Monkeypox: the epidemic potential will continue increasing, with diminishing herd immunity against orthopoxviruses (responsible for smallpox)

Monkeypox is an emerging infectious disease for which outbreak frequency and expected outbreak size in human populations have steadily increased. The geographic spread of monkeypox cases has expanded beyond the forests of central Africa, where cases were initially found, to other parts of the world, where cases have been imported. This transmission pattern is likely due to the worldwide decline in orthopoxvirus immunity (monkeypox virus), following cessation of smallpox vaccination, once smallpox was declared eradicated in 1980. Monkeypox could therefore emerge as the most important orthopoxvirus infection in humans. We use mathematical modelling to argue that, in a population with diminishing herd immunity against orthopoxvirus species, the epidemic potential of monkeypox will continue increasing. Monkeypox is caused by the monkeypox virus, member of the orthopoxvirus genus.

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