ETIDIOH - NEW

  Highlights • All clades of monkeypox virus (MPXV) continue to circulate.  - Unless mpox outbreaks are rapidly contained and human-to-human transmission is interrupted, there is a risk of sustained community transmission .   • At the time of reporting, data from the WHO European Region for December 2025 had not yet been submitted; therefore, the information presented below does not include the European Region .  • In December 2025 , 31 countries across five WHO regions (European Region excluded) reported a total of 1040 new confirmed mpox cases , including six deaths (case fatality ratio [CFR] 0.6%).  - Of these cases, 78% were reported in the African Region .  - Four regions observed a decline in confirmed cases in December, compared to November 2025, while the Eastern Mediterranean Region reported more cases than the previous month.      • Fifteen countries in Africa reported active transmission of mpox in the last six weeks (7 Decemb...

Abstract Monkeypox (MPOX) is an emerging zoonotic disease caused by monkeypox virus (MPXV), an orthopoxvirus closely related to smallpox . Initially confined to endemic regions in Central and West Africa , MPOX has recently gained global significance with outbreaks reported across multiple continents . MPXV is maintained in animal reservoirs but is increasingly transmitted from person to person , facilitated by close contact, respiratory droplets , and, in some cases, sexual transmission . Clinically, MPOX presents with fever, lymphadenopathy, and a characteristic vesiculopustular rash , though atypical manifestations have been observed in recent outbreaks, complicating diagnosis. Laboratory confirmation relies on molecular testing , while differential diagnosis must consider varicella, herpes, and other vesicular illnesses. Therapeutic options remain limited ; supportive care is the cornerstone of management, but antivirals such as tecovirimat and brincidofovir, as well as smallpox va...

ABSTRACT Faced with the global monkeypox outbreak, current vaccine development predominantly focuses on the mRNA platform despite its limitations in stability and long-term efficacy. Here, we engineered a recombinant vesicular stomatitis virus (rVSV)-vectored cocktail vaccine encoding four conserved monkeypox virus (MPXV) antigens (A35R, A29L, M1R, and B6R; >94% clade homology), leveraging the thermostable properties of the VSV platform validated for 4°C storage in Ebola vaccines. In BALB/c mice , this multi-antigen vaccine elicited a rapid humoral response with specific IgG detectable by day 7, effectively neutralized the virus, and induced a robust Th1/Th2 balanced cytokine response . Immunization conferred 100% survival against lethal vaccinia virus WR strain challenge , with undetectable viral loads in the lungs and serum , and sustained efficacy against secondary infection at 60 days. Histopathology confirmed minimal lung damage in vaccinated mice . Crucially, upon the successi...

  Highlights •  Epidemiological parameters differ by pathogen and by setting. •  Unsupervised machine learning classifies pathogens into distinct epidemiological archetypes. •  Pathogens can be allocated into defined groups outlining plausible parameter ranges across epidemiologically similar pathogens. Abstract Introduction In the light of the COVID-19 pandemic many countries are trying to widen their pandemic planning from its traditional focus on influenza . However, it is impossible to draw up detailed plans for every pathogen with epidemic potential. We set out to try to simplify this process by reviewing the epidemiology of a range of pathogens with pandemic potential and seeing whether they fall into groups with shared epidemiological traits. Methods We reviewed the epidemiological characteristics of 19 different pathogens with pandemic potential (those on the WHO priority list of pathogens, different strains of influenza and Mpox). We extracted data on key pa...

  Summary Background Given the continued global circulation of monkeypox virus (MPXV), we aimed to assess the long-term clinical consequences of MPXV infection and the continued presence of the virus in saliva, semen, and the anorectum . We also aimed to compare long-term antibody dynamics after MPXV infection with modified vaccinia Ankara–Bavarian Nordic (MVA-BN) vaccination. Methods In this mixed retrospective and prospective cohort study, adults with acute MPXV infection at the Institute of Tropical Medicine (Antwerp, Belgium) were enrolled in a clinical registry (MPX-COHORT) from May 13, 2022, with follow-up at 1 month after infection. On Oct 3, 2022, we initiated a long-term follow-up study (POQS-FU-PLUS) to extend follow-up of people with mpox and to establish a parallel cohort of adults who received MVA-BN vaccination between Aug 3, 2022, and Jan 4, 2023. Participants were eligible for the second cohort if they received two doses of MVA-BN, unless they had previous smallpox ...

  Last updated 27 October 2025 Latest update UKHSA is aware of small numbers of locally-acquired cases of clade Ib mpox in the USA , Spain, Italy , the Netherlands and Portugal which have no connection to countries with known clade Ib mpox transmission.   This suggests there is now community transmission of clade Ib mpox globally . Most of the new cases identified in Europe and the USA have been in gay, bisexual and other men who have sex with men , a population in which clade Ib mpox transmission has not previously been observed.   Mpox is usually a mild infection , and clade Ia and Ib mpox are no longer classified as a high-consequence infectious disease (HCID). However, it can be severe in some cases.  The UK has a routine mpox vaccination programme in place for eligible groups, including those who:   -- have multiple sexual partners   -- have group sex   -- visit sex-on-premises venues   Studies show that the vacc...

  ABSTRACT Mpox, caused by monkeypox virus (MPXV) infection, has emerged as a significant global health threat . The World Health Organization (WHO) has twice declared a Public Health Emergency of International Concern for mpox: first for the 2022–2023 global outbreak and subsequently for concurrent outbreaks in Africa. Beyond MPXV, other members of the Orthopoxvirus genus also pose growing risks of zoonotic spillover , with the potential to jump from animal reservoirs to humans . Clinically, mpox is distinguished from other Orthopoxvirus infections by its propensity to cause severe systemic manifestations alongside localized skin lesions , disproportionately affecting vulnerable groups such as children, pregnant women, and immunocompromised individuals . Although vaccines are available, effective therapeutics are equally essential in combating the mpox crisis. Current antiviral agents , including tecovirimat and brincidofovir , have demonstrated uncertain or disappointing efficacy...

Abstract Monkeypox virus (MPXV) has re-emerged globally since May 2022, posing a significant public health threat . To address this, we develop two multivalent mRNA vaccine candidates —AAL, encoding three MPXV antigens, and AALI, which combines AAL with an immune-enhancing IFN-α protein. Both vaccines are delivered via mannose-modified lipid nanoparticles to target dendritic cells . Here we show that these vaccines elicit strong antibody responses against vaccinia virus and multiple MPXV clades , induce robust memory B-cell and T-cell responses, and promote dendritic cell maturation . In mouse challenge models , both vaccines provide protection against clade IIb MPXV and vaccinia virus , significantly reducing viral loads and preventing lung damage. Immune profiling reveals enhanced B- and T-cell receptor diversity and distinct CDR3 motifs post-vaccination. These findings demonstrate the potential of using mRNA-based multivalent vaccines as an effective strategy for preventing mpox and...

Abstract Mpox was first identified against the backdrop of the smallpox eradication campaign. Monkeypox virus (MPXV), the causative agent of mpox, has been maintained in animal reservoirs in the forested regions of West and Central Africa as 2 distinct clades ; clade I has historically caused more severe infection in Central Africa than clade II , historically found in West Africa . However, rapid reemergence and spread of both MPXV clades through novel routes of transmission have challenged the known characteristics of mpox. We summarize mpox demographic distribution , clinical severity , and case-fatality rates attributed to genetically distinct MPXV subclades and focus on MPXV clade Ib, the more recently identified subclade. Broad worldwide assistance will be necessary to halt the spread of both MPXV clades within mpox endemic and nonendemic regions to prevent future outbreaks. Source: US Centers for Disease Control and Prevention,  https://wwwnc.cdc.gov/eid/article/31/8/24-1551...

Summary Background Clade I monkeypox virus is endemic in DR Congo. We aim to describe the epidemiological trends of the cocirculating subclades Ia and Ib mpox outbreaks in Kinshasa, DR Congo. Methods This retrospective observational study included suspected and laboratory-confirmed mpox cases reported between Jan 1, 2023, and Oct 31, 2024, in Kinshasa. Skin lesion swabs or blood samples were collected as part of a routine countrywide mpox surveillance programme. To confirm the diagnosis of mpox, all samples were tested at the Institut National de Recherche Biomédicale (INRB) using real-time PCR. Whole-genome sequencing was conducted for phylogenomic analysis and assessment of APOBEC3 type mutations. Samples that remained unassigned to subclade Ia or Ib after whole-genome sequencing and real-time PCR were labelled as an unknown subclade. Findings As part of routine disease surveillance, 1479 suspected mpox cases were reported in Kinshasa. Samples were collected from 1314 suspected mpox ...

Abstract Mpox clade Ib is significant as it is associated with human cases and plays a key role in understanding the transmission and public health implications of mpox outbreaks. Here we present a case report of the first confirmed human infection of clade Ib in China , which occurred in December 2025 in Zhejiang Province. The case was a 28-year-old woman from South Africa who had sexual contact with an asymptomatic man from the Democratic Republic of the Congo . She presented with disseminated vesicular lesions on the extremities, face, buttocks, trunk, palms, and dorsum of the hands, but lesions were absent from the oral cavity, perineum, and anus. By the 18th day post-onset (DPO), only vesicles remained on the dorsum of the right foot and in the finger web spaces, with complete resolution by the 24th DPO. Among 59 consecutive samples collected, 55 tested positive for mpox virus . Oropharyngeal swabs turned negative by the 16th DPO, while skin lesion samples, urine samples, and scab...

Summary Background Mpox, caused by the monkeypox virus, is a serious public health threat in Africa , especially in DR Congo . Previously limited to endemic areas with clade 1a, monkeypox virus has recently spread to non-endemic regions, where clade 1b has emerged . This study provides a clinical comparison of mpox cases in DR Congo regions where clade 1a and clade 1b are prevalent. Methods We conducted a retrospective observational study , analysing PCR-confirmed mpox cases reported from sentinel health zones in seven provinces between Oct 1, 2023, and Sept 31, 2024. Cases from the newly affected provinces (South-Kivu and Kinshasa) were described along with those from four endemic provinces (Mai-Ndombe, Tshuapa, Tshopo, South-Ubangi, and Équateur). Surveillance data, including type of exposure, demographic details, clinical presentation, complications, and outcomes were collected from national surveillance systems and local health facilities, with laboratory confirmation using quantit...

Abstract The COVID-19 pandemic has increased the interest in the use of wastewater-based surveillance (WBS) strategy for infectious disease monitoring, especially when clinical cases are underreported. The excretion of monkey virus (MPXV) in the feces of both symptomatic and preclinical individuals has further driven the interest in WBS applicability to MPXV monitoring in wastewater to support its mitigation efforts. We performed a systematic review with meta-analysis, using six databases to assess MPXV detection in wastewater. We performed a random-effects model meta-analysis to calculate the pooled prevalence at a 95% confidence interval (95% CI). Also, we carried out a subgroup analysis according to the country regions and a sensitivity analysis excluding studies classified as having a high risk of bias. The overall MPXV positivity rate in wastewater was estimated at 22% (95% CI: 14−30%; I2 = 94.8%), with more detection rate in North America (26%, 95% CI: 8–43%) compared to Europe a...

{Excerpt} The zoonotic Orthopoxvirus monkeypox virus includes two main clades (ie, 1 and 2) relevant to human transmission .1 Two major outbreaks of monkeypox virus have occurred since 2022,1–3 and were declared public health emergencies of international concern by WHO in July, 2022, and August, 2024. The first outbreak was caused by a clade 2b strain that quickly spread worldwide, resulting in approximately 100 000 cases and 200 deaths.3 In the second outbreak, the novel clade 1b emerged .4 As of December, 2024, this upsurge has resulted in more than 55 000 reported or suspected cases and approximately 1000 deaths in DR Congo and neighbouring countries, including Burundi, Rwanda, Uganda , and Angola .4 A few imported clade 1b cases have also been reported in the UK, Sweden, Germany, Belgium, France, the USA, Canada , and Thailand .5 Prevention measures include patient isolation and care as well as vaccines. (...) Source: Lancet Infectious Diseases,  https://www.thelancet.com/journ...

Abstract We previously reported that mice immunized twice with a lipid nanoparticle vaccine comprising four monkeypox viral mRNAs raised neutralizing antibodies and antigen-specific T cells and were protected against a lethal intranasal challenge with vaccinia virus (VACV). Here we demonstrated that the mRNA vaccine also protects mice against intranasal and intraperitoneal infections with monkeypox virus and bioluminescence imaging showed that vaccination greatly reduces or prevents VACV replication and spread from intranasal, rectal, and dermal inoculation sites. A single vaccination provided considerable protection that was enhanced by boosting for at least 4 months. Protection was related to the amount of mRNA inoculated, which correlated with neutralizing antibody levels . Furthermore, immunocompetent and immunodeficient mice lacking mature B and T cells that received serum from mRNA-immunized macaques before or after VACV challenge were protected. These findings provide insights i...