Zoonotic orthopoxviruses after smallpox eradication: A shift from crisis response to a One Health approach

A systematic literature review was performed to assess the research trend on zoonotic orthopoxviruses (ZOPXV) as disease agents and as vectors for biomedical during 2000–2023. It has been evidenced that despite the limited number of research groups that have worked on ZOPXV diseases, they largely contributed not to turn off the spotlight. Given the small size of the ZOPXV research network, the epidemiological data remain restricted to a limited number of geographical contexts. Some inconsistencies between the geographic provenance of authors and the study area particularly in Africa were identified. MPX represents an exception, as the scientific interest has grown over the last 20 years, starting with the first outbreak outside endemic areas in 2003 and culminating during and after the 2022 pandemic, that boosted the number of publications from different countries over the last 2 years. Since the beginning of the millennium, authors have warned about the effects of waning immunity, after cessation of smallpox vaccination, and identified many social and ecological factors boosting the emergence and spread of the diseases. ZOPXV diseases remain neglected by the global health agenda, leading to the adoption of reactive measures in the event of an emergency.