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Pox

Pox is a medical and historical term that emerged in the late 15th century to denote infectious diseases marked by eruptive sores or pustules on the skin, encompassing conditions such as syphilis (known as the "great pox" or la grosse verole in French), smallpox (the "small pox" or la petite verole), and later distinctions like chickenpox. The term "pox" initially arose amid European outbreaks, where syphilis was differentiated from smallpox due to the scale and severity of its skin manifestations, with the former causing more widespread and destructive lesions. Chickenpox, caused by the varicella-zoster virus, was long conflated with smallpox until English physician William Heberden provided a precise clinical description in 1767, highlighting its milder course and distinct rash progression from papules to vesicles rather than deep pustules. In contrast, true pox diseases like smallpox, cowpox, and monkeypox are caused by viruses in the family Poxviridae, large double-stranded DNA viruses that replicate in the host cell's cytoplasm and produce characteristic brick-shaped particles observable under electron microscopy. Historically, pox diseases have profoundly shaped human health and medicine; smallpox alone killed hundreds of millions over centuries until its global eradication, certified by an independent commission in December 1979 and officially declared by the (WHO) in 1980 following a intensive vaccination campaign launched in 1967. played a pivotal role in this triumph, as utilized its milder symptoms in 1796 to develop the first against , coining the term variolae vaccinae () and laying the foundation for modern . , while bacterial and treatable today with antibiotics like penicillin, persisted as a major public health threat into the , often stigmatized under its "great pox" moniker. In contemporary contexts, pox-related concerns center on (formerly monkeypox), a zoonotic caused by a member endemic to Central and . A global outbreak of mpox IIb began in May 2022, resulting in over 99,000 cases across more than 100 countries/territories by mid-2023, with fewer than 200 deaths and primarily affecting men who have sex with men. Separately, an outbreak of the more severe I (particularly Ib sublineage) in , predominantly the (DRC), has reported over 29,000 cases and more than 800 deaths as of September 2024. As of November 2025, the WHO continues to monitor I mpox surges in , with over 40,000 suspected cases reported in the DRC in 2025 alone and sporadic travel-associated cases in non-endemic countries like the , emphasizing with modified vaccinia Ankara (MVA) and ring strategies to curb transmission, which occurs primarily through close contact, respiratory droplets, or contaminated materials. These developments underscore the enduring legacy of pox nomenclature in and , linking ancient scourges to ongoing efforts in and prevention.

Infections

Poxvirus infections

Poxviridae is a family of large, double-stranded DNA viruses belonging to the nucleocytoplasmic large DNA viruses group, characterized by their brick-shaped or ovoid virions measuring 220–450 nm in length and 140–260 nm in width, with a lipoprotein surface membrane. Unlike most DNA viruses, poxviruses replicate entirely within the host cell's cytoplasm, forming viral factories that enable independent transcription and assembly without relying on nuclear machinery. The family comprises two subfamilies: Chordopoxvirinae, which infects vertebrates and includes genera such as Orthopoxvirus (e.g., variola and monkeypox viruses), Avipoxvirus, Leporipoxvirus, and Capripoxvirus; and Entomopoxvirinae, which primarily affects insects. Among human pathogens in the family, , caused by the variola virus (an ), was a highly transmitted primarily through respiratory droplets or contact with contaminated materials, leading to symptoms such as high fever, severe fatigue, back pain, and a characteristic progressing from macules to pustules and scabs over 2–4 weeks. The disease had a case-fatality rate of up to 30% in unvaccinated individuals, with survivors often bearing permanent scars or blindness. vaccination originated in 1796 when demonstrated that inoculation with virus material protected against variola, laying the foundation for global efforts. The World Health Organization's intensified eradication campaign, launched in 1967, employed targeted vaccination and surveillance, culminating in smallpox's declaration as eradicated worldwide in 1980, with the last natural case occurring in 1977. Mpox, caused by the (another ), presents with symptoms resembling a milder form of , including fever, headache, muscle aches, , and a rash that evolves from flat lesions to pustules over 2–4 weeks, with transmission occurring through direct contact with infected animals or humans, bodily fluids, or contaminated surfaces. A global outbreak beginning in 2022 (clade IIb) has resulted in more than 114,000 cases across 122 countries as of July 2025, primarily through close human contact, prompting the to rename the disease "mpox" in 2022 to reduce while retaining "monkeypox" for established contexts. The case-fatality rate for mpox is generally low at 1–3%, though higher in vulnerable populations such as children and immunocompromised individuals. Other human poxvirus infections include , caused by (Molluscipoxvirus), a common, self-limited presenting as small, pearly papules with central umbilication, transmitted through skin-to-skin contact, affecting children and adults, particularly in immunocompromised individuals. Parapoxviruses cause zoonotic infections like orf (contagious ) and bovine papular (milker's nodules), resulting in localized pustular or nodular lesions on the hands from contact with infected sheep, goats, or cattle, typically resolving without treatment in 4–6 weeks. Tanapox, caused by tanapox virus (Yatapoxvirus), is a mild, self-limiting febrile illness with a single skin nodule, endemic to and transmitted by arthropods or direct contact with infected . Zoonotic poxvirus infections highlight the family's broad host range, with cowpox virus (Orthopoxvirus) serving as the original source for Jenner's smallpox vaccine due to its cross-protective mild lesions in humans, typically acquired from rodents or cats via contact or bites. Buffalopox virus, closely related to vaccinia virus, causes outbreaks in livestock in India and sporadically infects humans through milking or close contact, resulting in localized pustular lesions. Camelpox virus similarly affects camels in the Middle East and Africa, with rare human zoonotic cases presenting as mild skin infections from handling infected animals. Animal-specific poxvirus diseases include , caused by fowlpox virus (), which manifests in birds as cutaneous lesions on unfeathered or diphtheritic membranes in the , transmitted mechanically by mosquitoes or direct contact, leading to reduced egg production and mortality in young . Swinepox, induced by swinepox virus (Suipoxvirus), produces mild, self-limiting skin eruptions in pigs, particularly affecting piglets under poor management conditions, and spreads through direct contact or fomites without significant systemic involvement. Myxomatosis, resulting from (), is lethal in European rabbits, causing tumor-like swellings around the eyes and genitals, fever, and respiratory distress, with transmission via vectors like fleas and mosquitoes; it is benign in native South American rabbits. Prevention of poxvirus infections relies on , exemplified by the JYNNEOS vaccine, a live-attenuated (derived from virus) approved for and protection in at-risk adults, administered in two doses to induce immunity without replication in humans. For context, is often confused with true poxvirus diseases but is caused by the unrelated varicella-zoster virus, a herpesvirus.

Other pox-like conditions

Several diseases not caused by poxviruses have been historically termed "pox" due to their pustular or vesicular rashes resembling those of , leading to early diagnostic confusion in medicine. In Renaissance Europe, physicians often misattributed eruptive skin conditions based on superficial similarities, as diagnostic tools were limited and the term "pox" broadly denoted any rash-forming illness; for instance, outbreaks of were initially lumped with viral poxes until differentiated through clinical observation. This etymological overlap persisted into early modern medicine, where symptomatic parallels overshadowed etiological distinctions. Syphilis, caused by the bacterium , emerged in around the late and was dubbed the "Great Pox" to distinguish its larger, more destructive lesions from the "Small Pox" of variola virus infection. In 1530, Italian physician and poet formalized the name in his seminal work Syphilis sive morbus Gallicus, a didactic poem that described the disease's progression and blamed its origin on a named Syphilus, while also noting its and societal . The disease advances through stages: primary syphilis features a painless at the infection site; secondary syphilis involves a , fever, and ; and untreated cases may progress to tertiary syphilis, including with neurological damage. Penicillin, introduced in the , revolutionized by effectively eradicating the spirochete in early stages, rendering prior mercury- and arsenic-based therapies obsolete. Chickenpox, or varicella, results from infection with the varicella-zoster virus in the herpesvirus family, not , but earned its "pox" moniker in the due to its blistering rash mimicking milder forms of . Highly contagious via respiratory droplets or vesicle fluid, it primarily affects children, manifesting as fever, malaise, and crops of itchy vesicles that crust over 4–7 days. A key long-term complication is reactivation as herpes zoster () decades later, especially in immunocompromised individuals or the elderly. The live , licensed in the United States in 1995, has dramatically reduced incidence by over 90% in vaccinated populations. Rickettsialpox, caused by the bacterium akari, was first identified during urban outbreaks in in the 1940s and named for its vesicular resembling . Transmitted to humans via bites from mites (Liponyssoides sanguineus) infesting house mice, it presents mildly with fever, , an initial at the bite site, and a sparse, non-pruritic that spares the palms and soles. Unlike true poxviruses, it is self-limited, resolving in 1–2 weeks without sequelae, though shortens symptoms; the 1946–1950 epidemics affected over 500 cases in , highlighting its zoonotic urban risk.

Arts, entertainment, and media

Games

Several games across various formats have incorporated "Pox" in their titles or central themes, often drawing on concepts of , , or corruption within sci-fi or contexts. These titles span handheld , board games, and digital collectible card games, emphasizing mechanics like creature customization, disease control, and tactical battles. The 2001 handheld electronic game POX: The Game of Creation, developed and published by , allows players to create and evolve customizable alien creatures known as POX Infectors using an LCD screen and simple controls. Gameplay involves battling these creatures in single-player arena modes or multiplayer encounters via communication, where stronger POX units defeat opponents and replicate themselves across devices, simulating spread in a sci-fi setting. The game was marketed as a portable virtual pet-style battler, with different starter units like Plasmo, Spino, and Cycro offering unique attributes for strategic depth. Pox: Save the People, a cooperative board game released in 2011 by Tiltfactor (designed by Mary Flanagan, Zara Downs, and Max Seidman), challenges 1-4 players to contain a fictional deadly disease outbreak in a community through vaccination, treatment, and resource management using cards and tokens. Players collaborate to achieve herd immunity by strategically placing cures and vaccines on a modular board representing neighborhoods, while dice rolls introduce uncertainty in disease progression; the game also serves an educational purpose, promoting understanding of public health concepts like epidemiology. An iOS adaptation followed, expanding accessibility for digital play. Poxnora, launched in 2006 by Octopi Media as an online , blends with fantasy , where players build decks of "runes" (cards representing champions, spells, and relics) to command armies on a grid-based battlefield. Core mechanics include capturing font nodes for resources, deploying units with abilities influenced by the game's lore-heavy world of Poxnora—a plague-ravaged —though direct "" effects are integrated via certain rune abilities that debuff or alter enemy stats. Originally a browser-based title using , it evolved into a model with optional rune purchases for deck expansion, undergoing publisher transitions to Online Entertainment in 2010 and later Games, which revitalized its community through updates and integration; reception highlights its depth as a hybrid of CCGs and miniatures games, appealing to niche enthusiasts despite a steep .

Literature, film, and other works

In literature, the term "pox" frequently evokes the historical and cultural dimensions of , often termed the "Great Pox" to distinguish it from . Deborah Hayden's 2003 book Pox: Genius, Madness, and the Mysteries of explores the disease's profound influence on prominent historical figures, including , , and , while tracing its broader cultural history from the onward as a symbol of affliction and enigma. The work draws on medical records, biographies, and artistic representations to argue that contributed to episodes of and , reshaping perceptions of in . Metaphorical uses of "pox" appear prominently in canonical works, serving as curses or emblems of and corruption. In William Shakespeare's Romeo and Juliet (1597), the character invokes "A pox on both your houses!" during a fatal brawl, using the term interchangeably with "" to curse the feuding and Capulet families, reflecting Elizabethan anxieties over venereal diseases and societal discord. This phrase, rooted in the era's conflation of poxes with divine or contagious punishment, recurs in Victorian novels as a for ethical decline and . For instance, in George Gissing's New Grub Street (1891), symbolizes the erosion of masculine integrity amid economic pressures and literary commodification, linking personal vice to broader cultural decay. Similarly, employs pox-like afflictions in Bleak House (1853) to illustrate and institutional rot, where diseases mirror the contaminating effects of poverty and injustice on the . Eighteenth-century satire further weaponized "pox" through venereal humor, portraying it as a satirical on , , and sexuality. Noelle Gallagher's 2019 book Itch, Clap, Pox: Venereal Disease in the Eighteenth-Century Imagination analyzes how writers like and used pox metaphors in and to mock pretensions, associating with and while navigating the disease's status. These depictions often blended fear with comedy, elevating venereal woes to allegories of societal ills. Visual art from the era incorporated pox allusions to convey and , particularly in depictions of diseased or grotesque figures. Hieronymus Bosch's paintings, such as (c. 1490–1500), feature tormented bodies with lesions and deformities suggestive of syphilitic ravages, symbolizing lust's hellish consequences amid the disease's spread across post-Columbus. These motifs extended to satirical prints and panels, where pox-marked sinners embodied moral warnings, influencing later artists like in evoking communal vice. In film, "pox" has inspired niche explorations of absurdity and alienation. The 2011 short film Pox, directed by , presents a surreal comedy fusing Charles Manson family lore with spy thriller elements, centering on a protagonist named Pox who navigates betrayal and spa escapism under the guidance of an invisible alien manager. This 20-minute work, expanded from a cable-access series, uses pox as a titular motif for personal and cosmic affliction, blending with anti-establishment satire.

Other uses

Pox (beverage)

Pox is a traditional spirit originating from the region, where it holds deep cultural significance among the indigenous people. The name "pox," pronounced "posh," derives from the Tzotzil language, meaning "medicine" or "healing," reflecting its historical use as a curative and spiritual elixir. Dating back to pre-Columbian times, pox has been employed in ceremonial rituals marking life events such as births, marriages, and deaths, serving as a communal offering to connect participants with the divine and foster social bonds. The production of pox involves fermenting and distilling a blend of corn—typically including white, yellow, red, and black varieties—along with (often in the form of piloncillo) and malted wheat or wheat bran. The corn is nixtamalized, ground into , and mixed with the other ingredients before in wooden vats, followed by distillation in or clay stills, either once for a rustic profile or twice for a smoother finish. Minimal aging occurs, resulting in a clear, unaged spirit with an (ABV) generally ranging from 40% to 50%, though variations exist based on the producer's methods. Varieties of pox include the plain, unadulterated version as well as flavored iterations infused with ingredients like , , , or , often at lower ABVs around 20% for digestif-style options. Notable brands such as Poshería, which offers an array of artisanal expressions including ancestral and flavored types, and Siglo Cero, founded in 2010 and the first to enter the U.S. market in 2017, have helped commercialize and diversify the spirit while preserving traditional techniques. In , pox is traditionally consumed neat, poured into small clay cups (copitas) and paired with fresh fruit slices, such as , or roasted to complement its sweet, earthy notes reminiscent of corn and subtle . Its cultural role extends beyond rituals into daily life as a symbol of and among Maya communities, with modern producers emphasizing sustainable practices tied to local . Since 2020, pox has gained international traction in craft cocktail scenes, appearing in bars across , the U.S., and , where mixologists highlight its versatility in drinks featuring , , or tropical elements.

Pox as exclamation and slang

The phrase "a pox on you" emerged in Elizabethan English as a potent invoking the suffering of pox diseases, often used to wish plague-like affliction upon an enemy. This exclamatory form appears in William Shakespeare's (circa 1611), where the character Trinculo exclaims, "A pox o' your throat, you bawling, blasphemous, incharitable dog!" to express vehement disdain. By the 17th and 18th centuries, such curses drew on the era's familiarity with devastating pox outbreaks, blending epidemiological dread with rhetorical force, as seen in broader Tudor-era invectives. In usage, "the pox" historically referred to , a venereal disease notorious for its disfiguring pockmarks, particularly in 16th- to 18th-century where it was euphemistically termed to avoid direct . This permeated literature and daily speech, reflecting the disease's and prevalence before effective treatments; for instance, it symbolized moral decay in 18th-century cultural depictions. By the 19th century, "pox" had softened into a mild or adjective like "poxy," denoting something inferior or contemptible, as in for subpar quality. Modern informal uses include " party," a pre-vaccine practice where parents deliberately exposed children to varicella to induce mild and confer immunity, popular until the 1995 vaccine introduction but now discouraged due to risks of severe complications. These linguistic remnants persist in literature and idioms, echoing pox's historical terror while diminishing in everyday curses following smallpox's global eradication in 1980, though exact usage trends remain anecdotal.

POX in technology

In , POX stands for Plain Old XML, a lightweight approach to services that involves exchanging raw XML documents over HTTP without the envelope or additional WS-* standards. This method emphasizes simplicity and , serving as an alternative to the more complex SOAP-based protocols by focusing on basic HTTP messaging with XML payloads. POX gained prominence in the mid-2000s through frameworks like (WCF), where it enables direct XML communication for RPC-style services, reducing overhead in scenarios requiring minimal protocol layers. In , POx refers to poly(2-oxazoline)s, a class of biocompatible polymers synthesized via cationic of 2-oxazoline monomers, offering tunable hydrophilicity and low . These polymers have been explored since the for biomedical applications, particularly in systems such as micelles and conjugates, where their amphiphilic nature allows encapsulation of hydrophobic therapeutics. A key property is their stealth coating capability, mimicking (PEG) by forming a hydrated brush-like layer on nanoparticles that evades immune recognition and extends circulation time . In (SDN), POX is a Python-based platform originally developed as an controller to manage flows programmatically, decoupling control from data planes. Introduced in the early 2010s by the NOX team, it functions as a lightweight prototyping tool for SDN experiments, supporting modules for tasks like switching, firewalls, and load balancing via protocols. POX has been widely adopted in educational contexts, including Georgia Tech's SDN courses, due to its simplicity and ease of extension for testing innovations without heavy dependencies.

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