Transmission of monkeypox virus clade I: overall risk remains low in the EU/EEA
The first instances of confirmed transmission of monkeypox virus (MPXV) clade I among close contacts of imported cases within the EU/EEA have been reported by Germany and Belgium. The European Centre for Disease Prevention and Control (ECDC) is in contact with national public health authorities in these countries regarding this recent development. The overall risk for the EU/EEA population remains low, as assessed in the rapid risk assessment published by ECDC on 16 August 2024.
As detailed in ECDC’s epidemiological update, eleven individuals with MPXV clade I have been reported in the EU/EEA since August 2024. One case was reported by Sweden in August 2024, seven by Germany (one in October, five in December 2024 and one in January 2025), two cases by Belgium in December 2024 and one case by France in January 2025. The disease was mild in all individuals.
Among the cases in Germany, a cluster reported in December 2024 included an individual who had travelled to an affected area and three of their household members, including children, who had not travelled abroad recently. There was no reported transmission beyond the household. In Belgium, one affected child was a household contact of an affected individual with a travel history to an affected country. Besides the cases reported in the EU/EEA, several countries outside the African continent have also reported travel-associated cases.
Only the United Kingdom and China have reported secondary transmission of mpox due to MPXV clade I outside the EU/EEA and Africa. Updated information on the epidemiology and transmission patterns of mpox due to clade I can be found in the weekly Communicable Diseases Threats Report.
In response to the increased transmission of MPXV clade I in the Democratic Republic of the Congo and neighbouring countries, ECDC published a rapid risk assessment on mpox caused by MPXV clade I in August 2024, highlighting the possibility of cases in the EU/EEA following travel to affected countries in Africa, and further cases due to close contact with such imported cases.
Although significant uncertainties exist about the severity of mpox caused by MPXV clade I, most people experience mild to moderate symptoms, followed by a full recovery. It is important to note that close physical (skin-to-skin) contact or touching virus-contaminated materials is necessary to transmit MPXV.
During periods of extensive international travel, EU/EEA countries may consider raising awareness among travellers to/from areas with ongoing MPXV transmission and among primary and other healthcare providers who may be consulted by such patients. People planning to travel to regions with ongoing MPXV transmission should consult their healthcare provider or travel health clinic for general advice and their eligibility for vaccination against mpox.
Travellers to areas where the virus is circulating are at a higher risk of becoming infected if they are in close contact with people who may have mpox, potentially infected, sick or dead animals, and do not practice good hand hygiene. To ensure early diagnosis, treatment, and isolation to avoid further spread, travellers to areas with ongoing MPXV transmission should closely monitor their health during their visit and for 21 days after returning and contact healthcare services should they develop mpox symptoms (such as a rash, fever, headache, and muscle pain).
If mpox is detected, contact tracing, partner notification and post-exposure preventative vaccination of eligible individuals are important public health response measures. When possible, and certainly for clade I, contacts of a case need to be followed up by public health authorities or their healthcare provider 21 days after the last potential infectious exposure.
Read the epidemiological update
Epidemiological update
Epidemiological update, 14 January 2025: Mpox due to monkeypox virus clade I
In recent months there have been reports of monkeypox virus clade I cases in different EU/EEA countries following the geographic expansion of monkeypox virus clade I since mid-2024. This epidemiological update summarises these recent events.
E-learning
Mpox: Infection prevention and control
ECDC E-learning providing information on mpox prevention and control.