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Monkeypox, A Primer


by Stuart M Caplen, MD

Monkeypox was first discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of research monkeys. The first human case of monkeypox occurred in 1970 in the Democratic Republic of the Congo. Monkeypox virus belongs to the Orthopoxvirus genus of the family Poxviridae. It is uncertain what the natural reservoir of monkeypox is but African rodents and non-human primates such as monkeys may harbor the virus and potentially infect people.[1]

In the recent world-wide outbreak, as of June 15, 2022, there have been 84 confirmed U.S. cases and 2,207 cases in 36 countries, which is probably an undercount of actual total cases. So far, the identified cases have been infected with the West African monkeypox virus. The West African monkeypox virus is associated with milder disease, fewer deaths, and limited human-to-human transmission, while Central African monkeypox virus infections are typically more severe and have a higher mortality rate. Person-to-person spread is well-documented for Central African monkeypox virus. In Africa, monkeypox mortality has been found to be as high as 10%, but typically is from 3% to 6%.[2,3,4,5]



Monkeypox rash
Monkeypox rash [7]

The full Monkeypox article includes more about:

Sources of infection



Current U.S. Pre-exposure Prophylaxis Recommendations





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Stuart M. Caplen, MD, FACEP, MSM

Dr. Caplen is a retired emergency medicine physician and former emergency department medical director, who also has a Master of Science in Management degree, and green belt certification in Lean/Six Sigma.


[1] About Monkeypox. CDC. Last reviewed: June 9, 2022. Retrieved from:

[2] U.S. Monkeypox 2022: Situation Summary. CDC. Last reviewed: June 9, 2022. Retrieved from:

[3] 2022 Monkeypox and Orthopoxvirus Outbreak Global Map. CDC. Last reviewed: June 3, 2022. Retrieved from:

[4] Multi-country monkeypox outbreak in non-endemic countries: Update. WHO. 29 May 2022, Retrieved from:

[5] Monkeypox. WHO. 19 May 2022. Retrieved from:

[6] Monkeypox Signs and Symptoms. CDC. Last reviewed: July 16, 2021. Retrieved from:

[7] Monkeypox Clinical Recognition. CDC. Last reviewed: May 23, 2022. Retrieved from:

[8] Thomson J. Does Monkeypox Leave Scars? Newsweek. June 9, 2022. Retrieved from:

[9] Monkeypox Transmission. CDC. Last reviewed: May 29, 2022. Retrieved from:

[10] Monkey Prevention. CDC. Last reviewed: June 9, 2022. Retrieved from:

[11] Monkeypox and Smallpox Vaccine Guidance. CDC. Last reviewed: June 2, 2022. Retrieved from:

[12] Interim Clinical Guidance for the Treatment of Monkeypox. CDC. Interim Clinical Guidance for the Treatment of Monkeypox. Last reviewed: June 10, 2022. Retrieved from:

[13] Monkey pox Treatment. CDC. Last reviewed: June 9, 2022. Retrieved from:

[143] Clinician FAQs; How long does my patient need to isolate? CDC. Last reviewed: June 10, 2022. Retrieved from:

[15] Duration of Isolation Procedures. CDC. Last reviewed: May 31, 2022. Retrieved from:

[16] Preparation and Collection of Specimens. CDC. Last reviewed: June 9, 2022. Retrieved from:

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