused by an Orthopoxvirus of the Poxviridae family. Human infections are often severe and are a public health problem.

Patients And Method: We conducted a monkeypox outbreak investigation of suspected case patients in five villages of the Alindao-Mingala Health District following blood sample confirmation of the virus by the Institut Pasteur in Bangui. Read More

Evol Bioinform Online 2018 9;14:1176934318761368. Epub 2018 Mar 9.

Department of Biotechnology, Vignan's University, Guntur, India.

The evolution of bias in synonymous codon usage in chosen monkeypox viral genomes and the factors influencing its diversification have not been reported so far. In this study, various trends associated with synonymous codon usage in chosen monkeypox viral genomes were investigated, and the results are reported. Identification of factors that influence codon usage in chosen monkeypox viral genomes was done using various codon usage indices, such as the relative synonymous codon usage, the effective number of codons, and the codon adaptation index. Read More

Wkly Epidemiol Rec 2018 Mar 16;93(11):125-32. Epub 2018 Mar 16.

MMWR Morb Mortal Wkly Rep 2018 Mar 16;67(10):306-310. Epub 2018 Mar 16.

The recent apparent increase in human monkeypox cases across a wide geographic area, the potential for further spread, and the lack of reliable surveillance have raised the level of concern for this emerging zoonosis. In November 2017, the World Health Organization (WHO), in collaboration with CDC, hosted an informal consultation on monkeypox with researchers, global health partners, ministries of health, and orthopoxvirus experts to review and discuss human monkeypox in African countries where cases have been recently detected and also identify components of surveillance and response that need improvement. Endemic human monkeypox has been reported from more countries in the past decade than during the previous 40 years. Read More

Viruses 2018 03 5;10(3). Epub 2018 Mar 5.

School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW 2006, Australia.

Ectromelia virus (ECTV) is an orthopoxvirus and the causative agent of mousepox. Like other poxviruses such as variola virus (agent of smallpox), monkeypox virus and vaccinia virus (the live vaccine for smallpox), ECTV promotes actin-nucleation at the surface of infected cells during virus release. Homologs of the viral protein A36 mediate this function through phosphorylation of one or two tyrosine residues that ultimately recruit the cellular Arp2/3 actin-nucleating complex. Read More

Viruses 2018 02 28;10(3). Epub 2018 Feb 28.

Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge CB2 1QP, UK.

The increasing frequency of monkeypox virus infections, new outbreaks of other zoonotic orthopoxviruses and concern about the re-emergence of smallpox have prompted research into developing antiviral drugs and better vaccines against these viruses. This article considers the genetic engineering of vaccinia virus (VACV) to enhance vaccine immunogenicity and safety. The virulence, immunogenicity and protective efficacy of VACV strains engineered to lack specific immunomodulatory or host range proteins are described. Read More

J Med Virol 2018 Jun 12;90(6):1134-1141. Epub 2018 Mar 12.

Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy.

Variola virus (VARV), the causative agent of smallpox, is an exclusively human virus belonging to the genus Orthopoxvirus, which includes many other viral species covering a wide range of mammal hosts, such as vaccinia, cowpox, camelpox, taterapox, ectromelia, and monkeypox virus. The tempo and mode of evolution of Orthopoxviruses were reconstructed using a Bayesian phylodynamic framework by analysing 80 hemagglutinin sequences retrieved from public databases. Bayesian phylogeography was used to estimate their putative ancestral hosts. Read More

R Soc Open Sci 2018 Jan 31;5(1):171089. Epub 2018 Jan 31.

Department of Ecology and Evolutionary Biology, Institute of the Environment and Sustainability, University of California, Los Angeles, CA, USA.

Infectious diseases that originate from multiple wildlife hosts can be complex and problematic to manage. A full understanding is further limited by large temporal and spatial gaps in sampling. However, these limitations can be overcome, in part, by using historical samples, such as those derived from museum collections. Read More

Mil Med 2018 01;183(1-2):e59-e65

CBRN Program Office, Office of the U.S. Army Surgeon General, Falls Church, VA 22041.

Background: Defense policy planners and countermeasure developers are often faced with vexing problems involving the prioritization of resources and efforts. This is especially true in the area of Biodefense, where each new emerging infectious disease outbreak brings with it questions regarding the causative agent's potential for weaponization. Recent experience with West Nile Virus, Severe Acute Respiratory Syndrome, Monkeypox, and H1N1 Influenza highlights this problem. Read More

Lancet Infect Dis 2018 03 18;18(3):246. Epub 2018 Jan 18.

Nigeria Centre for Disease Control, Abuja, Nigeria.

Viruses 2017 12 12;9(12). Epub 2017 Dec 12.

US Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, GA 30329, USA.

Monkeypox is a smallpox-like illness that can be accompanied by a range of significant medical complications. To date there are no standard or optimized guidelines for the clinical management of monkeypox (MPX) patients, particularly in low-resource settings. Consequently, patients can experience protracted illness and poor outcomes. Read More

Front Microbiol 2017 17;8:2196. Epub 2017 Nov 17.

Division of Biology, Kansas State University, Manhattan, KS, United States.

Poxviruses continue to cause serious diseases even after eradication of the historically deadly infectious human disease, smallpox. Poxviruses are currently being developed as vaccine vectors and cancer therapeutic agents. Resveratrol is a natural polyphenol stilbenoid found in plants that has been shown to inhibit or enhance replication of a number of viruses, but the effect of resveratrol on poxvirus replication is unknown. Read More

Emerg Infect Dis 2017 12;23(13)

Preventing zoonotic diseases requires coordinated actions by government authorities responsible for human and animal health. Constructing the frameworks needed to foster intersectoral collaboration can be approached in many ways. We highlight 3 examples of approaches to implement zoonotic disease prevention and control programs. Read More

Virol J 2017 11 3;14(1):210. Epub 2017 Nov 3.

Division of Medicine, U.S. Army Medical Research Institute of Infectious Diseases, 1425 Porter Street, Fort Detrick, Frederick, MD, 21702-5011, USA.

Background: In 1980, smallpox disease was eradicated from nature and Variola virus, the etiological agent of smallpox, was confined to two laboratories, one located in Russia (Moscow) later moved to VECTOR (Novosibirsk, Siberia) and one in the United States (CDC Atlanta). Vaccinations among the general public ceased shortly after the successful eradication campaign, resulting in an increasingly immunologically susceptible population. Because of the possibility of intentional reintroduction of Variola virus and the emergence of other pathogenic poxviruses, there is a great need for the development of medical countermeasures to treat poxvirus disease. Read More

J Infect Dis 2017 10;216(7):795-797

Donald P. Shiley BioScience Center.

J Infect Dis 2017 10;216(7):824-828

L'Institut National de Recherche Biomédicale.

Human monkeypox is an endemic disease in rain-forested regions of central Democratic Republic of Congo. We report fetal outcomes for 1 of 4 pregnant women who participated in an observational study at the General Hospital of Kole (Sankuru Province), where 222 symptomatic subjects were followed between 2007 and 2011. Of the 4 pregnant women, 1 gave birth to a healthy infant, 2 had miscarriages in the first trimester, and 1 had fetal death, with the macerated stillborn showing diffuse cutaneous maculopapillary skin lesions involving the head, trunk and extremities, including palms of hands and soles of feet. Read More

Viruses 2017 10 3;9(10). Epub 2017 Oct 3.

U.S. Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, 1600 Clifton Rd. NE, Atlanta, GA 30333, USA.

During 2012, 2013 and 2015, we collected small mammals within 25 km of the town of Boende in Tshuapa Province, the Democratic Republic of the Congo. The prevalence of monkeypox virus (MPXV) in this area is unknown; however, cases of human infection were previously confirmed near these collection sites. Samples were collected from 353 mammals (rodents, shrews, pangolins, elephant shrews, a potamogale, and a hyrax). Read More

Ecohealth 2017 09 11;14(3):564-574. Epub 2017 Sep 11.

UCLA Fielding School of Public Health, 41-275 CHS, 650 Charles E. Young Dr. South, Los Angeles, CA, 90095, USA.

From 2006 to 2007, an active surveillance program for human monkeypox (MPX) in the Democratic Republic of the Congo identified 151 cases of coinfection with monkeypox virus and varicella zoster virus from 1158 suspected cases of human MPX (13%). Using clinical and socio-demographic data collected with standardized instruments by trained, local nurse supervisors, we examined a variety of hypotheses to explain the unexpectedly high proportion of coinfections among the sample, including the hypothesis that the two viruses occur independently. The probabilities of disease incidence and selection necessary to yield the observed sample proportion of coinfections under an assumption of independence are plausible given what is known and assumed about human MPX incidence. Read More

PLoS Negl Trop Dis 2017 Sep 11;11(9):e0005857. Epub 2017 Sep 11.

Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

Background: Human monkeypox (MPX) occurs at appreciable rates in the Democratic Republic of Congo (DRC). Infection with varicella zoster virus (VZV) has a similar presentation to that of MPX, and in areas where MPX is endemic these two illnesses are commonly mistaken. This study evaluated the diagnostic utility of two surveillance case definitions for MPX and specific clinical characteristics associated with laboratory-confirmed MPX cases. Read More