N Engl. J Med. 379, 44–53 (2018)

The antiviral tecovirimat is a promising candidate for therapy in the case of a smallpox outbreak.

Credit: Elena Ryabchikova/Voisin/Science Source

Smallpox has been eradicated, but the variola virus still exists, and there are fears of an outbreak due to bioterrorism or warfare. Just one infection would be a worldwide public health emergency.

Because of its infectious and pathogenic nature, it is unethical to expose humans deliberately to variola. Scientists from SIGA Technologies established the efficacy of the antismallpox therapy tecovirimat in two animal models of smallpox infection. They determined its safety in uninfected individuals.

Tecovirimat was approved as a smallpox therapy by the Food and Drug Administration on July 13, 2018.