More than 40 years after humans claimed victory by eradicating smallpox, scientists apprehend that suspension of immunisation back in 1980s could be one of the reasons behind the current outbreak of monkeypox in regions outside Central and Western Africa. Though the World Health Organisation (WHO) has speculated that monkeypox spread is less likely to take the form of a pandemic, the outbreak remains an issue of concern on account of multiple uncertainties looming across. Scientists are struggling to de-clutter the sudden spread of the virus. There is no doubt that the outbreak is abrupt but it can also be seen as a continuation of the long tradition of human-virus interaction. A report in Nature traces the origin of viral infections some thousands of years back. It won't be wrong to say that humans have been living with viruses since ages. This relation has been affected time and again by socio-environmental changes. In recent history, on account of increased deforestation and disproportionate clearance of forests, zoonotic spill overs have become more common. Since monkeypox is known to spread from rodents found in Central and Western African forests, zoonotic spillover cannot be ruled out as a causal factor behind the recent outbreak as well. However, what the scientists are finding hard to explain is why the disease is spreading across different parts of the globe having wide-ranging regional variations. Presently, the answer to this conundrum can only be sought through various explanations and theories as there are no concrete findings yet. One of the widely cited explanations is that amid the subsiding pandemic and resultant surge in international travel, individuals visiting Central and Western Africa might have been infected and spread the virus to those coming in close contact. Interestingly, the genome sequencing of monkeypox samples from countries including Belgium, France, Germany, Portugal and the United States has shown that these samples resemble the strain found in Western Africa — which is less lethal than the Central African strain. The respective death rate of the two strains is 1 per cent and 10 per cent. Going by the theory that recognises international travel as the possible cause of the outbreak, it would appear that the viral spread is triggered by a small group or even individuals infected in the Western Africa. Another explanation states that monkeypox virus was already prevalent among non-African populations but was undetected. Now, finding a suitable climate, it has started showing its true colours. An article in Nature has ruled out this possibility as the signs of monkeypox virus, unlike that of SARS-Cov-2 virus, are largely visible on the skin of the infected persons. One would argue that these ambiguities and uncertainties be removed through concrete findings and genetic analysis. In fact, genetic evolution of the virus may appear to be a plausible explanation behind the monkeypox outbreak. But this is not confirmed yet. Rachel Roper, a virologist at East Carolina University, has said that since the genome of monkeypox virus is six times larger than that of SARS-Cov-2, it will be as much times harder to analyse. Essentially, there appears to be no concrete answer to the monkeypox conundrum as of now. Apart from origins and transmission, there are other uncertainties as well. WHO's Rosamund Lewis, in her public address, highlighted that a vast majority of monkeypox cases is being seen in gay, bisexual or men who have sex with men. This trend remains inexplicable as of now. Scientists, at best, state it to be a result of coincidence where the infection was first caught by a person of gay or bisexual nature. It is not even clear whether sex between individuals is a cause behind the spread of the virus — experts believe that rather than sex itself, the physical proximity during the sexual act could be a reason for viral spread. The WHO expert, however, noted that initially a large number of lesions among infected persons are found in the genital area — mostly invisible. To sum up, at present, there are so many uncertainties around the monkeypox virus and experts are striving hard to uncover and assemble credible information. If one is to rely on WHO's words, one reassuring certainty is that there are no signs of the monkeypox outbreak taking the form of a pandemic as of now. Another certain thing is that treatment and cautionary measures to prevent monkeypox outbreak are largely known. While waiting for health expert bodies to come up with reliable findings to eliminate uncertainties, we should focus on certainties to ensure the safety of all.