The Mpox virus is spreading worldwide, and in recent weeks cases of a new and potentially more deadly variant have been confirmed in additional countries, some far from the original outbreak in East Africa.

Where has Mpox spread?

To date, cases of MPOX have been reported outside the African continent in four countries – Sweden, Thailand, the Philippines and Pakistan. Cases have been reported in 14 African countries.

The World Health Organization (WHO) declared last week that the virus had become a “public health emergency of international concern.” Although the WHO has repeatedly stressed that Mpox is “not the new COVID,” this is the second emergency warning issued by the global health organization regarding Mpox in two years.

The current outbreak was triggered by Clade 1, a variant of the Mpox virus that is probably more severe than previously known and can spread through skin contact.

Mpox has been spreading in African countries since 2022 and was originally traced to the Democratic Republic of Congo (DRC). In 2023, a new strain of the Clade 1 variant – known as Clade 1b – was discovered in the country. African countries are reporting both Clade 1 and Clade 1b strains.

At the same time, another outbreak of the earlier Clade 2 variant of the virus is also spreading, albeit at a much lower level.

The Clade 2 strain caused a cross-country MPOX outbreak in 2022, spreading primarily through sexual contact. As of last month, cases of this strain had been reported in more than 100 countries.

Clade 2 is believed to cause milder infections. The fatality rate is 0.2 percent compared to 3.9 percent for Clade 1. The WHO officially declared the outbreak over in May 2023, but cases continue to be recorded.

Here’s where Mpox disease spread from January to August this year:

Africa

According to the Africa Centers for Disease Control and Prevention (Africa CDC) and the governments of Kenya, Mozambique, Uganda and Ivory Coast, the clade 1 variant of mpox has been detected this year in the following countries:

• Burundi (eight cases, zero deaths)
• Cameroon (35, two)
• Central African Republic (213, zero)
• Ivory Coast (28, one)
• Republic of Congo (146, one)
• Democratic Republic of Congo (13,791, 450)
• Ghana (four, zero)
• Liberia (five, zero)
• Nigeria (24, zero)
• Rwanda (two, zero)
• South Africa (22, 3)
• Uganda (two, zero)
• Kenya (one, zero)
• Mozambique (one, zero)

The Democratic Republic of Congo is currently experiencing the largest outbreak of the disease ever recorded. By August 21, thousands of people had already been infected. In December 2022, the government declared the outbreak an epidemic.

Almost all cases reported in Africa (96 percent) occur in the Democratic Republic of Congo, where 60 percent of cases are in children under 15, the Africa CDC said.

The new strain Clade 1b is also spreading rapidly. It has been detected this year in at least three countries neighboring the Democratic Republic of Congo: Kenya, Rwanda and Uganda. These countries had not reported any cases since the outbreak began in 2022.

So far, a total of 541 deaths from Mpox have been registered, of which 535 occurred in the Democratic Republic of Congo (97 percent). The Africa CDC does not classify the deaths by tribe. Most of the deaths were among children.

In Côte d’Ivoire, authorities say the outbreak is linked to the 2022 Clade 2 variant.

Asia

The Philippines, Thailand and Pakistan have reported new MPOX cases this month.

In Thailand, authorities said they are treating the country’s first known case, Patient Zero, as a Clade 1 infection while they await test results confirming the strain.

The person, a 66-year-old European man, reportedly returned from an unnamed African country currently experiencing a “major” outbreak of the Clade 1 variant before reporting to health authorities. He reportedly has no serious symptoms and is believed to have travelled through a Middle Eastern country before arriving in Thailand.

In the Philippines, authorities said the milder Clade 2 variant was confirmed as the cause of the latest case and the disease has likely been spreading undetected for some time. The patient is a 33-year-old Filipino man with no travel history. It is the tenth confirmed case in the country since 2022.

Pakistani authorities said the first patient reported there this year was a man and he was infected with the Clade 2 variant. But last week, authorities said they had not been able to locate the infected patient. He is believed to have travelled to another province before test results were released. Authorities said they are trying to trace him.

Europe

• Sweden (one case, zero deaths)

Only one country in Europe – Sweden – has reported a case of Mpox. The infection was reported on August 15 and was confirmed to be the more severe Clade 1 variant.

According to the European Centre for Disease Prevention and Control, it is “very likely” that more cases of the Clade 1 variant will be recorded in the European region due to frequent air traffic between Europe and Africa.

However, sustained transmission could be low in Europe if cases are diagnosed quickly and testing, surveillance and contact tracing are deployed, the agency said. The European Union has ruled out closing its borders to hard-hit countries.

America, Middle East, Oceania and Antarctica

No new cases of Clade 1 mpox have been reported in any country in North or South America.

However, countries in the Americas should be “on alert” for possible clade 1 and 2 cases, the Pan American Health Organization said in a statement on August 9.

From 2022 to July 2024, more than 62,000 cases of the clade 2 virus were reported in the region, including 141 deaths.

There are no confirmed cases of clade 1 mpox virus in Oceania or the Middle East.