Europe (Vax-Before-Travel News)

In light of the first detections of locally acquired mpox clade Ib cases in the European Union and the European Economic Area (EU/EEA), the European Center for Disease Prevention and Control (ECDC) is urging increased awareness and targeted prevention measures.

As of October 24, 2025, the ECDC stated locally acquired mpox cases have now been confirmed in four EU/EEA countries.

Spain reported its first such case on October 10, 2025, and the Netherlands reported its first such case on October 17, 2025.

These have been followed by additional cases reported in Italy (2) and Portugal (1).

This development is distinct from the previously reported travel-associated clade Ib cases.

These new cases have been reported among men, some of whom identify themselves as men who have sex with men, with no recent travel history to mpox-endemic areas. This indicates that transmission may be ongoing in sexual networks among men who have sex with men in European countries. 

Transmission among gay, bisexual, and other men who have sex with men and their social networks has also been recently reported in the Los Angeles, California area, after the detection of three unlinked clade Ib cases.

Some uncertainties remain regarding the transmissibility and clinical severity of clade Ib compared to the clade IIb virus that has circulated since 2022. Among the 29 clade Ib cases reported to ECDC before the current cases, seven were hospitalized; however, given the small number of cases, any comparison in severity with clade IIb is uncertain. 

While the immediate risk to the general population of acquiring the disease is low, the overall risk of infection is moderate for men who have sex with men. The risk of severe disease may be higher for those living with untreated HIV.  

Doctors should consider offering post-exposure vaccination to close contacts of cases, including sexual partners and individuals with other prolonged physical or high-risk contact, because the vaccine has been shown to confer protection even after exposure. 

To prevent further spread, vaccination offers the best protection, and individuals at higher risk of exposure, such as gay, bisexual, or other men or transgender people who have sex with men, should seek vaccination proactively.

In various countries, including the United States, the JYNNEOS® (MVA-BN®, IMVAMUNE®) mpox / smallpox vaccine is approved for use in 2025.