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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="review-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Annals of the Russian academy of medical sciences</journal-id><journal-title-group><journal-title xml:lang="en">Annals of the Russian academy of medical sciences</journal-title><trans-title-group xml:lang="ru"><trans-title>Вестник Российской академии медицинских наук</trans-title></trans-title-group></journal-title-group><issn publication-format="print">0869-6047</issn><issn publication-format="electronic">2414-3545</issn><publisher><publisher-name xml:lang="en">"Paediatrician" Publishers LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">17996</article-id><article-id pub-id-type="doi">10.15690/vramn17996</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>EPIDEMIOLOGY: CURRENT ISSUES</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>АКТУАЛЬНЫЕ ВОПРОСЫ ЭПИДЕМИОЛОГИИ</subject></subj-group><subj-group subj-group-type="article-type"><subject>Review Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">The epidemiological aspects and the main directions of the development of protective drugs in relation to mpox</article-title><trans-title-group xml:lang="ru"><trans-title>Эпидемиологические аспекты распространения mpox на неэндемичных территориях</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0135-7258</contrib-id><name-alternatives><name xml:lang="en"><surname>Onishchenko</surname><given-names>Gennadiy G.</given-names></name><name xml:lang="ru"><surname>Онищенко</surname><given-names>Геннадий Григорьевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD, Professor, Academician of RAS</p></bio><bio xml:lang="ru"><p>д.м.н, профессор, академик РАН</p></bio><email>48cnii@mil.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1817-0126</contrib-id><contrib-id contrib-id-type="spin">7768-3290</contrib-id><name-alternatives><name xml:lang="en"><surname>Sizikova</surname><given-names>Tatiana E.</given-names></name><name xml:lang="ru"><surname>Сизикова</surname><given-names>Татьяна Евгеньевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>PhD in Biology, Senior Research Associate</p></bio><bio xml:lang="ru"><p>к.б.н., с.н.с.</p></bio><email>48cnii@mil.ru</email><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6552-4599</contrib-id><name-alternatives><name xml:lang="en"><surname>Lebedev</surname><given-names>Vitaly N.</given-names></name><name xml:lang="ru"><surname>Лебедев</surname><given-names>Виталий Николаевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>PhD in Biology, Professor, Leading Research Associate</p></bio><bio xml:lang="ru"><p>д.б.н., профессор, в.н.с.</p></bio><email>48cnii@mil.ru</email><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6742-3919</contrib-id><contrib-id contrib-id-type="spin">5753-3400</contrib-id><name-alternatives><name xml:lang="en"><surname>Borisevich</surname><given-names>Sergey V.</given-names></name><name xml:lang="ru"><surname>Борисевич</surname><given-names>Сергей Владимирович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>PhD in Biology, Professor, Academician of the RAS</p></bio><bio xml:lang="ru"><p>д.б.н., профессор, академик РАН</p></bio><email>48cnii@mil.ru</email><xref ref-type="aff" rid="aff2"/><xref ref-type="aff" rid="aff3"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">I.M. Sechenov First Moscow State Medical University (Sechenov University)</institution></aff><aff><institution xml:lang="ru">Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Russian Academy of Sciences</institution></aff><aff><institution xml:lang="ru">Российская академия наук</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">48 Central Scientific Research Institute</institution></aff><aff><institution xml:lang="ru">48 Центральный научно-исследовательский институт</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2025-02-17" publication-format="electronic"><day>17</day><month>02</month><year>2025</year></pub-date><volume>80</volume><issue>1</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>65</fpage><lpage>70</lpage><history><date date-type="received" iso-8601-date="2024-06-23"><day>23</day><month>06</month><year>2024</year></date><date date-type="accepted" iso-8601-date="2025-02-08"><day>08</day><month>02</month><year>2025</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2025, "Paediatrician" Publishers LLC</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2025, Издательство "Педиатръ"</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="en">"Paediatrician" Publishers LLC</copyright-holder><copyright-holder xml:lang="ru">Издательство "Педиатръ"</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/" start_date="2025-11-17"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://vestnikramn.spr-journal.ru/jour/about/submissions</ali:license_ref></license></permissions><self-uri xlink:href="https://vestnikramn.spr-journal.ru/jour/article/view/17996">https://vestnikramn.spr-journal.ru/jour/article/view/17996</self-uri><abstract xml:lang="en"><p>The termination of vaccination after the elimination of smallpox currently, it has led to the fact that a significant part of the population has become highly susceptible to orthopoxvirus infection, including those with a zoonotic reservoir. Of these infections, the greatest danger to public health is monkey pox. The purpose of this review is to evaluate of potential danger of monkey pox proliferation in non-endemic territories in conditions of a decrease in the level of anti-inflammatory herd immunity the largest outbreak of monkey pox in the entire history of observations started in May 2022, spread to all inhabited continents is considered. Possible causes of the outbreak (a new path of pathogen transmission, the appearance of the monkey pox virus in the course of natural evolution of the variant, characterized by new properties, a decrease in the level of anti-inflammatory herd immunity) are analyzed.</p></abstract><trans-abstract xml:lang="ru"><p>Прекращение вакцинации после ликвидации натуральной оспы привело к тому, что значительная часть населения мира стала восприимчивой к патогенным для человека ортопоксвирусам, среди которых наибольшую опасность для здравоохранения представляет оспа обезьян (с 28 ноября 2022 г. оспа обезьян называется mpox). Целью настоящего обзора является анализ эпидемиологических особенностей распространения mpox на неэндемичных территориях. Рассмотрена начавшаяся в мае 2022 г. крупнейшая за всю историю наблюдений эпидемия оспы обезьян, распространившаяся на все обитаемые континенты. Проанализированы возможные причины возникновения вспышки, новый путь трансмиссии возбудителя, характеризующегося новыми свойствами. В настоящее время наиболее вероятная возможность возникновения вспышек mpox — распространение заболевания среди лиц нетрадиционной сексуальной ориентации, при этом индексный случай заболевания происходит вследствие контактов с людьми, посетившими эндемичные по mpox регионы.</p></trans-abstract><kwd-group xml:lang="en"><kwd>monkey pox</kwd><kwd>orthopoxviruses</kwd><kwd>non-traditional sexual orientation</kwd><kwd>phylogenetic tree</kwd><kwd>epidemic potential</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>оспа обезьян</kwd><kwd>ортопоксвирусы</kwd><kwd>нетрадиционная сексуальная ориентация</kwd><kwd>филогенетическое древо</kwd><kwd>эпидемический потенциал</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Chakraborty C, Bhattacharya M, Ranjan Sharma A, et al. 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