After more than three years of global mpox transmission, the world is seeing meaningful declines in new infections. Yet the World Health Organization’s (WHO)most recent global mpox assessment, released on Oct. 30 2025—cautions that these gains remain fragile. While global mpox cases have fallen since their peak earlier this year, the virus continues to adapt and expand geographically, with new community transmission of clade Ib MPXV now confirmed outside Africa.
Between 1 January and 30 September 2025, WHO received reports of 44,299 confirmed cases and 180 deaths across 93 countries. September alone saw 3,135 new confirmed cases and 12 deaths (a case fatality ratio of 0.4%), with over 80% of all cases reported from Africa.
Four WHO regions—the African, Eastern Mediterranean, Region of the Americas, and Western Pacific—recorded declining case trends in September, while Europe and South-East Asia saw increases, up 14% and 77% respectively compared to August.
Key Data and Highlights
- Total cases (Jan–Sep 2025): 44,299 confirmed; 180 deaths
- Countries reporting (2025): 93
- Highest-burden African countries (Sep–Oct 2025):
- Democratic Republic of the Congo: 1,189 cases, 2 deaths
- Liberia: 425 cases, 4 deaths
- Kenya: 285 cases, 3 deaths
- Ghana: 215 cases, 2 deaths
- September 2025 cases: 3,135 confirmed in 42 countries
- Active community transmission of clade Ib MPXV:
- In Africa: Democratic Republic of the Congo, Kenya, Liberia, Ghana
- Outside Africa: Italy, Malaysia, the Netherlands, Portugal, Spain, and the United States
- New countries detecting clade Ib MPXV for the first time: Malaysia, Namibia, the Netherlands, Portugal, and Spain
- Countries with imported clade Ib cases: Belgium, Canada, Germany, Italy, Qatar, and Spain
Africa: The Epicenter of Decline and Risk
Africa remains at the center of the mpox response, accounting for 39,799 confirmed cases and 178 deaths as of 19 October 2025. While overall trends are down, WHO warns against assuming uniform progress.
In the Democratic Republic of the Congo, case counts are declining steadily, contributing significantly to the continental decrease. Conversely, Kenya and Liberia are reporting renewed increases. Liberia’s 2025 total stands at over 1,095 confirmed cases and six deaths, most concentrated in Montserrado County near the capital, Monrovia. Initially linked to cross-border travel from Sierra Leone, most recent infections have no travel history, indicating sustained local transmission.
Kenya’s outbreak—currently 708 confirmed cases and nine deaths—is dominated by clade Ib MPXV, now detected in 31 of 47 counties. Mombasa alone accounts for 41% of all cases. All reported deaths occurred in people living with HIV, emphasizing the intersection between mpox and immunocompromising conditions.
The Expanding Reach of Clade Ib
WHO’s report marks a turning point in mpox surveillance: the emergence of sustained local circulation of clade Ib MPXV outside historically endemic regions. Since September 2025, six countries—Italy, Malaysia, the Netherlands, Portugal, Spain, and the United States—have confirmed cases without travel history. At least five of these cases occurred among men who have sex with men (MSM), offering the first documented evidence of clade Ib circulation within this population network, previously associated only with clade IIb infections.
The report notes that these trends suggest undetected transmission and possible asymptomatic or mild infections, particularly among younger, immunologically naïve individuals who were not reached during vaccination campaigns in 2022–2023. Emerging data on waning humoral immunity from prior vaccination adds urgency to monitoring efforts.
Maintaining Vigilance in a Shifting Epidemiological Landscape
WHO continues to assess the public health risk of clade Ib MPXV as moderate for MSM and low for the general population. However, it warns that insufficient contact tracing, stigma-related underreporting, and reduced funding for HIV/STI programs could enable undetected transmission chains.
The report calls for:
- Sustained contact tracing and genomic sequencing, even as overall case counts fall;
- Targeted vaccination of at-risk populations, including MSM and healthcare workers;
- Integration of mpox, HIV, and STI prevention services; and
- Strengthened community engagement and risk communication, particularly in urban centers and travel hubs.
In low-income settings, cuts to HIV testing and prevention funding threaten to undermine mpox control. WHO’s concurrent guidance on sustaining essential HIV and STI services warns that reduced diagnostic and preventive capacity could elevate overall outbreak risks.
Multi-country outbreak of mpox, External situation report #59. World Health Organization, 30 October 2025