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Mpox worldwide overview

Situation update, 29 September 2025

Monkeypox virus (MPXV) clade I and clade II are circulating in multiple countries, with the epidemiological trends remaining largely unchanged.

On the African continent, most mpox clade I cases have been reported by the Democratic Republic of the Congo (DRC), Uganda and Burundi. Trends are decreasing in DRC and Uganda with week-to-week fluctuations.

Sporadic mpox clade I cases have also been reported outside of the African continent during the past month. There is no indication of wider community transmission in any country outside Africa. 

The classification of transmission patterns has been updated as of 29 September 2025 (details are provided in the overview).

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

Overview:

Monkeypox virus (MPXV) clade I and clade II are circulating in multiple countries across the globe. Since 2022, MPXV clade II has been circulating outside the African continent, particularly among men who have sex with men. The epidemiological profile of cases reported outside Africa since 2022 remains simliar to previous weeks.

In 2024, an increase in MPXV clade Ia and Ib was reported in the Democratic Republic of the Congo (DRC). Clade Ia cases continued to be reported by the Central African Republic and the Republic of the Congo (Congo), where it is endemic. 

The countries in Africa that have reported clade I detection (Ia and/or Ib) in 2025 are: DRC, Uganda, Burundi, Kenya, Zambia, Tanzania, Rwanda, Congo, South Sudan, the Central African Republic, South Africa, Malawi, Angola, Ethiopia and Mozambique (Global Mpox Trends published 26 September 2025, data as of 21 September 2025). Senegal also recently reported mpox clade Ib cases (Ministry of Health of Senegal,Facebook Post 25 September 2025). DRC and Congo have reported clade II cases too. Mozambique reported clade II cases in 2022 (WHO Multi-country outbreak of mpox, External situation report 56 - 31 July 2025). In 2024, Zimbabwe reported cases of clade Ib and Gabon reported mpox cases for which clade information was not available (Global Mpox Trends published 21 September 2025, data as of 26 September 2025).

As of the end of September 2025, no major changes have been noted in the epidemiological trends of MPXV clade I in Africa.

Mpox clade II cases have continued to be reported in west Africa. Notable increases were reported in recent months in Guinea, Liberia and Ghana. In Sierra Leone, clade II cases peaked in May and have been decreasing since.

Clade I and II cases have been reported in 2025 in South Africa, the Republic of the Congo and DRC.

Mpox clade I summary and transmission patterns classification

Overall, in Africa, as of the end of September 2025, most confirmed and suspected clade I cases were reported from the DRC, Uganda and Burundi: 

Kenya has reported recent increases in the total number of mpox cases  (216 cases, including three deaths, during the last six weeks; Global Mpox Trends published 21 September 2025, data as of 26 September 2025). Zambia reported 42 cases (no deaths) during the last six weeks and as of 21 September 2025. Additional countries reporting cases during the same time period include Malawi and Tanzania (45 cases each) and South Sudan (one case). No cases were reported in the WHO Dashboard for Ethiopia, Rwanda, Angola, South Africa or Zimbabwe (Global Mpox Trends published 21 September 2025, data as of 26 September 2025).

Outside of the African continent, travel-associated cases or sporadic cases reporting epidemiological links with travel-associated cases of mpox clade I have been reported in the EU/EEA by Sweden (in 2024), Germany (in 2024 and 2025), Belgium (in 2024 and 2025), France, Ireland, Italy and Spain (in 2025). Limited onward transmission has been reported by Germany, Belgium, and Ireland.

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 and Türkiye. Japan also recently reported its first clade I case.

Most travel-associated cases reported outside African countries had links to affected countries in Africa. However, several countries have reported cases with travel links to countries of the WHO Eastern Mediterranean Region (including Oman and the United Arab Emirates). Imported cases with a travel history to Nepal, Thailand and China have also been reported (Global Mpox Trends published 21 September 2025, data as of 26 September 2025).

Confirmed secondary transmission of mpox due to MPXV clade I outside of Africa was reported in the EU/EEA for the first time in 2024. Outside of 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 of Africa has been low (range: 1–6 cases per event; Global Mpox Trends published 21 September 2025, data as of 26 September 2025). 

Based on the information available, all transmission events were due to close contact, secondary cases presented with mild symptoms and no deaths were reported.

Transmission patterns of mpox due to monkeypox virus clade I 

Update 29 Sep July 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,  India, Ireland, Italy, Japan, 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, Mozambique, and the United Arab Emirates;
  • Community transmission: Burundi, Central African Republic, Congo, DRC, Ethiopia, Kenya, Malawi, Rwanda, Tanzania, Uganda, and Zambia.

Pakistan, Oman, Qatar and the United Arab Emirates – all countries of the WHO Eastern Mediterranean Region – are in  different categories of this classification. However, considering that a number of countries have recently reported cases with travel history to the region and that further information on transmission chains is not available (Global Mpox Trends published 21 September 2025, data as of 26 September 2025), there may be ongoing undetected transmission of mpox clade I in the region.

The categorisation was last updated on 29 September 2025 to include Senegal and Japan in the category of countries reporting only travel-associated cases or cases with a clear link to travel-associated cases.

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, including secondary transmission, are not unexpected.

The risk for EU/EEA citizens travelling to or living in the affected areas is considered to be moderate if they have close contact with affected individuals, 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. However, more imported mpox cases due to MPXV clade I are likely to be reported by the EU/EEA and other countries.

EU/EEA countries may 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.

Please see the latest ECDC 'Risk assessment for the EU/EEA of the mpox epidemic caused by monkeypox virusclade I in affected African countries'.