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Can Smallpox and Monkeypox (Mpox) be prevented and are there treatment options?

Updated November 03, 2023

In May 1980, smallpox was declared eradicated by the World Health Organization (WHO), however, public health officials remain concerned that the virus could be used for biological warfare. 

The FDA has approved an antiviral medication, tecovirimat (TPOXX), for the treatment of smallpox  and monkeypox.  This drug was approved in July 2018; however, it is not known whether it is effective against smallpox. It was approved because the drug appeared to stop the virus in a laboratory setting and was effective in animals with diseases similar to smallpox. Tecovirimat was also approved for use under an investigational new drug (IND) protocol for the treatment of smallpox vaccine reactions.

Two additional antivirals, cidofovir and brincidofovir, are not FDA-approved for the treatment of smallpox; however, in the event of an outbreak, they could be given under an IND protocol or Emergency Use Authorization (EUA). They might also be permitted for use to treat smallpox vaccine reactions.  Cidofovir is also authorized for the treatment of mpox during an outbreak. 

While tecovirimat, cidofovir, and brincidofovir are currently stockpiled in the National Strategic Stockpile, they have never been used to treat a person with smallpox and their effectiveness is not yet known. 

The oral form of tecovirimat has been approved for use in Europe for the treatment of smallpox, cowpox, and monkeypox. 

IMPORTANT NOTE: NVIC encourages you to become fully informed about smallpox/monkeypox (Mpox) and the smallpox/monkeypox (Mpox) vaccine by reading all sections in the Table of Contents, which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself. This information is for educational purposes only and is not intended as medical advice.

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