Mpox, formerly known as monkeypox, is a double-stranded DNA virus closely related to smallpox that has gained global attention in recent years. In this episode, Florian Krammer explains the biology of the virus, its complex life cycle, and its ability to spread both through zoonotic transmission from animal reservoirs such as rodents and through human-to-human contact, including close physical and sexual contact. The discussion covers typical symptoms like fever and rash, differences between viral clades with varying severity, and the global outbreak that began in 2022, which spread to more than 100 countries. The episode also looks at the ongoing outbreak in Central Africa, the role of declining smallpox immunity in the population, and available countermeasures, including vaccines based on vaccinia virus and antiviral treatments, highlighting both the risks and the tools available to control future outbreaks.

Study showing the transmission of monkeypox virus from fire-footed rope squirrels to sooty mangabeys: https://www.nature.com/articles/s41586-025-10086-y

WHO information about mpox : https://www.who.int/health-topics/mpox#tab=tab_1

Pictures showing mpox rash: https://en.wikipedia.org/wiki/Mpox#/media/File:Monkeypox.jpg and https://en.wikipedia.org/wiki/Mpox#/media/File:22-1374-F1.jpg

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Krammer laboratory information

Krammer Laboratory at the Icahn School of Medicine at Mount Sinai

Ludwig Boltzmann Institute for Science Outreach and Pandemic Preparedness

Ignaz Semmelweis Institute

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Conflict of interest statement

The Icahn School of Medicine at Mount Sinai has filed patent applications relating to influenza virus vaccines and therapeutics, SARS-CoV-2 serological assays and NDV-based SARS-CoV-2 vaccines which name me as inventor. Mount Sinai has spun out a company, CastleVax, to commercialize NDV-based SARS-CoV-2 vaccines and I am named as co-founder and scientific advisory board member of that company.

I have previously consulted for Curevac, Merck, Gritstone, Sanofi, Seqirus, GSK and Pfizer and I am currently consulting for 3rd Rock Ventures (US) and Avimex (Mexico).

My laboratory has been collaborating in the past with Pfizer on animal models of SARS-CoV-2 and with GlaxoSmithKline and VIR on the development of influenza virus vaccines and therapeutics and we are currently collaborating with Dynavax, Inspirevax and Inimmune on development of influenza virus vaccines.

My work in the on immunity and infectious diseases in the US is supported by the National Institutes of Health, but also by FluLab and Tito’s Handmade Vodka. In the past I have also received funding from the Bill and Melinda Gates Foundation, PATH and the US Department of Defense.

My work in Austria is supported by the Ludwig Boltzmann Gesellschaft and by the Ignaz Semmelweis Institute through the Medical University of Vienna.