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In 2003, an outbreak of human monkeypox — a severe smallpoxlike illness — occurred in the U.S. following importation of infected rodents from Africa (JW Infect Dis Jul 28 2003). This disease was first reported in 1970, in Zaire (now the Democratic Republic of Congo [DRC]). Its incidence in Africa was relatively low in the 1970s and 1980s, presumably because of cross-protective immunity from vaccinia immunization for smallpox. Smallpox vaccination campaigns ended in the DRC in 1980, and WHO surveillance for human monkeypox — initiated in 1981 — ended in 1986. To determine the current risk for this illness, researchers established an active surveillance program in regions of the DRC where the virus was known to circulate.
In 2006–2007, 760 cas…