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Mpox worldwide overview

Situation update, 30 October 2025

Monkeypox virus (MPXV) clades I and clade II are circulating in multiple countries across the globe. Since 2022, mpox clade II has been circulating outside the African continent, particularly among men who have sex with men. The epidemiological profile of mpox clade II cases reported outside Africa since 2022 remains similar to previous weeks. With regards to clade I, cases have been reported by several countries outside Africa 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 (Multi-country outbreak of mpox, External situation report #59 - 30 October 2025). 

A summary of the recently observed global trends of clades I and II is provided below along with the classification of countries based on the clade I transmission.

EU/EEA countries with reported clade I cases
Belgium, France, Germany, Italy, Portugal, Sweden, Spain and the Netherlands
Countries with community transmission of mpox clade I
Burundi, Central African Republic, Congo, the DRC, Ethiopia, Kenya, Malawi, Mozambique, Rwanda, Tanzania, Uganda and Zambia.

Overview:

Mpox clade II has been circulating globally since 2022. Following the spread and increases outside endemic areas in Africa in 2022, in 2025, increases of clade II have been reported mostly in west African countries (e.g., Ghana, Guinea, Sierra Leone, Liberia) (Multi-country outbreak of mpox, External situation report #59 - 30 October 2025). 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 24 October 2025, data until 19 October 2025). In African countries with recent increases of clade II, cases have been reported among young adults males and females and sexual contact has been described as a driver of spread (Africa CDC Epidemic Intelligence Weekly Report, October 2025 – Africa CDC and Multi-country outbreak of mpox, External situation report #59 - 30 October 2025)

Mpox clade I summary and transmission patterns classification

Overall, in Africa, as of October 2025, most confirmed and suspected clade I cases were reported from the DRC, Uganda and Burundi. However, in recent weeks, increases have been observed in Kenya, CAR and Tanzania compared to the previous six-week period (weeks 37-42 vs weeks 31-36; Special Briefing on Mpox and other Health Emergencies, 30 October 2025). 

Summary of recent trends in selected African countries: 

Between 19-22 October, Namibia reported two mpox cases, the first cases in the country. The first case was liked to a probable case that had travel history to Tanzania and the second was linked to the first. Clade Ib was detected, according to WHO (Multi-country outbreak of mpox, External situation report #59 - 30 October 2025). 

In EU/EEA, travel-associated cases or sporadic cases reporting epidemiological links with travel-associated cases of mpox clade I have been reported by Sweden (in 2024), Germany (in 2024 and 2025), Belgium (in 2024 and 2025), France, Ireland, Italy, and Spain (in 2025), as well as by Greece (in October 2025). In addition to Africa and the EU/EEA, since August 2024, clade I cases have been reported by Thailand, India, the United Kingdom, the United States, Canada, Pakistan, Oman, China, the United Arab Emirates, Qatar, Brazil, Switzerland, Australia, Türkiye, and Japan. Most travel-associated cases reported outside African countries had links to affected countries in Africa. Imported cases with a travel history to Lebanon, Malaysia, Nepal, Thailand and China have also been reported (Global Mpox Trends published 24 October 2025, data as of 19 October 2025). In October 2025, Italy, the Netherlands, Portugal and Spain reported five cases of mpox clade I without travel history and with two of individuals reporting having sexual contact with another male. In addition, the United States reported three unlinked cases of clade I in California without travel history with the investigation indicating that person-to-person transmission among gay, bisexual and other men who have sex with men and their social networks may be ongoing in the state (Community Spread of New Mpox Type (Clade I) in California Has Been Identified; Risk to General Public Remains Low). Confirmed limited secondary transmission of mpox due to MPXV clade I outside of Africa was reported in the EU/EEA since 2024 by Germany, Belgium, and Ireland. Outside the EU/EEA, secondary transmission has been reported in the UK, China, Qatar, and Australia. The number of secondary cases reported in these events outside Africa has been low (range: 1–6 cases per event; Global Mpox Trends published 24 October 2025, data as of 19 October 2025). Based on the information available, all transmission events were due to close contact and no deaths were reported.

Transmission patterns of mpox due to monkeypox virus clade I 

Update 30 October 2025

Since September 2024, following an analysis of the patterns of MPXV transmission observed at the national level and given the limitations and uncertainties, ECDC has used official epidemiological information to classify countries according to whether MPXV clade I is endemic or was reported for the first time since 2024. The categories are as follows: 

  • Countries reporting only travel-associated cases or cases with a clear link to travel-associated cases: Angola, Australia, Belgium, Brazil, Canada, France, Germany, Greece, India, Ireland, Japan, Namibia, Oman, Pakistan, Qatar, Senegal, South Africa, South Sudan, Sweden, Switzerland, Thailand, Türkiye, the United Kingdom, the United States, and Zimbabwe;
  • Clusters of cases or limited transmission: China, Italy, Malaysia, the Netherlands, Portugal, Spain, the United Arab Emirates, and the United States;
  • Community transmission: Burundi, Central African Republic, Congo, DRC, Ethiopia, Kenya, Malawi, Mozambique, Rwanda, Tanzania, Uganda, and Zambia. 

The extend of ongoing undetected transmission of mpox clade I cannot be quantified with certainty. A number of countries have reported cases with travel history to regions/countries with limited number of clade I cases or no clade I cases and further information on transmission chains is not available (Global Mpox Trends published 24 October 2025, data as of 19 October 2025), For example, Nepal and Lebanon have not reported any mpox clade I detection and they have been reported as places of travel of known cases elsewhere. Imported cases with a travel history to Malaysia, Thailand and China have also been reported but a small number of mostly travel associated cases has been reported by each of these countries (Global Mpox Trends published 24 October 2025, data as of 19 October 2025). 

The categorisation was last updated on 30 October 2025. The epidemiological situation is continuously being monitored and the classification is reviewed and adjusted depending on a qualitative assessment of reported trends. 

On 13 August 2024, Africa CDC declared mpox a Public Health Emergency of Continental Security, and this decision remains valid (Mpox Still a Continental Emergency, Africa CDC Advisory Group Recommends – Africa CDC). On 14 August 2024, WHO also declared the outbreak of mpox due to MPXV clade I to be a public health emergency of international concern (PHEIC), which was declared over on 5 September 2025 (WHO Director-General's opening remarks at the media briefing – 5 September 2025).

Actions:

ECDC is closely monitoring and assessing the evolving epidemiological situation related to mpox on a global basis. The Centre's recommendations are available here.

Reporting through the Communicable Disease Threats Report is monthly. As the global epidemiological situation is monitored continuously, ad hoc epidemiological updates may be published.

ECDC assessment

The epidemiological situation regarding mpox due to MPXV clade Ib remains similar to previous weeks. The sporadic cases of mpox clade I that have been reported outside Africa, inThe epidemiological situation regarding mpox due to MPXV clade I remains similar to previous weeks. The sporadic cases of clade I that have been reported outside of Africa, including secondary transmission, are not unexpected. However, a new pattern of transmission is emerging in countries outside Africa, including in the EU/EEA, among men who have sex with men.

The risk for EU/EEA residents travelling to or living in the affected areas is considered moderate if they have close contact with affected individuals, including sexual contact, and low if they do not have contact with affected individuals. The overall risk to the general population in the EU/EEA is currently assessed as low. Imported mpox cases due to MPXV clade I are likely to continue being reported by the EU/EEA and other countries. 

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, contact tracing, partner notification and post-exposure preventive vaccination of eligible contacts are the main public health response measures. 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.