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

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.
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