Smallpox Antiviral May Help Ease Monkeypox Symptoms, Study Says
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An antiviral normally used to treat smallpox may reduce the duration of monkeypox illness, according to a study published Tuesday by the Lancet Infectious Diseases, possibly opening a new avenue to limit the ongoing international monkeypox outbreak.

Key Facts

The study analyzed all seven patients diagnosed with monkeypox in the U.K. between August 2018 and September 2021, and was conducted by researchers from Liverpool University Hospitals NHS Foundation Trust, Liverpool School of Tropical Medicine and other institutions.

The only patient who took the smallpox antiviral tecovirimat spent only 10 days in the hospital with monkeypox, about 15 days less than average for the series of patients as a whole, the study found.

However, the study’s authors said they could not draw hard-and-fast conclusions because of their small sample size, and recommended further research into tecovirimat and other possible smallpox treatments.

The U.S. keeps 1.7 million doses of tecovirimat in its Strategic National Stockpile, pharmaceutical manufacturer SIGA Technologies announced in 2021, which could be a major asset for monkeypox response if the drug’s effectiveness is confirmed by additional research.

Three patients included in the study took brincidofovir, a smallpox antiviral that—like tecovirimat—has proven effective against monkeypox in animals, but brincidofovir did not show any effectiveness against monkeypox among those patients, and was consistently associated with impaired liver function, researchers said.

Key Background

The monkeypox outbreak first identified earlier this month has grown to include at least 131 cases in 19 countries where the virus is not endemic—including at least one confirmed case and four presumed cases in the United States. Monkeypox is closely related to smallpox, and treatments for smallpox are sometimes effective against both. On Monday, Centers for Disease Control and Prevention officials announced the Strategic National Stockpile will release doses of Jynneos, a vaccine that the U.S. accumulated in preparation for a possible smallpox outbreak but is also effective against monkeypox. Monkeypox can be transmitted through broken skin or through the mucus membranes, and causes symptoms like fever and exhaustion, followed by a rash that can develop into pustules and scabs.


Though monkeypox can be fatal, it is usually mild. The current outbreak poses only a minor risk to the public, Dr. Raj Panjabi—senior director for global health security and biodefense at the National Security Council—told NPR’s Morning Edition Monday. Typically, even countries with less robust healthcare infrastructure manage to keep deaths under 1% among patients infected with the relatively mild monkeypox strain involved in the current outbreak. All seven monkeypox patients involved in the Lancet Infectious Diseases study made a full recovery.

Further Reading

“Monkeypox Outbreak ‘Not Normal’ But ‘Containable’ As Confirmed Cases Grow, WHO Says” (Forbes)

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