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Smallpox used to kill millions of people every year. Here’s how humans beat it.

More contagious than Covid-19 and with a 30 percent mortality rate, smallpox was one of history’s biggest killers. Now it’s gone.

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Massachusetts health authorities said Wednesday that they confirmed a case of a rare and sometimes serious viral illness called monkeypox — the first infection identified in the United States this year amid a rash of cases outside the disease's typical territory.

Monkeypox, which can be passed to animals and humans, is usually found in Central and West Africa. But health authorities in Europe have confirmed more than a dozen cases this month and are investigating more. The two latest infections confirmed in the United Kingdom "have no travel links" to a place where monkeypox is regularly found, officials said, suggesting the virus may be spreading through the community.

Scientists are trying to answer questions about the outbreak of a disease not known to spread easily between humans. The fact that cases are emerging in several countries - with signs of "sustained" spread in people — is striking, said Aris Katzourakis, a professor of evolution and genomics at the University of Oxford.

"So it's either a lot of bad luck or something quite unusual happening here," Katzourakis said.