ECDC recommends enhancing preparedness as more imported cases of clade I mpox highly likely
In a new risk assessment, the European Centre for Disease Prevention and Control (ECDC) has said that it is highly likely that the EU/EEA will see more imported cases of mpox caused by the clade I virus currently circulating in Africa. However, the likelihood of sustained transmission in Europe is very low provided that imported cases are diagnosed quickly and control measures are implemented.
Due to frequent and close travel links between the EU/EEA and Africa, ECDC recommends that EU/EEA Member States issue travel advice for people visiting or returning from areas affected by the outbreak. The likelihood of infection for people from the EU/EEA travelling to affected areas who have close contact with affected communities is high. Additionally, there is a moderate risk for close contacts of possible or confirmed imported cases into the EU/EEA.
“As a result of the rapid spread of this outbreak in Africa, ECDC has increased the level of risk for the general population in the EU/EEA and travellers to affected areas. Due to the close links between Europe and Africa, we must be prepared for more imported clade I cases,” says Pamela Rendi-Wagner, Director of ECDC.
Through strengthened surveillance and preparedness activities as well as the robust healthcare and response capacity in EU/EEA Member States, ECDC predicts that the impact on the EU/EEA from MPXV clade I will be low.
ECDC recommends that public health authorities in the EU/EEA maintain high levels of preparedness planning and awareness raising activities to enable rapid detection and response of any further MPXV clade I cases that may reach Europe. Ensuring effective surveillance, laboratory testing, epidemiological investigation and contact tracing capacities will be vital to detecting cases of MPXV clade I on the continent and activating any response.
Raising awareness among clinicians and establishing effective case management processes once a suspected case is identified will be crucial to detecting any further cases of MPXV clade I in the EU/EEA and preventing any secondary infections. If a clade I infection is detected, the event should be promptly communicated at the EU level via EpiPulse or EWRS. ECDC recommends travellers to epidemic areas consult their healthcare provider or travel health clinic regarding eligibility for vaccination against mpox.
The new risk assessment follows Africa CDC’s declaration of a Public Health Emergency of Continental Security and the declaration of a Public Health Emergency of International Concern by the World Health Organization. ECDC continues to work with local and international partners to help control the spread of mpox on the African continent.
The outbreak in Africa is distinct from the global MPXV clade IIb outbreak that occurred in 2022 and which continues to circulate at low levels in Europe and globally.
Notes
EpiPulse is an integrated online portal for European public health authorities and global partners to collect, analyse, share, and discuss infectious disease data for threat detection, monitoring, risk assessment and outbreak response. The portal facilitates the collection, analysis and dissemination of indicator- and event-based surveillance data on infectious diseases and associated health issues, including global epidemic intelligence, whole-genome sequencing, and health determinants.
Since November 2023, the Democratic Republic of the Congo (DRC) has seen a significant increase in mpox cases and the emergence of a new MPXV subclade of clade I. The country has reported over 16 000 new cases and more than 500 deaths in 2024. Confirmed mpox cases have been reported in countries neighbouring DRC, such as the Republic of the Congo, Central African Republic, and recently Rwanda, Uganda and Burundi. Monkeypox virus clade Ib which was first identified in DRC has now been detected in Rwanda, Uganda, Burundi and in Kenya.
Experts from across ECDC have been working closely with their partners at Africa CDC to support their outbreak response. Through the ‘ECDC and Africa CDC partnership project’, ECDC experts are contributing to a rapid literature review to help identify gaps in the knowledge of the clade I mpox variant and guide future research. They are also supporting an in-action review of the mpox outbreak response in DRC to inform preparedness and response activities. The EU Health Task Force (EUHTF) has deployed an epidemiologist to DRC to contribute to mpox surveillance, field investigation and research projects.