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Pandemics and Biosecurity
22OCT

Europe starts a monthly mpox watch

3 min read
16:36UTC

ECDC launched a monthly clade I mpox bulletin after confirming 336 cases across 15 EU and EEA countries, with local transmission now established in Spain, the Netherlands, Italy and Portugal.

ScienceDeveloping
Key takeaway

ECDC's new monthly mpox bulletin institutionalises tracking of local European transmission that was already established.

The European Centre for Disease Prevention and Control (ECDC) launched a monthly mpox surveillance report on 17 June, having confirmed 336 clade I cases across 15 EU and European Economic Area (EEA) countries between April 2025 and March 2026⁠1. mpox is a viral disease caused by the monkeypox virus; clade I is the more severe of its two lineages, and the EEA extends EU single-market rules to Norway, Iceland and Liechtenstein.

Local transmission, meaning chains with no link to travel from Africa, is now established in at least four countries: Spain, the Netherlands, Italy and Portugal, predominantly among men who have sex with men. Cases peaked at 89 in January 2026 and averaged around 80 a month in February and March. ECDC rates the risk to men who have sex with men as moderate and to the general population as low.

Clade Ib circulating locally in Europe was reported a fortnight ago, and the recombinant clade Ib/IIb virus before that, so the new bulletin formalises timing rather than marking a discovery. The transmission was already documented; what changes now is that ECDC commits to a standing monthly cadence to track it, an institutional rhythm arriving after the pattern it watches was established rather than before. A monthly report formalises monitoring of spread that European laboratories had been logging case by case for the better part of a year.

Deep Analysis

In plain English

mpox (previously called monkeypox) is a viral disease that spreads primarily through close skin-to-skin contact, including sexual contact. There are two main variants: clade IIb (which caused a global outbreak in 2022, mainly in Europe and North America) and clade I (more severe, originally from central Africa). Clade I has now been confirmed spreading locally inside Europe: people are catching it from each other within EU countries, without any link to Africa travel. ECDC (the EU's disease monitoring agency) has counted 336 confirmed clade I cases across 15 EU and European Economic Area countries between April 2025 and March 2026. In four countries (Spain, the Netherlands, Italy, and Portugal) people contracted it within the country rather than abroad. Most cases are among men who have sex with men. The agency now publishes a monthly report specifically tracking this situation, which signals it expects this transmission chain to continue.

What could happen next?
  • Precedent

    ECDC launching a dedicated monthly clade I surveillance bulletin marks the formal reclassification of clade I mpox from an imported exotic disease to a European endemic-transmission concern, with institutional monitoring consequences.

  • Risk

    The reported 80-per-month clade I case plateau in early 2026 may undercount true incidence by two to four times in countries without systematic case-finding, based on diagnostic-infrastructure differences across reporting EU member states.

First Reported In

Update #8 · Ebola reaches France through a screening blind spot

European Centre for Disease Prevention and Control· 25 Jun 2026
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Written with AI from Lowdown's published reporting. Not individually reviewed by an editor. Editorial standards.