Orthopox viruses: is the threat growing?

Boehm, Erik; Summermatter, Kathrin; Kaiser, Laurent (2024). Orthopox viruses: is the threat growing? (In Press). Clinical microbiology and infection Elsevier 10.1016/j.cmi.2024.02.011

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BACKGROUND

Smallpox was a major source of human mortality until its eradication, but the threat from orthopox viruses has not disappeared. Since the eradication of smallpox and the cessation of the related vaccination campaigns, the threat has been growing, as evidenced by the currently ongoing worldwide Mpox outbreak. In addition to threats from an evolving Mpox, we must also be aware of a myriad of other threats that remain. Many countries still lack biosecurity regulations reflecting the recent technological advances and the threat of bioterrorism remains ever present. Reconstruction of smallpox is a distinct possibility, as are other scenarios whereby other orthopox viruses may be made more fit for transmission in humans.

OBJECTIVES

To outline and discuss potential biosafey and biosecurity threats posed by orthopox viruses.

SOURCES

Published scientific literature, news articles, and international agreements.

CONTENT AND IMPLICATIONS

It would be wise to take steps to mitigate these threats now. Vaccination campaigns should be considered in areas with frequent orthopox outbreaks, and more effort must be made to put a final end to the Mpox outbreak. In many countries, national biosafety and biosecurity regulations may need to be revised and strengthened to better reflect the threats posed by new technologies, including controls on synthesis of smallpox sequences. Furthermore, more international cooperation and aid is needed. The present global Mpox outbreak could likely have been prevented had areas where Mpox is endemic not been neglected. Future outbreaks could be much worse.

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