Mpox outbreak in Africa: ongoing public health emergency
The World Health Organization (WHO) declared the current mpox outbreak in Africa a public health emergency of international concern (PHEIC) in August 2024, and this has since been reaffirmed multiple times.
In the past 12 months, approximately 41,000 laboratory-confirmed cases of mpox have been reported in Africa, including 167 deaths (as of 3 August 2025). The three countries with the majority of cases were the DRC, Uganda, and Sierra Leone.[13]
The current spread of mpox in Africa is attributed to two distinct ongoing outbreaks in the DRC:
A clade Ia outbreak primarily in mpox-endemic areas mainly affecting children.
A clade Ib outbreak in the eastern part of the country that has been rapidly spreading and reaching neighboring countries that have not previously reported mpox cases. The outbreak is affecting both children and adults, and is spreading rapidly among adults through close contact including sexual contact identified within networks of sex workers and their clients.
Imported travel-related cases of clade Ib mpox have also been reported in countries outside of the African continent. As of 8 August 2025:[13]
In the UK, 10 confirmed cases have been reported. Most cases were imported, with three cases due to secondary household transmission from an imported case, and one case with no travel history or reported link with a confirmed case.
In the US, 5 confirmed cases have been reported. All cases were in people who had recently traveled to affected areas in Central and Eastern Africa, and the cases were not linked.
Other countries include: Australia, Belgium, Brazil, Canada, China, France, Germany, India, Ireland, Italy, Oman, Pakistan, Qatar, South Africa, Sweden, Switzerland, Thailand, Turkey, and the United Arab Emirates.
The WHO has assessed the overall global public health risk to be moderate. The risk is high for clade Ib mpox, and moderate for all other clades (as of June 2025).[25] The wider risk to the general population in the UK and US is low.
Updated information on the situation is available from public health authorities.
This is the second time the WHO has declared an mpox outbreak to be a PHEIC, with the first one declared in July 2022 due to a global outbreak in countries that had not previously experienced cases. This outbreak was due to the clade IIb variant. The emergency was declared over in May 2023 as the number of cases had decreased significantly since their peak in August 2022. However, clade II mpox is still circulating globally with outbreaks in many countries.
Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- rash/lesion(s)
- anorectal symptoms
- fever
- lymphadenopathy
Otros factores de diagnóstico
- fatigue/asthenia/malaise
- myalgia
- headache
- sore throat
- backache
- cough
- nausea/vomiting
- diarrhea
- delirium/confusion
- seizures
Factores de riesgo
- recent travel to/living in endemic country or country with outbreak
- contact with suspected, probable, or confirmed case
- occupational exposure
- unprotected sexual encounters or multiple sexual partners
- recent tattoo or piercing
- contact with infected animal
- children (severe disease)
- pregnant women (severe disease)
- immunocompromised (severe disease)
- HIV infection (severe disease)
- sexually transmitted infection (STI)
- acute or chronic skin conditions (severe disease)
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- reverse-transcription polymerase chain reaction (RT-PCR)
- CBC
- blood urea nitrogen and electrolytes
- LFTs
- sexually transmitted infection (STI) tests
Pruebas diagnósticas que deben considerarse
- CT abdomen/pelvis
- serology
- blood culture
- malaria antigen test
Algoritmo de tratamiento
Colaboradores
Autores
David L. Heymann, MD, DTM&H
Professor of Infectious Disease Epidemiology
London School of Hygiene and Tropical Medicine
University of London
Head
Centre on Global Health Security - Chatham House
London
UK
Disclosures
DLH declares that he has no competing interests.
Acknowledgements
Dr David L. Heymann would like to gratefully acknowledge Dr Tom Blanchard, the previous contributor to this topic.
Disclosures
TB is the principal investigator on an MRC/Wellcome/Newton Fund grant to make a Zika vaccine based on recombinant modified vaccinia Ankara.
Peer reviewers
Miguel G. Madariaga, MD, MSc, FACP
Infectious Diseases Consultant
Naples Community Hospital
Naples
FL
Disclosures
MGM declares that he has no competing interests.
Jimmy Whitworth, MD, FRCP, FFPH, FMedSci, DTM&H
Emeritus Professor
London School of Hygiene & Tropical Medicine
London
UK
Disclosures
JW declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
World Health Organization. Clinical management and infection prevention and control for mpox: living guideline, May 2025. Jun 2025 [internet publication].Full text
Centers for Disease Control and Prevention. Clinical overview of mpox. Apr 2025 [internet publication].Full text
World Health Organization. Surveillance, case investigation and contact tracing for mpox: interim guidance, 27 November 2024. Dec 2024 [internet publication].Full text
Centers for Disease Control and Prevention. Clinical treatment of mpox. Aug 2025 [internet publication].Full text
World Health Organization. Diagnostic testing for the monkeypox virus (MPXV): interim guidance. May 2024 [internet publication].Full text
Centers for Disease Control and Prevention. Clinical considerations for pain management. Sep 2024 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available here.
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