Epidemiological summary

Since June 2026, the number of reported mpox cases in the EU/EEA has increased, driven primarily by an increase in reported clade I cases, while the number of reported clade II mpox cases has continued to decline.
Trends should be interpreted with caution, as case notifications, clade information and other epidemiological data may be updated retrospectively.

Current month (September 2026)

Clade I

  • A total of 342 mpox cases caused by clade I MPXV were reported by 17 countries, with the largest number of cases being reported by Spain (94).

  • For comparison, in August, 354 cases were reported by 18 countries, and in July, 317 cases were reported by 13 countries.


Clade II

  • In September 2026, three mpox cases caused by clade II MPXV were reported by three countries: Denmark, France and Portugal.

  • For comparison, in August, seven cases were reported by three countries, and in July, 22 cases were reported by five countries.

Past 12 months (October 2025 to September 2026)

In the past 12 months, 23 countries have reported 1 939 clade I mpox cases and 19 countries have reported 751 clade II mpox cases.

  • In total, 91% of the clade I mpox cases and 91% of the clade II mpox cases with complete information were reported among men who have sex with men.

  • Overall, 13% of the clade I mpox cases and 7% of the clade II mpox cases with complete information were hospitalised.

  • A total of 18% of the clade I mpox cases and 18% of the clade II mpox cases with complete information were vaccinated with two doses.

Implications for prevention and control

ECDC’s latest advice on mpox is available in the ‘Threat Assessment Brief on the detection of autochthonous transmission of monkeypox virus (MPXV) clade Ib in the EU/EEA’ published in October 2025.

Countries should prioritise:

  • Increasing vaccination uptake, particularly among populations at higher risk of exposure.

  • Sequencing positive cases and sharing genomic data to support surveillance and risk assessment.

Data sources and methods

This report presents data on mpox cases reported to the European Surveillance System (EpiPulse Cases). EU/EEA countries report case-based data on diagnosed mpox cases. For case numbers by country, the Western Balkans and Türkiye are included.

The epicurve shown includes all mpox cases reported since 2022. The rest of the report includes data on the total number of cases in the past full 12 calendar months (October 2025 to September 2026).

Cases are analysed by date of diagnosis. This report includes cases reported to ECDC as of 13 October 2026.

Epicurves

Total number of mpox cases – all clades – from January 2022 and as of 13 October, EU/EEA

Total number of mpox cases by clade, by month of diagnosis in the past 12 months (October 2025 to September 2026), EU/EEA

Mpox cases by clade and country in the past 12 months (October 2025 to September 2026), EU/EEA

The five countries with the largest number of cases in the past 12 months are shown separately and all other countries that reported cases are grouped as ‘Other’

Maps

Mpox cases by clade in the past 12 months (October 2025 to September 2026), EU/EEA and the Western Balkans and Türkiye

Clade I

Clade II

Tables

Mpox cases by clade in the past 12 months (October 2025 to September 2026), and past calendar month (September 2026), EU/EEA and the Western Balkans and Türkiye

Mpox cases by age and sex in the past 12 months (October 2025 to September 2026), EU/EEA

The distributions by age and gender of clade I and clade II are similar.

Mpox cases by sexual behaviour reported in people aged 15 years and above in the past 12 months (October 2025 to September 2026), EU/EEA*

The vast majority of mpox cases in clade I and clade II are among men who have sex with men.

Mpox cases by hospitalisation status in the past 12 months (October 2025 to September 2026), EU/EEA

The percentage of cases hospitalised is higher in clade I mpox cases than in clade II mpox cases.

In the past 12 months there have been two deaths reported in people infected with clade II. One death has been reported in a person infected with clade I.

Mpox cases by vaccination status in the past 12 months (October 2025 to September 2026), EU/EEA

Among cases with known vaccination status, the majority of both clade I and clade II mpox cases were not vaccinated.

Mpox cases by travel status in the past 12 months (October 2025 to September 2026) and past calendar month (September 2026), EU/EEA

The proportion of travel-related cases has been low and similar between clade I and clade II over the past 12 months.

ASSESSMENT

Following a decline between April and June, the overall number of reported mpox cases in the EU/EEA increased in July and August, and this trend continued into September. Clade I cases represent the majority of cases with known clade information, while reported clade II cases remain low and continue to decline.

Clade I mpox case notifications from the EU/EEA suggest ongoing transmission across the region, primarily among men who have sex with men. In terms of severity, hospitalisation rates remain low overall but are higher in clade I than in clade II mpox cases. Information from Member States suggests that clinical presentation is generally mild, including among hospitalised cases.

Trends should be interpreted with caution, as case notifications, clade information and other epidemiological data may be updated retrospectively.

ACTIONS

ECDC is continuously monitoring mpox in the EU/EEA and globally through event- and indicator-based surveillance, and remains in contact with partners. ECDC’s ‘Threat Assessment Brief on the detection of autochthonous transmission of monkeypox virus (MPXV) clade Ib in the EU/EEA’ was published on 24 October 2025. It summarises actions that EU/EEA countries can take, and the knowledge gaps that remain. ECDC is in contact with affected countries to gather further information and consider response options.

Increasing vaccination uptake is the single most important measure for mitigating the spread of both clades.

Health promotion interventions and community engagement are also critical to ensure effective outreach and high vaccine acceptance and uptake among those most at risk of exposure.

Further response options for EU/EEA countries include raising awareness among healthcare professionals, supporting sexual health services in case detection, contact tracing, case management, and making testing easily accessible.

Countries should continue efforts to sequence all positive cases and ensure that sequences are deposited in public repositories (European Nucleotide Archive (ENA), Sequence Read Archive (SRA), and/or GISAID EpiPox) or shared with ECDC through the EpiPulse platform or other means.