Mpox continues to be reported in multiple countries worldwide, with both monkeypox virus (MPXV) clade I and clade II in circulation and sexual contact described as a driver of transmission for both, the European Centre for Disease Prevention and Control (ECDC) has warned.
Clade II has been circulating globally since 2022, and in recent outbreaks in African countries including Ghana, Guinea and Liberia, cases have been reported among young adults of both sexes, the ECDC said on Monday.
Outside Africa, reported cases have mostly been in adults (99%) and males (97%), with the majority reporting having had sex with men (89%), ECDC said, citing World Health Organization (WHO) data.
Clade I has been reported in a number of countries outside Africa, including cases without travel links to countries with ongoing clade I transmission.
In Africa, the countries reporting the most confirmed and suspected clade I cases since 2025 include the Democratic Republic of the Congo (DRC), Uganda and Burundi, followed by Kenya and Madagascar.
Over the past six weeks as of 1 March 2026, Madagascar reported 357 confirmed clade I cases and the DRC reported 216, while other African countries with clade I detections reported fewer than 100 cases in that period.
A decreasing trend in clade I cases reported in Africa since May 2025 was continuing in March 2026.
Clade I cases reported in Europe and beyond
Since August 2024, EU and European Economic Area countries including Sweden, Germany, Belgium, France, Ireland, Italy, Spain, Greece, Romania, Czechia and Austria have reported travel-associated or locally acquired clade I cases, ECDC said.
Clade I cases have also been reported since August 2024 in countries including Thailand, India, Turkey, the UK, the US, Canada, Pakistan, Oman, China and the United Arab Emirates.
Most travel-associated clade I cases reported outside Africa were linked to affected African countries.
There have been imported cases with travel history to countries including China, Germany, Lebanon, Malaysia, Nepal, the Netherlands, Oman, Pakistan, Russia, Thailand, the United Arab Emirates and Vietnam.
Since October 2025, several EU/EEA countries have reported clade I infections in men who have sex with men, with most reporting no travel history, ECDC said.
Limited household transmission has also been confirmed in the EU/EEA — mainly among household contacts — in Germany, Belgium and Ireland.
Outside the EU/EEA and Africa, secondary transmission has been reported in the UK, China, Qatar and Australia, with between one and six cases per event and no deaths reported. All the described transmission events were linked to close contact.
The ECDC said it classifies countries reporting MPXV clade I cases as either having “community transmission” or having “travel-associated cases or limited transmission”, based on official epidemiological information and available data.
The agency stated it was continuing to monitor the global mpox situation and publishes recommendations on its website.
