21JUL

ECDC counts clade I mpox rise in Europe

2 min read

09:12UTC

EU and EEA countries reported 342 clade I mpox cases in September, and ECDC says cases have risen since June. The June plateau did not hold.

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ScienceAssessed

Key takeaway

Europe's clade I mpox cases are rising again, and few patients had two vaccine doses.

EU and European Economic Area (EEA) countries reported 342 cases of clade I mpox in September, and the European Centre for Disease Prevention and Control (ECDC) says cases have risen since June, driven mainly by clade I⁠¹. Clade I is the more severe branch of mpox, a virus related to smallpox that causes painful skin lesions. The plateau reported in June did not hold.

Over the year to September ECDC counted 1,939 clade I cases in 23 countries, and puts nine in ten of them among men who have sex with men. Only 18% of clade I patients with a known vaccination status had received two doses, so most of those with a known status had not had both doses, although nine in ten were in the group offered the vaccine. ECDC cautions that missing clade data limit how far the trend can be read.

Deep Analysis

In plain English

mpox is a virus related to smallpox. It causes fever and painful skin sores and spreads through close physical contact, including sex. There are two main branches, or clades. Clade I has caused more severe illness in Central Africa and its case count in Europe has risen since June. A vaccine is available, given in two doses. In Europe it is offered mainly to people at higher risk, including gay and bisexual men with several partners.

Deep Analysis

Root Causes

mpox vaccination in Europe uses two doses of MVA-BN, given weeks apart. Many people at risk had one dose or two in 2022 and have not been offered a booster, while others reached adulthood or joined the same networks after the 2022 campaign ended.

Europe's data come from 23 reporting systems. Not every country sequences each sample to separate clade I from clade II, so a rise in reported clade I can reflect more testing as well as more transmission.

What could happen next?

Risk
A continued rise in clade I would test whether Europe can reach the same people it vaccinated in 2022 a second time.
Consequence
Higher European orders for MVA-BN may delay deliveries to African countries with active clade Ib outbreaks.

Source Landscape

This story draws on neutral-leaning sources

Primary parallel: In 2022 clade II mpox spread through sexual networks of men who have sex with men across Europe and North America, then fell sharply within months as vaccination, testing and changes in behaviour took hold inside the same communities.

Counter-parallel: In Kamituga, a mining town in South Kivu, clade Ib emerged in 2023 in sexual networks with no vaccine available, then spread into households and across borders. Without doses, the network-based outbreak did not burn out.

Bavarian Nordic of Denmark makes MVA-BN, the only mpox vaccine approved in the EU. A rise in European demand lands on one manufacturer that is also supplying African outbreaks through donation and procurement deals.

For sexual-health clinics, a clade I rise means more isolation advice, contact tracing and vaccine appointments drawn from budgets set before the year began.

Consensus view: ECDC reads the rise as sexual-network transmission driven mainly by clade I, the pattern Europe met in 2022 with clade II, which suggests the same tools apply: targeted two-dose vaccination, testing and contact notification.

Counter-view: WHO's mpox reporting from Africa points to the other side of the supply chain. Madagascar's clade Ib outbreak spread across 75 of its 115 districts amid vaccine stockouts and broken cold chains, so Europe's demand for doses competes with countries where the virus is spreading faster.

Key tension: Whether Europe's clade I chains can be cut by raising two-dose uptake in a group already offered the vaccine, or whether the cases reflect repeated imports that vaccination at home cannot stop.

Sources:ECDC

Mentions:mpox →ECDC →European Union →South Kivu →North America →Madagascar →European Economic Area →

First Reported In

Update #15 · Ebola travels to Kenya and Nigeria

ECDC· 22 Oct 2026

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Causes and effects

Caused by

Europe's clade I mpox line goes flat

Europe's clade I mpox count rose again after the June plateau.

Occurred 17 Jul 2026

Read story →

This Event

ECDC counts clade I mpox rise in Europe

The more severe mpox branch is rising again in Europe, mostly among people eligible for a vaccine that few had fully received.

Different Perspectives

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UK Health Security Agency

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ECDC

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Ghana Ministry of Health

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Government of Côte d'Ivoire

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World Health Organization

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