How does mpox spread compared to smallpox?

Smallpox spread almost exclusively person-to-person through respiratory droplets and direct contact with skin lesions, and was highly contagious with a basic reproduction number (R0) of 5-7. Mpox is less transmissible: clade IIb (2022 outbreak) spread primarily through close physical and sexual contact, with an estimated R0 of 1.1-2.4 in the MSM community. Mpox also has a zoonotic reservoir (rodents, primates), meaning it can re-enter the human population from animals — unlike smallpox, which had no animal reservoir.