Implications for the EU/EEA of the outbreak of mpox caused by Monkeypox virus clade I in the Democratic Republic of the Congo
An outbreak of mpox is ongoing in the Democratic Republic of the Congo (DRC), with 12 569 cases reported between 1 January and 12 November 2023.
Executive summary
- The vast majority of infections are caused by Monkeypox virus (MPXV) clade I, which is generally considered to be more virulent than MPXV clade II.
- A cluster of mpox cases from March 2023 was recently documented as the first detection of sexually transmitted MPXV clade I infections. The presumed index case of this cluster is a European traveller who reportedly developed mpox soon after his arrival in DRC.
- Currently, there is no evidence that MPXV clade I is circulating outside certain central African countries and available MPXV sequences do not suggest circulation in the EU/EEA.
- The likelihood of infection from the ongoing epidemic mpox due to MPXV clade I is assessed as very low for the general EU population and the impact from such an infection is assessed as low. The overall risk is assessed as low.
- The overall risk for men who have sex with men (MSM) with multiple sexual partners in the EU/EEA from this outbreak in the DRC is low. Although the likelihood of infection with clade I virus for this population is considered higher than that of the general population, it is still estimated as low, as it is attenuated by the immunity in this population due to prior infection with MPXV clade II and/or vaccination in 2022-23. The impact from such infection is also estimated to be low, also influenced by increased immunity and availability of vaccines and therapeutics in the EU/EEA.
- Public health authorities should continue efforts to increase awareness among clinicians about mpox.
- Contact tracing, testing and sequencing of samples from detected mpox cases should continue, along with sharing the detected sequences. In the event of mpox case(s) with increased severity and/or the detection of a MPXV clade I infection, the event should be promptly communicated at the EU-level via EpiPulse.
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Erratum – on 11 December 2023, page 4, the heading “Phylogenetic overview of currently circulating MPXV genotypes worldwide“ was replaced with “Overview of MPXV genomes sequenced worldwide in 2023“. This section provides information on the number of MPXV genomic sequences available in public sequence databases and not about the evolutionary relationships among them. The new heading also clearly states the time frame of the analysis.
