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Viruses 2017, 9(11), 320;

The Role of Brincidofovir in Preparation for a Potential Smallpox Outbreak

Chimerix, Durham, NC 27713, USA
Department of Molecular Microbiology and Immunology, Saint Louis University School of Medicine, St. Louis, MO 63104, USA
Author to whom correspondence should be addressed.
Received: 29 September 2017 / Revised: 20 October 2017 / Accepted: 26 October 2017 / Published: 30 October 2017
(This article belongs to the Special Issue Smallpox and Emerging Zoonotic Orthopoxviruses: What Is Coming Next?)
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Smallpox (variola) virus is considered a Category A bioterrorism agent due to its ability to spread rapidly and the high morbidity and mortality rates associated with infection. Current recommendations recognize the importance of oral antivirals and call for having at least two smallpox antivirals with different mechanisms of action available in the event of a smallpox outbreak. Multiple antivirals are recommended due in large part to the propensity of viruses to become resistant to antiviral therapy, especially monotherapy. Advances in synthetic biology heighten concerns that a bioterror attack with variola would utilize engineered resistance to antivirals and potentially vaccines. Brincidofovir, an oral antiviral in late stage development, has proven effective against orthopoxviruses in vitro and in vivo, has a different mechanism of action from tecovirimat (the only oral smallpox antiviral currently in the US Strategic National Stockpile), and has a resistance profile that reduces concerns in the scenario of a bioterror attack using genetically engineered smallpox. Given the devastating potential of smallpox as a bioweapon, preparation of a multi-pronged defense that accounts for the most obvious bioengineering possibilities is strategically imperative. View Full-Text
Keywords: smallpox; variola virus; bioterrorism; bioweapon; brincidofovir; CMX001; antiviral smallpox; variola virus; bioterrorism; bioweapon; brincidofovir; CMX001; antiviral

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Foster, S.A.; Parker, S.; Lanier, R. The Role of Brincidofovir in Preparation for a Potential Smallpox Outbreak. Viruses 2017, 9, 320.

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