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Human Monkeypox Virus Infection Part 1: What You Need to Know — Epidemiology

  • Authors: Susan L. Smith, MN, PhD
  • CME / ABIM MOC / CE Released: 8/25/2022
  • Valid for credit through: 8/25/2023
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  • Credits Available

    Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s)™

    ABIM Diplomates - maximum of 0.25 ABIM MOC points

    Nurses - 0.25 ANCC Contact Hour(s) (0 contact hours are in the area of pharmacology)

    Pharmacists - 0.25 Knowledge-based ACPE (0.025 CEUs)

    Physician Assistant - 0.25 AAPA hour(s) of Category I credit

    IPCE - 0.25 Interprofessional Continuing Education (IPCE) credit

    You Are Eligible For

    • Letter of Completion
    • ABIM MOC points

Target Audience and Goal Statement

This activity is intended for clinicians who work in primary care and public health settings.

The goal of this activity is that learners will be better able to differentiate animal-to-human monkeypox virus infection from the current outbreaks of human-to-human monkeypox virus infection.

Upon completion of this activity, participants will:

  • Have increased knowledge regarding the
    • Ways in which human-to-human monkeypox virus is transmitted
    • People at greatest risk of acquiring and transmitting human monkeypox virus
    • Implications to the healthcare team


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All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships.


  • Susan L. Smith, MN, PhD


    Owns stock (publicly traded) in: Hepion

Editor/Compliance Reviewer

  • Esther Nyarko, PharmD

    Director, Accreditation and Compliance, Medscape, LLC


    Esther Nyarko, PharmD, has no relevant financial relationships.

Compliance Reviewer/Nurse Planner

  • Amy Bernard, MS, BSN, RN, NPD-BC, CHCP

    Senior Director, Accreditation and Compliance, Medscape, LLC


    Amy Bernard, MS, BSN, RN, NPD-BC, CHCP, has no relevant financial relationships

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In support of improving patient care, Medscape, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

This activity was planned by and for the healthcare team, and learners will receive 0.25 Interprofessional Continuing Education (IPCE) credit for learning and change.

    For Physicians

  • Medscape, LLC designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.25 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

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    For Nurses

  • Awarded 0.25 contact hour(s) of nursing continuing professional development for RNs and APNs; 0.00 contact hours are in the area of pharmacology.

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    For Pharmacists

  • Medscape designates this continuing education activity for 0.25 contact hour(s) ( 0.025 CEUs) (Universal Activity Number: JA0007105-0000-22-301-H01-P).

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  • For Physician Assistants

    Medscape, LLC has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 0.25 AAPA Category 1 CME credits. Approval is valid until 8/25/2023. PAs should only claim credit commensurate with the extent of their participation.

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

Follow these steps to earn CME/CE credit*:

  1. Read about the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or print it out.
  3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate, but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period, you can print out the tally as well as the certificates from the CME/CE Tracker.

*The credit that you receive is based on your user profile.


Human Monkeypox Virus Infection Part 1: What You Need to Know — Epidemiology

Authors: Susan L. Smith, MN, PhDFaculty and Disclosures

CME / ABIM MOC / CE Released: 8/25/2022

Valid for credit through: 8/25/2023



  1. Thornhill JP, Barkati S, Walmsley J, et al. for the SHARE-net Clinical Group. Monkeypox virus infection in humans across 16 countries — April—June 2022. N Engl J Med. Published online July 21, 2022.
  2. Centers for Disease Control and Prevention. 2022 U.S. Monkeypox Outbreak. Updated July 28, 2022.
  3. Centers for Disease Control and Prevention. Monkeypox. 2022 U.S. Map & Case Count. Updated August 5, 2022.
  4. Biden-Harris administration bolsters monkeypox response; HHS Secretary Becerra declares public health emergency. August 4, 2022.
  5. World Health Organization. WHO Director-General declares the ongoing monkeypox outbreak a Public Health Emergency of International Concern. July 23, 2022.
  6. Philpott D, Hughes CM, Alroy KA, et al. Epidemiologic and clinical characteristics of monkeypox cases — United States, May 17-July 22, 2022. MMWR Morb Mortal Wkly Rep. 2022;71(32):1018-1022.
  7. Centers for Disease Control and Prevention. Information for healthcare professionals: 2022 U.S. monkeypox outbreak. Updated June 23, 2022.
  8. Centers for Disease Control and Prevention. Technical report: multi-national monkeypox outbreak, United States, 2022. Updated July 28, 2022.
  9. Alakuhnle E, Moens U, Nchinda G, Okeke MI. Monkeypox virus in Nigeria: infection biology, epidemiology, and evolution. Viruses. 2020;12(11):1257.
  10. RCSB PDB. Poxviruses.
  11. von Magnus P, Andersen EA, Petersen KB, Birch-Andersen A. A pox-like disease in cynomolgus monkeys. Acta Path Microbiol Scand. 1959;46(2):159-176.
  12. Simpson K, Heymann D, Brown CS, et al. Human monkeypox – After 40 years, an unintended consequence of smallpox eradication. Vaccine. 2020;38(33):5077-5081.
  13. Adalja A, Inglesby T. A novel international monkeypox outbreak. Ann Intern Med. 2022;175(8):1175-1176.
  14. Adler H, Gould S, Adler H, Gould S, Hine P, et al. Clinical features and management of human monkeypox: a retrospective observational study in the UK Lancet Infect Dis. 2022;22(8):1153-1162.
  15. Vaughan A, Aarons E, Astbury J, et al. Two cases of monkeypox imported to the United Kingdom, September 2018. Eurosurveillance. 2018;23:1800509.
  16. Yinka-Ogunleye A, Aruna O, et al. Reemergence of human monkeypox in Nigeria, 2017. Emerg Infect Dis. 2018;24(6):1149-1151. 
  17. Nolen LD, Osadebe L, Katomba J, et al. Extended human-to-human transmission during a monkeypox outbreak in the Democratic Republic of the Congo. Emerg Infect Dis. 2016;22(6):1014-1021.
  18. Centers for Disease Control and Prevention. Monkeypox. How it spreads. Updated July 29, 2022.
  19. Mbala PK, Huggins JW, Riu-Rovira T, et al. Maternal and fetal outcomes among pregnant women with human monkeypox infection in the Democratic Republic of Congo. J Infect Dis. 2017;216(7):824-828.
  20. Seang S, Burrel S, Todesco E, et al. Evidence of human-to-dog transmission of monkeypox virus. Lancet. Published online August 10, 2022.
  21. Likos AM, Sammons SA, Olson VA, et al. A tale of two clades: monkeypox viruses. J Gen Virol. 2005;86(Pt 10):2661-2672.
  22. Bunge EM, Hoet B, Chen L, et al. The changing epidemiology of human monkeypox—A potential threat? A systematic review. PLoS Negl Trop Dis. 2022;16(2):e0010141.
  23. Centers for Disease Control and Prevention. Past US Cases and Outbreaks. Updated June 6, 2022.
  24. Erez N, Achdout H, Milrot E, et al. Diagnosis of Imported Monkeypox, Israel, 2018. Emerg Infect Dis. 2019;25(5):980-983.
  25. Yong SEF, Ng OT, Ho ZJM, et al. Imported Monkeypox, Singapore. Emerg Infect Dis. 2020;26(8):1826-1830.
  26. Isidro J, Borges V, Pinto M, et al. Phylogenomic characterization and signs of microevolution in the 2022 multi-country outbreak of monkeypox virus. Nat Med. Published online June 24, 2022.
  27. O'Shea J, Filardo TD, Morris SB, et al. Interim guidance for prevention and treatment of monkeypox in persons with HIV infection — United States, August 2022. MMWR Morb Mortal Wkly Rep. 2022;71(32):1023-1028.
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