Addressing poxvirus challenges in the Middle East to enhance biosafety and biosecurity measures

The emergence and zoonotic transmission of poxviruses in the Middle East have been recognized as complex public health issues. Poxviruses, a vast family of DNA viruses, can infect many hosts, including animals and humans. The Middle East has had multiple epidemics of poxvirus infections (e.g., Monkeypox, Smallpox, and Camelpox) that have raised concerns owing to their detrimental effects on livestock, wildlife, and sporadic human cases. This review aims to thoroughly examine the complexity of the epidemiological patterns, intricate genetic diversity, and several contributing factors that support the emergence and zoonotic transmission of poxviruses in the Middle East. Several aspects of poxviruses contribute to the emergence of endemics and zoonotic breakouts, such as the complex nature of human-animal interactions, environmental changes, and their subtle capacity for viral adaptability. This review was compiled in the hopes of contributing to the current understanding of poxvirus biology and its implications for human and animal health in the Middle East. We provide a comprehensive overview of the most common poxviruses in the Middle East, including their classification, structure, replication cycle, pathogenesis, route of transmissions, and of how the Middle East has developed ways to mitigate these biological threats.