#18,543
Note quite 5 months ago (Aug 14th) the WHO declared the Mpox outbreak in Central Africa to constitute a PHEIC (Public Health Emergency of International Concern) after reports that a recently emerged clade (Ib) of the virus had begun to spread outside of the DRC (see More African Nations Reporting Mpox - Africa CDC Mpox Update (Jul 30th)).Complicating matters, there are now 4 distinct clades of Mpox circulating in Africa, with Clade II and IIb considered the mildest, and Clade I and Ib considered more severe. Laboratory testing, however, remains quite limited in many of these regions.
Since then we've been monitoring both the spread of the Ib clade in Africa, and internationally. Over the past 2 weeks we've seen 3 new countries (Belguim, France, and China) report their first imported cases, and in a few countries (UK, Germany, and China) we've seen local transmission.
Last month the WHO published a new, updated risk assessment, which puts the risk of national and international spread as HIGH.
Today the WHO published their first Mpox update of 2025 . The full report runs 26 pages, so I've only posted some highlights. Follow the link to read it in its entirety.
I'll have a brief postscript when you return.
Highlights
• The outbreak of clade Ib monkeypox virus (MPXV) continues predominantly in the Democratic Republic of the Congo, Burundi and Uganda, with new travel-related cases identified in previously unaffected countries.
• Recent travel-associated mpox cases highlight the risk of undetected transmission in countries, emphasizing the need for strengthened surveillance and timely reporting to improve global monitoring and prevent international spread.
• The Democratic Republic of the Congo remains the most affected country, experiencing circulation of both clade I MPXV subclades. Despite many of the provinces reporting stable trends in cases, the situation in the country remains concerning with continued high circulation of the virus.
• Burundi and Uganda continue reporting between 100-200 new mpox cases per week, with a plateauing trend, possibly impacted by a decline in surveillance and reporting during the December festive season.
• Since the last update (23 December 2024), Uganda has reported six deaths, bringing the total to 12 deaths among confirmed mpox cases in the country.
• A travel-related case of mpox due to clade Ib MPXV i in Germany (the second importation) led to secondary household transmission.
• Clade Ib MPXV has been detected in three additional countries, Belgium, China and France, directly or indirectly linked to travel to affected countries in Central Africa.
• Kosovo2 has reported its first case of mpox. Information on the MPXV clade is not yet available.
Since the global eradication of smallpox in the 1970s, there is a general feeling that poxviruses - much like polio and the plague - are relics of the first half of the last century; something you only read about in history books.
But our collective immunity to poxviruses has greatly diminished since smallpox vaccination was halted in the 1970s.
While the smallpox virus may be gone, its relatives are still out there, and we increasingly provide them with a target rich environment.
