Disease

Mpox

Overview / History

Mpox is a viral illness, mostly spread through close contact with an infected person. It is caused by different clades: clade I, typically found in Western Africa, and clade II, found in Central Africa.

As of 5 September 2025, the WHO has officially declared the mpox Public Health Emergency of International Concern (PHEIC) over. The PHEIC was first declared in August 2024 due to the rapid global spread of a new mpox clade and the need for coordinated international response. The decision to lift the emergency reflects a sustained decline in cases and deaths, particularly in the DRC, Burundi, Sierra Leone, and Uganda. While the emergency status has ended, mpox remains a public health concern.

In 2022, a global outbreak of mpox due to clade II affected over 100 countries where the virus was not commonly reported, with cases continuing into 2024. Since July 2024, clade Ib, a newly emerged strain from the DRC, has spread to neighbouring countries, and the first case of this clade outside Africa was identified in Sweden in August 2024.

SEE MAP FOR MPOX CASES PRIOR TO 2024

Links to:

Download the infographic

English [PDF, 854kb]

Arabic [PDF, 755kb]

Chinese (Simplified) [PDF, 375kb]

Chinese (Traditional) [PDF, 639kb]

French [PDF, 852kb]

German [PDF, 1.4 mb]

Italian [PDF, 1.4 mb]

Japanese [PDF, 652kb]

Portuguese (Angola) [PDF, 666kb]

Spanish [PDF, 1.1mb]

Listen to the International SOS Podcast

06 September 2024 Mpox Outbreak Update and FAQs with Dr Irene Lai, Global Medical Director and Tarun Nijjer, Lead Security Analyst
16 August 2024 Mpox Public Health Emergency with Dr Chris van Straten, Global Health Advisor and Diego Zendejas, Public Health Coordinator
15 June 2022 Monkeypox - its origins and implications with Dr Abraham Udoudom in Port Harcourt and Dr Chris Van Straten in Johannesburg
26 May 2022 Monkeypox — how much of an emerging global health threat? with Dr Kate O'Reilly

Transmission

Human to human transmission can occur in several ways:

through close direct contact with the rash or body fluids of an infected person.
through exposure to virus-contaminated objects, such as bedding or clothing.
through infected respiratory droplets during prolonged face-to-face contact.
in healthcare settings when there are breaches in infection control.
during pregnancy via the placenta.

Animal to human transmission can occur through bites, contact with blood or other bodily fluids, or touching the rash on an infected animal's skin.

Symptoms

People usually become sick about 5 to 21 days after they have contact with the mpox virus. The first symptoms are flu-like: fever, headache, muscle aches, backache, swollen lymph nodes, chills and a general feeling of discomfort and exhaustion. About one to three days after the fever begins, patients develop a rash. The rash can be painful and involve any area, including the face, mouth, arms, legs, hands, feet, genital and perianal area. The rash progresses through several stages, forming blisters, which become pustular, before crusting and falling off. The disease can be severe with skin infection, involvement of the cornea (clear part of the eye), pneumonia, and inflammation of the brain. Most people usually recover within about 2 to 4 weeks, although there can be long-term scarring of the skin or cornea. Severe infections can be fatal. Children and people with immune deficiency are at higher risk of severe disease.

People are thought to be infectious until all the crusts have fallen off, however, some authorities advise using condoms for a further 12 weeks.

Diagnosis

The diagnosis is made by laboratory testing of blood, swabs of the rash and other parts of the body.
Specialised laboratories can test for mpox. Testing capabilities may be limited in some locations.

Treatment

Antiviral medications to treat mpox are in limited supply. Authorisation, availability and treatment protocols differ from one country to another.

Tecovirimat is an antiviral medication that was developed for smallpox. It was licensed by the European Medical Association (EMA) for mpox in 2022. Other potentially beneficial antivirals are cidofovir and brincidofovir.

Some locations are using intravenous antibody treatment.

Research and development are ongoing.

Vaccination

There are three vaccines which were developed against smallpox that are being used to prevent mpox. Their authorisation, indications, guidelines for use and eligibility differ between jurisdictions. Supply is limited. In outbreak situations vaccination may be reserved for people at highest risk, including healthcare workers, household contacts and intimate partners,

JYNNEOS also known as Imvamune and Imvanex, is a "third generation" smallpox vaccine which contains a live but weakened virus that cannot multiply in the body. The primary vaccination course requires two doses, given 28 days apart. When used after exposure to mpox, it should be ideally given within 4 days of exposure, but up to 14 days later. In some jurisdictions, the vaccine can be used in children in certain circumstances. In September 2024, the European Medicines Agency recommended extending use from adults to include adolescents aged 12 to 17.
LC16 is a "third generation" smallpox vaccine which uses a live but weakened virus. It requires a single dose, has been used in children in the past, and some authorities recommend it as the preferred preparation for children.
ACAM2000 is an older "second generation" smallpox vaccine which also contains live weakened but "replicating" virus. There are greater potential risks and side effects compared to the Jynneos preparation.

There are other mpox vaccines in various stages of research and development.
See the World Health Organization Mpox Vaccine Tracker - List of vaccine candidates in research & development 30 August 2024

Prevention

In addition to vaccination, prevention is through:

Observing good personal hygiene:
- Washing hands well and often.
- Avoiding skin-to-skin contact, including avoiding crowds and minimising bare skin if likely to be in crowded environments.
- Avoiding contact with objects and materials that may be contaminated with mpox (used towels, bed linen).
Preventing sexual transmission.
- Limiting the number of sexual partners.
- Wearing condoms for a further 12 weeks after recovering from a mpox infection. Using condoms reduces the risk of exposure to mpox but does not prevent infection through close physical contact.
Taking extra precautions if caring for a sick person, and cleaning areas / items that have been used by them. This includes isolation as much as practically possible, not sharing items, using a face mask (infected person) and respirator (carer) when in contact with each other, using gloves to handle contaminated items, and cleaning frequently in a safe manner ("wet methods", vaccuum using device with high-efficiency filter, using N95 or equivalent respirator). For more information see the United States Centers for Disease Control and Prevention guidelines for Isolation and Infection Control in the Home

In areas where mpox is present in animals, additional preventive measures are:

Avoiding contact with wild animals.
Avoiding touching objects which have been in contact with animals.
Avoiding preparing or eating "bush meat" (wild game).

Risk to travellers

International SOS is monitoring the situation closely.
The risk to travellers is low if they avoid direct contact with infected people, and animals.
Alerts for outbreaks of mpox are published on the International SOS location guides.
Enhanced entry screening has been implemented in some locations, See the Mpox Screening and Travel Restrictions page

Trackers

WHO Mpox Dashboard

Joint ECDC-WHO Regional Office for Europe Mpox Surveillance Bulletin

Our World In Data Mpox Data Explorer

Quick Links