Interesting Q, but I have no insights to offer. We have seen Monkey pox before; e.g. we had cases in 2003. A shipment of animals from Ghana imported 800 small mammals representing nine different species, including six types of rodents, to Texas. Some of the infected animals were housed near prairie dogs in an Illinois facility. Forty-seven people from Illinois, Indiana, Kansas, Missouri, Ohio, and Wisconsin became ill with monkeypox after having contact with infected pet prairie dogs.

Since 2016, confirmed cases of monkeypox have increased in countries where the virus is considered "endemic," including Central African Republic, Democratic Republic of the Congo, Liberia, Nigeria, Republic of the Congo, and Sierra Leone. There was an outbreak of over 80 cases in Nigeria in 2017.

I look forward to hearing how Monkeypox re-entered the USA, but the disease is certainly not new. Let's hope it remains remarkably limited.