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Mpox
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Mpox

A viral disease caused by monkeypox virus; clade I is the more severe lineage currently circulating in Africa and now establishing local transmission in Europe.

In September 2026, EU and EEA countries reported 342 clade I mpox cases, part of 1,939 cases recorded across 23 countries that year.

Last refreshed: 22 October 2026 · Appears in 1 active topic

Key Question

Why is Europe tracking mpox monthly in 2026 when the clade Ib emergency is in central Africa?

Timeline for mpox

#15 16 Oct
#14 14 Sept
#11 17 Jul

Held flat in confirmed clade I case counts across the EU/EEA in June

Pandemics and Biosecurity: Europe's clade I mpox line goes flat
#8 17 Jun

Europe starts a monthly mpox watch

Pandemics and Biosecurity
View full timeline →

Background

monkeypox virus causes the infectious disease mpox. It can spread through close contact with an infected person, contaminated materials or infected animals. Symptoms can include a rash, fever, swollen lymph nodes and pain. Surveillance distinguishes viral clades because their geography, severity and transmission patterns can differ. Laboratory sequencing therefore helps researchers identify where transmission occurs.

Clade I is monitored in both African and European surveillance systems. The European Centre for Disease Prevention and Control publishes a monthly bulletin and separates risk assessments for groups with different exposure patterns. Missing clade data can limit comparisons between countries and months. Large outbreaks can also produce high test positivity and substantial under-detection, as Madagascar's reporting showed. Vaccination, case finding and clear contact advice are central control measures.

Key Issues
Mpox spread

Clade I transmission spans continents

EU and EEA countries reported 342 clade I mpox cases in September 2026. Across January to September, the European disease agency counted 1,939 cases in 23 countries, mostly among men who have sex with men. Missing clade data limited how confidently the trend could be read.

The European rise followed a large outbreak in Madagascar. That country reported 703 of the world's 1,370 confirmed cases in July and had 3,436 confirmed cases by 16 August. Together, the events show clade I transmission in very different settings, while the missing surveillance data prevent a complete comparison between them.

Common Questions

Clade Ib finds a new epicentre

How many mpox clade I cases has the EU recorded?
336 cumulative cases across 15 countries between April 2025 and March 2026, plus a further 129 in June 2026 alone.Source: ECDC
Is mpox getting worse in Europe?
No. June 2026 was the first month since ECDC's dedicated clade I bulletin began in which the confirmed case count held flat, at 129 cases, rather than rising.Source: ECDC
Which European countries have local mpox transmission in 2026?
As of the ECDC report covering up to March 2026, local transmission of clade I mpox was established in four EU countries: Spain, the Netherlands, Italy and Portugal, primarily among men who have sex with men.Source: ECDC

Reference

What is the difference between mpox clade I and clade II?
Clade I is more severe and drives outbreaks in central Africa; clade II is milder and spreads globally, mostly through sexual contact.Source: ECDC
Why did WHO declare mpox a global health emergency?
WHO declared a PHEIC in August 2024 over a severe clade Ib surge in the Democratic Republic of Congo and neighbouring states.Source: WHO
Is mpox still a global health emergency in 2026?
Yes. WHO declared mpox a Public Health Emergency of International Concern in August 2024 over the clade Ib surge in the DRC and neighbouring countries. As of mid-2026 the PHEIC remains in force.Source: WHO
Source Material

Written with AI from Lowdown's published reporting. Not individually reviewed by an editor. Updated 22 October 2026. Editorial standards.