The end of smallpox was ... the beginning for mpox

October 8, 2024
In 1970, a 9-month-old boy became the first known human case of mpox in the Democratic Republic of Congo. Now, over 50 years later, mpox has surged to over 30,000 suspected cases in 15 African countries in 2024. This outbreak is linked to the eradication of smallpox. The closely related viruses share immunity, meaning the end of smallpox vaccination inadvertently created an opening for mpox. This story of unintended consequences highlights how medical triumphs can have unexpected repercussions, emphasizing the need to understand mpox's history to regain control over the virus.
The story of mpox began innocuously in 1970 with a 9-month-old boy's visit to his grandmother in the Democratic Republic of Congo. What started as a fever and rash led to a startling discovery: the first known human case of monkeypox, now called mpox. This child became patient zero in a narrative that would unfold over more than five decades.
Fast forward to 2024, and the world faces an unprecedented surge in mpox cases. Over 30,000 suspected cases have been reported across 15 African countries, a number that dwarfs previous yearly totals. This alarming increase has prompted health experts to revisit the virus's history, seeking answers in its past to address the present crisis.
The origins of mpox are inextricably linked to the fight against smallpox. As Ugandan health minister Jane Ruth Aceng noted, "We vaccinated for smallpox and eradicated it. But look, something came out of that: monkeypox." This observation highlights a crucial aspect of the mpox story: unintended consequences.
Smallpox and mpox are closely related viruses, sharing a level of immunity. The eradication of smallpox, while a monumental achievement in public health, inadvertently created an opening for mpox. As smallpox vaccinations ceased, the world's immunity to mpox diminished. Moreover, the medical expertise needed to combat pox viruses began to wane.
This historical context offers valuable insights into the current mpox situation. It demonstrates how the virus has evolved, how our medical capabilities have changed, and what strategies might be effective in regaining control over the outbreak.
The mpox story serves as a reminder of the complex interconnections in public health. It underscores the importance of maintaining vigilance and expertise even after a disease is considered conquered, as new challenges may emerge from unexpected quarters. As we grapple with the current mpox outbreak, understanding its history becomes crucial in formulating effective strategies for the future.
