Key facts
- In October 2026, 342 mpox cases caused by clade I monkeypox virus (MPXV) were reported by 15 EU/EEA countries, representing a decrease compared with previous months. One mpox case caused by clade II MPXV was reported by Germany, continuing a decreasing trend.
- Transmission for both clades occurs predominantly within networks of men who have sex with men, with ongoing circulation across the EU/EEA and most cases reported among unvaccinated individuals.
- Disease severity remains generally mild, with low hospitalisation rates reported for both clades.
Overview
The monthly surveillance report on mpox in the EU/EEA, Western Balkans and Türkiye, covering the period up to October 2026, has been published on ECDC's website.
October 2026 update
A total of 219 clade I mpox cases were reported by 15 countries, with the largest number of cases being reported by Germany (70).
One clade II mpox case was reported by Germany.
Overview of the past 12 months (November 2025 to October 2026)
In the past 12 months, 24 countries have reported 2 221 clade I mpox cases and 18 countries have reported 638 clade II mpox cases.
Among cases with complete information:
- In total, 91% of the clade I mpox cases and 90% of the clade II mpox cases with complete information were reported among men who have sex with men.
- Overall, 13% of the clade I mpox cases and 7% of the clade II mpox cases with complete information were hospitalised.
- A total of 19% of the clade I mpox cases and 16% of the clade II mpox cases with complete information were vaccinated with two doses.
The number of reported mpox cases in the EU/EEA increased from July to September 2026, driven primarily by an increase in reported clade I mpox cases, while the number of reported clade II mpox cases has continued to decline. Although the number of reported cases declined in October 2026 compared with September, case numbers remained higher than during the first half of 2026.
However, interpretation of trends is limited due to reporting delays and retrospective updates to case notifications, clade information and other epidemiological data.
Based on information provided by EU/EEA countries, clinical presentation is generally mild, including among hospitalised cases. Clades Ib and IIb account for the vast majority of reported mpox cases. Among cases with known clade, only one case of clade Ia and two cases of clade IIa have been reported in the EU/EEA since the start of surveillance in 2022.
ECDC assessment
Both clade I and clade II mpox cases continue to be reported across the EU/EEA, with generally mild clinical presentation.
While early clade I cases were mainly imported from outside the EU/EEA and reported among heterosexual individuals and their close contacts, most cases are now reported among men who have sex with men. Transmission in these networks is observed for both clades and occurs predominantly among unvaccinated individuals.
The risk assessment in ECDC's Threat Assessment Brief published on 24 October 2025 remains valid: '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. 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.'
Actions
ECDC's Threat Assessment Brief outlines actions that EU/EEA countries can take. ECDC continues to monitor mpox in the EU/EEA and globally through event- and indicator-based surveillance and collaboration with partners.
EU/EEA countries are encouraged to increase vaccination uptake, particularly among populations at higher risk of exposure, including men who have sex with men. Increasing vaccination coverage remains the most important intervention to mitigate the spread of both clades, particularly during the spring and summer seasons. Health promotion and community engagement are also critical to ensure effective outreach and high vaccine acceptance and uptake among those most at risk of exposure.
Primary preventive vaccination (PPV) and post-exposure preventive vaccination (PEPV) strategies may be combined to target 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. Strategies should also prioritise individuals at risk of occupational exposure, based on epidemiological or behavioural criteria.
Further response options for EU/EEA countries include:
- Raising awareness among healthcare professionals;
- Supporting sexual health services in case detection, contact tracing and case management;
- Ensuring that testing is easily accessible.
Countries should continue efforts to sequence all confirmed cases and ensure that sequences are deposited in public repositories (European Nucleotide Archive (ENA), Sequence Read Archive (SRA), and/or GISAID EpiPox (GISAID’s mpox genomic surveillance platform)) or shared with ECDC through the EpiPulse platform.
