Broader transmission of mpox due to clade Ib MPXV – Global situation

See all DONs related to this event Read more about Mpox Situation at a glance The purpose of this report is to raise awareness about the local transmission of clade Ib monkeypox virus (MPXV) among men who have sex with men (MSM) in countries previously unaffected or to date reporting only cases linked to travel. This report summarizes recent epidemiological developments, response activities, and the associated global public health risk. The second declaration of a public health emergency of international concern (PHEIC) for mpox was lifted on 5 September 2025. As both MPXV clades I and II and their subclades continue to circulate globally, leading to substantial outbreaks in African countries, WHO continues to advise emergency preparedness and response activities. Multiple modes of transmission underlie ongoing virus circulation, with sexual contact remaining the primary amplifier of transmission in most settings. Since 5 September 2025, several countries across four of six WHO regions have confirmed clade Ib MPXV infection in individuals with no recent travel reported (WHO African Region, Region of the Americas, the European Region and the Western Pacific Region), most of which are being detected among men who have sex with men, suggesting local transmission, particularly given that infections often manifest with few or no symptoms (paucisymptomatic or asymptomatic cases) leading to undetected onward transmission. Overall, the surveillance data in most countries is sufficient to detect and respond effectively to mpox outbreaks. However, thorough epidemiological investigation, contact tracing and implementation of public health interventions to control spread remain challenging. Mpox is known to resolve on its own over two to four weeks in most cases. However, timely access to quality healthcare is essential to identify, prevent and manage secondary bacterial infections and other complications. Individuals living with immune suppressive conditions remain at high risk of more severe mpox disease and death, most notably people living with undetected and/or untreated, uncontrolled human immunodeficiency virus (HIV) infection. Men who have sex with men with new and/or multiple partners remain at increased risk of clade Ib and also IIb MPXV infection. WHO assesses the public health risk posed by clade Ib MPXV to men who have sex with men as moderate and the risk to the general population as low in most countries. Description of the situation Since the lifting of the second PHEIC for mpox on 5 September 2025, and as of 24 November 2025, 43 new confirmed cases of clade Ib MPXV have been reported across six WHO regions outside areas where sustained community transmission of this virus strain has been occurring. In four of these regions (Region of the Americas, South-East Asia Region, European Region and the Western Pacific Region), 24 cases had reported no recent international travel, suggesting local transmission. Based on this, Italy, Malaysia, the Netherlands, Portugal, Spain, and the United States of America are now considered to be experiencing community transmission of clade Ib MPXV. In addition, travel-related cases continue to be reported in many countries. Among the 43 cases, half (22) were documented among men who have sex with men, while other cases were linked to travel to countries with known community transmission of clade Ib, or secondary to travel-related cases (household contacts and/or sexual partners).This report provides an overview of these recent cases of mpox confirmed to be due to clade Ib MPXV, by WHO region and country, summarizing key available epidemiological information, followed by WHO’s rapid risk assessment and public health advice. Summary of reported mpox due to clade Ib MPXV in WHO Regions and countries from 5 September to 24 November 2025WHO African RegionSince the lifting of the PHEIC on 5 September 2025 and as of 24 November 2025, one country, Namibia, has reported clade Ib MPXV cases for the first time. Community transmission persists in Burundi, the Democratic Republic of the Congo, Kenya, Malawi, Mozambique, Republic of Congo, Rwanda, South Africa, the United Republic of Tanzania, Uganda, and Zambia. NamibiaNamibia notified WHO of one probable and two confirmed cases of mpox due to clade Ib MPXV. The index (probable) case linked to travel within the African Region and the two confirmed cases were his household contacts. No further cases have been reported following detection of this cluster.These are the first cases of mpox reported in the country.WHO Region of the AmericasTwo countries in the WHO Americas Region have reported a total of four confirmed cases of mpox due to clade Ib MPXV. One case detected in Canada had recently travelled, while three cases in the United States of America had no recent travel history or known epidemiological links to travellers. CanadaCanada notified WHO of one confirmed mpox case due to clade Ib MPXV in an adult male with recent travel outside of the country and reporting no sexual partners after returning to Canada. The case received counselling on preventing further transmission.United States of AmericaThe United States of America reported three unrelated cases of mpox due to clade Ib MPXV in Long Beach (one case) and Los Angeles (two cases) counties, California. All three occurred among men who have sex with men, none of whom had a history of recent international travel or known exposure to mpox cases. None of the individuals had a previous MPXV infection or prior orthopoxvirus vaccination, and one case was immunocompromised. All three individuals were hospitalized, received standard medical care, and have fully recovered. Prior to the lifting of the PHEIC, the United States of America had reported six cases of mpox due to clade Ib MPXV, all linked to travel.Public health authorities conducted contact tracing among household, healthcare-facility and social contacts. No additional cases of mpox due to clade Ib MPXV have been detected to date. Public health investigations suggest ongoing community transmission of clade Ib MPXV among men who have sex with men and their social networks in southern California. Viral genomic sequencing data indicate that the three California cases may be linked to a previously reported case in the country in August 2025.WHO South-East Asia RegionFrom 5 September to 24 November 2025, five cases of mpox due to clade Ib MPXV have been reported in the WHO South-East Asia Region, all in Thailand. All cases had a recent history of international travel and three self-identified as men who have sex with men.ThailandThailand notified WHO of five new cases of mpox cases due to clade Ib MPXV. The cases included four males, three of whom self-identified as men who have sex with men, and one female. Travel histories indicate associations with recent travel to the United Arab Emirates, Oman, and the Russian Federation, where exposure to infection is likely to have occurred. Prior to 5 September, Thailand had reported five cases of mpox due to clade Ib MPXV, all of which were associated with international travel. WHO Eastern Mediterranean RegionThree countries in the WHO Eastern Mediterranean Region, Egypt, Lebanon and Qatar have reported six cases of mpox. Although the clade was not documented in Egypt and Lebanon, two cases attributed to clade Ib MPXV were reported in Qatar.QatarQatar notified WHO of two cases of mpox due to clade Ib MPXV. One adult male and one adult female, linked to travel within the Eastern Mediterranean Region. Prior to this period, Qatar had reported three cases of mpox due to clade Ib MPXV, all of which were associated with international travel.WHO European RegionCountries in the WHO European Region have reported a total of 27 mpox cases due to clade Ib MPXV. Of these, 18 cases were classified as autochthonous, with no relevant history of recent international travel, suggesting undetected community transmission (Italy, the Netherlands, Portugal, and Spain). Two cases (reported from Belgium and the United Kingdom) were related to travel within Europe and five cases to travel outside of Europe (East Africa, Uganda, United Arab Emirates), either to or from countries experiencing community transmission of clade Ib MPXV but also to or from countries where no community transmission has been reported, including Angola, the United Arab Emirates, and Viet Nam. Furthermore, at least 15 of the 27 cases, and 14 of the 18 locally acquired cases occurred among individuals who self-identified as men who have sex with men. BelgiumBelgium reported to WHO one case of mpox due to clade Ib MPXV with recent travel to the Netherlands. This individual reported having had multiple sexual contacts with other men while in the Netherlands. Prior to 5 September, Belgium had reported six mpox cases caused by clade Ib MPXV, all linked to travel.France France notified WHO of one case of mpox due to clade Ib MPXV in an adult male traveller who had returned from East Africa. Prior to this period, France had reported three cases of mpox due to clade Ib MPXV, all linked to travel.Germany Germany notified WHO of three cases of mpox due to clade Ib MPXV. All three cases had a recent history of international travel: one, an adult male who had travelled to Angola, another an adult female who had travelled to Uganda, and the third, an adult male who had travelled to Viet Nam. Uganda has community transmission of clade Ib and Viet Nam has not previously reported cases of this subclade. Prior to 5 September, Germany had reported 12 mpox cases due to clade Ib MPXV, most of which were linked to travel.Greece Greece notified WHO of its first case of mpox due to clade Ib MPXV, in an adult male with a recent history of travel to the United Arab Emirates before arriving in Greece.IrelandIreland reported two cases linked to a small cluster which was reported before 5 September 2025. The index case had history of recent travel outside Europe. The firs...