When the World Health Organization declared small-pox eradicated in 1979, smallpox vaccination was discontinued worldwide. Although cessation of smallpox vaccination is well justifi ed, given the risks associated with complications from the vaccine, lack of vaccination never-theless creates a growing population of persons now sus-ceptible to infection by a few poxviruses previously covered by the smallpox vaccine. These include the orthopoxvirus-es monkeypox; cowpox; and, ironically, vaccinia, the virus used for smallpox vaccination. Although few persons die from these infections, they are nevertheless a public health nuisance and expense. Thus, understanding the epidemiol-ogy of these viruses is in the interest of public health
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