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 (April 2025 to March 2026).

Epidemiological summary

In March 2026, 80 mpox clade I cases were reported by 10 countries, with the most cases being reported by Spain (23). In February, 78 cases were reported by 11 countries and in January 89 cases were reported by eight countries.

In March 2026, 22 mpox clade II cases were reported by seven countries, with the most cases being reported by Spain (11). In February, 63 cases were reported by nine countries and in January 98 cases were reported by eight countries.

In the past 12 months, 15 countries reported 336 clade I cases and 17 countries reported 1 016 clade II cases.

  • 95% of the clade I cases and 92% of the clade II cases with complete information were reported among men who have sex with men.

  • 14% of the clade I cases and 7% of the clade II cases with complete information were hospitalised.

  • 23% of the clade I cases and 18% of the clade II cases with complete information were vaccinated with two doses.

Epicurves

Total number of mpox cases – all clades – from Jan 2022 and as of April 30, EU/EEA countries

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

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

Clade I

Clade II

TABLES

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

Mpox cases by age and sex in the past 12 months (April 2025 to March 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 (April 2025 to March 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 (April 2025 to March 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 (April 2025 to March 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 (April 2025 to March 2026) and past calendar month (March 2026), EU/EEA

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

ASSESSMENT

Following an increase in the number of mpox clade I cases reported to ECDC during the end of 2025 and until January when 89 cases were reported, 78 cases were reported in February and 80 cases in March. In March, the most mpox clade I cases were reported by Spain (23) and Germany (19). In February, Spain had 27 cases and Germany 22. In addition to these cases reported through case based surveillance, Denmark and Slovakia have reported their first cases of mpox clade I to ECDC through event-based surveillance indicating ongoing transmission among MSM across the EU/EEA (Denmark 2 cases and Slovakia 5 cases with dates in March and April). A limitation to the interpretation of trends is that not all cases have clade reported - several cases were reported in March with unknown clade (Italy 10 cases, France 11 cases and Spain 12 cases). In terms of severity, the rate of hospitalisation is low and largely similar between clade I and clade II (14% vs 7%). Direct communication with Member States shows that even among hospitalised cases symptoms are in most cases not severe.

Most cases of both clades are among those not vaccinated.

With the commencement of the spring and summer season, increased travel and attendance at mass gatherings such as Pride events there is a risk for further spread of both clade I and clade II of mpox.

This highlights the need for Member States to increase efforts to vaccinate and raise awareness among men who have sex with men in particular.

ECDC published a Threat Assessment Brief on October 24, 2025 to assess the new situation and this risk assessment remains valid: The risk of clade Ib infection is assessed as moderate for men who have sex with men and low for the general population in the EU/EEA. The risk for clade IIb infection remains low for men who have sex with men and very low for the general population in the EU/EEA.

While early cases of clade I were imported from outside the EU/EEA and among hererosexuals and their close household and other contacts, most cases are now among MSM, as expected.

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.