uncontrolled HIV-1 infections. One case of encephalitis and bronchopneumonia was fatal in a neonate, and two HIVnegative adults died with bronchopneumonia and sepsis. Although secondary bacterial infections were relatively common in this outbreak, other serious complications such as encephalitis, keratitis or bronchopneumonia were rare in both this outbreak and the 2003 outbreak in the U.S. The availability of advanced health care facilities and good supportive care, as well as the absence of poor nutrition and concurrent diseases, may contribute to higher survival rates for monkeypox in some areas. Internet Resources Centers for Disease Control and Prevention (CDC). Monkeypox European Centre for Disease Prevention and Control (ECDC). Monkeypox Public Health Agency of Canada. Pathogen Safety Data Sheets The Merck Manual The Merck Veterinary Manual Wisconsin National Primate Research Center (WNPRC), University of Wisconsin World Health Organization. Monkeypox Acknowledgements This factsheet was written by Anna Rovid Spickler, DVM, PhD, Veterinary Specialist from the Center for Food Security and Public Health. The U.S. Department of Agriculture Animal and Plant Health Inspection Service (USDA APHIS) provided funding for this factsheet through a series of cooperative agreements related to the development of resources for initial accreditation training. The following format can be used to cite this factsheet. Spickler, Anna Rovid. 2020. Monkeypox. Retrieved from http://www.cfsph.iastate.edu/DiseaseInfo/factsheets.php. References Acha PN, Szyfres B (Pan American Health Organization [PAHO]). Zoonoses and communicable diseases common to man and animals. Volume 2. Chlamydiosis, rickettsioses and viroses. 3rd ed. Washington DC: PAHO; 2003. Scientific and Technical Publication No. 580. Poxes of monkeys; p. 235-45. Armed Forces Institute of Pathology [AFIP}. Case I – 952287 (AFIP 2554549. AFIP Wednesday slide conference – No. 14. AFIP; 1997 Jan. Available at: http://www.afip.org/vetpath/WSC/WSC96/96wsc14.htm.* Accessed 30 Jun 2003. Armed Forces Institute of Pathology [AFIP]. Department of Infectious and Parasitic Diseases. Monkeypox. AFIP; 2003 Jul. Available at: http://www.afip.org/Departments/infectious/mp/index.html.* Accessed 1 July 2003. Baskin GB. Pathology of nonhuman primates [online]. Primate Info Net. Wisconsin Primate Research Center; 2002 Feb. Available at: http://www.primate.wisc.edu/pin/pola6– 99.html.* Accessed 7 Jun 2003. Baxby D. Poxviruses. In: Baron S, editor. Medical microbiology. 4th ed.New York: Churchill Livingstone;1996. Available at: http://www.gsbs.utmb.edu/microbook/ch069.htm.* Accessed 27 June 2003. Beer EM, Rao VB. A systematic review of the epidemiology of human monkeypox outbreaks and implications for outbreak strategy. PLoS Negl Trop Dis. 2019;13(10):e0007791. Bernard SM, Anderson SA. Qualitative assessment of risk for monkeypox associated with domestic trade in certain animal species, United States.Emerg Infect Dis. 2006;12(12):1827-33. Breman JG, Bernadou J, Nakano JH. Poxvirus in West African nonhuman primates: Serological survey results. Bull. World Health Org. 1977;55:605-12. Brown K, Leggat PA. Human monkeypox: Current state of knowledge and implications for the future. Trop Med Infect Dis. 2016;1. pii: E8. doi: 10.3390/tropicalmed1010008. Brown University. Monkeypox. Laboratory primate newsletter. 1997;36(3) Available at: http://www.brown.edu/Research/ Primate/lpn36–3.html#pox.* Accessed 30 Jun 2003. Centers for Disease Control and Prevention [CDC]. Considerations for selection and prioritization of animal specimens for laboratory testing [online]. CDC; 2003 Jun. Available at: http://www.cdc.gov/ncidod/monkeypox/labsubmissionguid.htm. Accessed 2 Feb 2013. Centers for Disease Control and Prevention [CDC]. Interim case definition for animal cases of monkeypox [online]. CDC; 2008 Sept. Available at: http://www.cdc.gov/ncidod/ monkeypox/animalcasedefinition.htm. * Accessed 2 Feb 2013. Centers for Disease Control and Prevention [CDC]. Interim guidance for necropsy and animal specimen collection for laboratory testing [online]. CDC; 2008 Sept. Available at: http://www.cdc.gov/ncidod/monkeypox/necropsy.htm.*. Accessed 2 Feb 2concentrate on face, arms, legs (centrifugal distribut Human Monkeypox Epidemiologic and Clinical Characteristics, Diagnosis, and Prevention Eskild Petersen, MD, DMSc, DTMHa,b,c, *, Anu Kantele, MD, PhDd , Marion Koopmans, DVM, PhDe , Danny Asogun, MBBS, FWACPf,g , Adesola Yinka-Ogunleye, BDS, MPHh , Chikwe Ihekweazu, MBBS, MPH, FFPHh , Alimuddin Zumla, FRCP, PhD, FRCPathi All authors contributed equally. A. Zumla, D. Asogun, and C. Ihekweazu are members of the PANDORA-ID-NET Consortium. PANDORA-ID-NET (EDCTP Reg/Grant RIA2016E-1609) is funded by the European and Developing Countries Clinical Trials Partnership (EDCTP2) programme, which is supported under Horizon 2020, the European Union’s Framework Programme for Research and Innovation. A. Zumla is in receipt of a National Institutes of Health Research senior investigator award. Conflicts of Interest: All authors have an interest in global public health and