Overview

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

An epicurve is shown including 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 (May 2025 to April 2026).

Cases are analysed by date of diagnosis. This report includes cases reported to ECDC as of 31 May 2026.

Epidemiological summary

In April 2026, 102 mpox cases caused by clade I MPXV were reported by 11 countries, with the most cases being reported by Spain (33). In March, 98 cases were reported by 12 countries, and in February, 82 cases were reported by 11 countries.

In April 2026, 23 mpox cases caused by clade II MPXV were reported by seven countries, with the most cases being reported by Germany (12). In March, 31 cases were reported by eight countries, and in February, 64 cases were reported by 10 countries.

In the past 12 months, 16 countries reported 458 clade I mpox cases and 18 countries reported 921 clade II mpox cases.

  • 92% 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.

  • 13% of the clade I mpox cases and 8% of the clade II mpox cases with complete information were hospitalised.

  • 22% of the clade I mpox cases and 17% of the clade II mpox cases with complete information were vaccinated with two doses.

Epicurves

Total number of mpox cases – all clades – from Jan 2022 and as of May 31, EU/EEA countries

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

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

The five countries with most 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 (May 2025 to April 2026), EU/EEA and Western Balkans and Türkiye

Clade I

Clade II

TABLES

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

Mpox cases by age and sex in the past 12 months (May 2025 to April 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 15 years and older in the past 12 months (May 2025 to April 2026), EU/EEA

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

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

Rates of hospitalisation are similar between clade I and clade II.

In the past 12 months there has been one death reported in a person infected with clade II. No deaths reported in people infected with clade I.

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

The majority of both clade I and clade II cases are not vaccinated.

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

The proportion of travel related cases is low and similar between clade I and clade II.

ASSESSMENT

The number of reported clade I mpox cases in the EU/EEA remains relatively stable, while clade II mpox cases show a decreasing trend.

Following an increase in late 2025, the number of clade I mpox cases stabilised in 2026, with 90 cases reported in January, 82 in February, 98 in March, and 102 in April. In April, the highest numbers of clade I mpox cases were reported by Spain (33) and Germany (30), compared with 34 and 19 cases respectively in March. Additional EU/EEA countries also reported clade I mpox cases in April, suggesting ongoing transmission across the region, primarily among men who have sex with men.

In contrast, clade II mpox cases have declined month-to-month.

Interpretation of these trends remains limited due to missing clade information for approximately 39% of reported cases in the past 12 months, including 40% of cases reported in April. In addition, one case with co-infection with both clade I and clade II was coded as clade II in the dataset.

In terms of severity, hospitalisation rates remain low and broadly similar between clade I and clade II infections (13% vs 8%). Information from Member States suggests that clinical presentation is generally mild, including among hospitalised cases.

ACTIONS

Increasing vaccination uptake is the single most important intervention to mitigate the spread of both clades in the spring and summer season. Primary preventive vaccination (PPV) and post-exposure preventive vaccination (PEPV) strategies may be combined to focus on individuals at substantially higher risk of exposure and close contacts of cases, respectively, particularly in the event of limited vaccine supply. PPV strategies should prioritise gay, bisexual, and transgender people, and men who have sex with men, who are at higher risk of exposure, as well as individuals at risk of occupational exposure, based on epidemiological or behavioural criteria. 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, and case management and making testing easily accessible.

The 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 the information on the new cases and outlines actions EU/EEA countries can take, as well as the knowledge gaps that remain.

ECDC is continuously monitoring mpox in the EU/EEA and globally through event- and indicator-based surveillance, and remains in contact with partners. ECDC is in contact with affected countries to gather further information and consider response options.

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