Monkeypox is endemic in West and Central Africa, and the virus occasionally causes outbreaks elsewhere in the world, but most are quickly contained or peter out by themselves. A disproportionate number of cases are in men who have sex with men (MSM), an unusual twist given that researchers have never convincingly shown sexual transmission occurs in monkeypox. As of 26 May, two dozen countries in the Americas, Europe, North Africa, the Middle East, and Australia had reported more than 350 suspected and confirmed cases of the disease, a much milder cousin of smallpox, the deadly scourge that the World Health Organization (WHO) deemed eradicated in 1980. With the COVID-19 pandemic still raging, a second public health threat has the world on high alert: a global outbreak of monkeypox. Update, 26 May, 10:20 a.m.: This story has been updated with the latest on the outbreak.