Europe’s disease prevention agency has warned that more imported cases of a more severe strain of mpox, currently circulating in Africa, are “highly likely” in Europe in the coming weeks.
Despite raising the risk alert level, the agency said that the likelihood of sustained transmission remains “very low,” provided that swift diagnosis and control measures are in place.
ECDC says it has strengthened surveillance and preparedness activities in the EU member states plus the three countries that are in the European Free Trade Association (EFTA)—known collectively as members of the European Economic Area (EEA).
“As a result of the rapid spread of this outbreak in Africa, ECDC has increased the level of risk for the general population in the EU/EEA and travellers to affected areas. Due to the close links between Europe and Africa, we must be prepared for more imported clade I cases,” Pamela Rendi-Wagner, director of ECDC, said in a statement.
The agency called on public health authorities in individual EU/EEA member states to maintain high levels of preparedness planning and awareness raising activities to detect any newly imported clade I mpox cases.
“Ensuring effective surveillance, laboratory testing, epidemiological investigation and contact tracing capacities will be vital to detecting cases of MPXV clade I on the continent and activating any response,” the agency said.
The ECDC’s heightened alert follows the rapid spread of the more severe strain of the virus in Africa, particularly in the Democratic Republic of Congo, where an outbreak involving both an endemic form and a newly emerged offshoot, clade Ib, has raised global concerns. This clade I subvariant has been spreading from Congo to countries that have never reported mpox cases, such as Kenya and Uganda.
The charity said that the main source of transmission is sexual but the disease is also transmitted in other ways, including through direct or indirect contact with blood, body fluids, skin lesions, or mucous membranes of infected animals.
“There is a real risk of explosion, given the huge population movements in and out,” Dr. Louis Massing, the group’s medical director for Congo, said in a statement at the end of July.
So far this year, 12 African countries have reported over 17,500 mpox cases, including 517 deaths, per Africa CDC. That represents a 160 percent increase by the end of July compared to the same period in 2023. Congo has reported the highest number of cases, accounting for around 97 percent of the fatalities.
The clade I variant causes more severe illness and is more infectious, with the CDC stating that some outbreaks have killed up to 10 percent of people who get sick.
The agency recommends that individuals consider vaccination as a protective measure. Additional precautions include avoiding contact with individuals showing symptoms of mpox, steering clear of wild animals in regions where the virus is present, and refraining from consuming meat from wild animals.