Mpox worldwide overview
Situation update, 26 June 2026
Monkeypox virus (MPXV) clades I and II are circulating in multiple countries globally. The epidemiological profile of mpox cases due to MPXV clade II cases reported outside Africa since 2022 remains similar to previous weeks. With regards to mpox clade I, cases have been reported by several countries outside Africa with and without travel history to countries with ongoing clade I transmission. For both clade I and II, sexual contacts have been described as drivers of transmission.
A summary of the recently observed global trends of clades I and II is provided below.
Mpox clade II summary
Mpox clade II has been circulating globally since 2022. In African countries with mpox clade II outbreaks in 2025-2026 (e.g. Ghana, Guinea, Liberia), cases have been reported among young adults, affecting both males and females. Sexual contact has been described as a main driver of transmission (Multi-country outbreak of mpox, External situation report #60 - 8 December
2025, Multi-country outbreak of mpox, External situation report #62-23 January 2026, Multi-country external situation report #63 – 24 February 2026, Multi-country outbreak of mpox, External situation report #66 - 31 May 2026). According to WHO data published on 22 June including cases as of 14 June 2026, Guinea has reported 15 cases the past six weeks, as of 14 June. Outside Africa, cases were mostly reported in adults (99%) and males (97%), the majority of whom
reported having had sex with men (89%) (Global Mpox Trends published 22 June 2026).
Mpox clade I summary
In Africa, since 2025, the five countries that reported most confirmed mpox clade I cases are DRC, Uganda, Madagascar Burundi, and Kenya. According to WHO, in the past six weeks, and as of 14 June 2026, most confirmed cases of clade I were reported by Madagascar (689 cases). All other countries in Africa with clade I detections, including DRC, have reported fewer than 100 cases during the last six weeks. Overall, a decreasing trend in mpox clade I cases that has been reported in Africa since May 2025 continues in June 2026 (Global Mpox Trends published 22 June 2026).
Since August 2024 and as of May 2026 in EU/EEA travel-associated mpox clade I cases, or locally-acquired mpox clade I cases have been reported by several EU/EEA countries (Surveillance of Mpox in the EU/EEA, monthly report). In addition to Africa and the EU/EEA, since August 2024, mpox clade I cases have been reported by Thailand, India, Türkiye, the United Kingdom, the United States, Canada, Pakistan, Oman, China, the United Arab Emirates, Qatar, Brazil, Switzerland, Australia, Japan, Nepal, Mexico, Israel, Argentina, Singapore, Ecuador, Colombia, Argentina, and Ecuador (Global Mpox Trends published 22 June 2026). Most travel-associated cases reported outside African countries had links to affected countries in Africa. Imported cases with a travel history to Asia, the European Region (including EU/EEA countries) and the Eastern Mediterranean Region have also been reported (Global Mpox Trends published 22 June 2026).
ECDC mpox reporting
ECDC will continue monitoring the transmission of mpox clade I and clade II trends through event-and indicator-based surveillance.
A monthly surveillance report on mpox in the EU/EEA, Western Balkans and Türkiye is published on the ECDC website and the Communicable Disease Threats Report. Events outside the EU/EEA such as those indicating changes in mpox epidemiology, including unusual/unexpected incidence or severity, will be reported on an ad hoc basis in the Communicable Disease Threats Report.
ECDC assessment:
The epidemiological situation regarding mpox due to MPXV clade I remains similar to previous weeks. The cases of clade I that have been reported outside of Africa, including secondary transmission, are not unexpected. A new pattern of transmission is emerging in countries outside Africa, including in the EU/EEA, among men who have sex with men.
ECDC published a Threat Assessment Brief on 24 October 2025 to assess the new situation. The risk of clade Ib infection is assessed as moderate for men who have sex with men and low for the general population in the EU/EEA, reflecting current evidence and considerable uncertainties around transmissibility and severity of clade Ib infection relative to clade IIb. The risk for clade IIb infection remains low for men who have sex with men and very low for the general population in the EU/EEA.
The Threat Assessment Brief on the detection of autochthonous transmission of monkeypox virus (MPXV) clade Ib in the EU/EEA summarises the information on new cases and outlines actions EU/EEA countries can take, including testing, sequencing and contact tracing; promoting vaccination; risk communication; and community engagement activities. The brief also outlines the remaining knowledge gaps, including on transmissibility and severity of MPXV clade Ib compared with clade IIb.
Recommendations for EU/EEA countries include raising awareness among healthcare professionals; supporting sexual health services in case detection, contact tracing, and case management; making testing easily accessible; implementing vaccination strategies with a focus on pre-exposure vaccination; and maintaining active risk communication and community engagement.
Primary preventive vaccination (PPV) and post-exposure preventive vaccination (PEPV) strategies may be combined to focus on individuals at substantially higher risk of exposure and close contacts of cases, respectively, particularly in the event of limited vaccine supply. PPV strategies should prioritise gay, bisexual, and transgender people, and men who have sex with men, who are at higher risk of exposure, as well as individuals at risk of occupational exposure, based on epidemiological or behavioural criteria. Health promotion interventions and community engagement are also critical to ensure effective outreach and high vaccine acceptance and uptake among those most at risk of exposure.
In addition to increased risk of local transmission of MPXV clade Ib among men who have sex with men, it is likely that mpox cases caused by MPXV clade I will continue to be introduced into the EU/EEA through returning travellers. This is especially the case after holiday travel. It is important to raise awareness concerning the possible importation of cases, both among returning travellers from affected African countries and among healthcare professionals who may see such patients.
EU/EEA countries should consider raising awareness in travellers to/from areas with ongoing MPXV transmission and among primary and other healthcare providers who may be consulted by such patients. If mpox is detected, the main public health response measures are contact tracing, partner notification, and post-exposure preventive vaccination of eligible contacts. Clade identification and virus sequencing should also be prioritised.
Please see the latest ECDC 'Risk assessment for the EU/EEA of the mpox epidemic caused by monkeypox virus clade I in affected African countries' and the Threat Assessment Brief 'Detection of autochthonous transmission of monkeypox virus clade Ib in the EU/EEA'.