Europe calls for vigilance in face of local clade 1b mpox transmission

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mpox virus
NIAID / Flickr cc

The European Centre for Disease Prevention and Control (ECDC) is urging the use of targeted prevention measures after four countries documented five cases of locally acquired clade 1b mpox, indicating community transmission.

In a news release and threat assessment today, the ECDC described the cases, which were reported by Spain, the Netherlands, Italy, and Portugal. Symptoms began from September 16 to October 7, and the disease courses were mild. Two of three patients with available information were men who have sex with men (MSM).

"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 ECDC said. "The risk of severe disease may be higher for those living with untreated HIV."

Previous cases acquired in mpox-endemic areas

The previous clade 1b cases reported beginning in August 2024 were among travelers returning from mpox-endemic areas outside of the European Union and their contacts.

Among 29 clade Ib cases reported to ECDC before the current cases, seven were hospitalised for treatment, although with such a small number of cases, any estimation of severity in comparison to clade IIb is uncertain.

Clade 1b disease is thought to be more severe than that caused by clade 2b, which has caused outbreaks around the world since 2022, but uncertainties remain. "Among 29 clade Ib cases reported to ECDC before the current cases, seven were hospitalised for treatment, although with such a small number of cases, any estimation of severity in comparison to clade IIb is uncertain," the release said. 

Outside of Europe, three unrelated cases of non–travel-related clade 1 mpox were also recently reported in California among MSM and their social networks.

The ECDC called for a multipronged public health response, including vaccination of people at risk for infection (including post-exposure vaccination), accessible testing, clade identification, prompt diagnosis and isolation of infected patients, contact tracing, and education. 

Cholera outbreak in DR Congo is intensifying, MSF warns

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Cholera in DRC
Oxfam East Africa / Flickr cc

An intensifying cholera outbreak in the Democratic Republic of the Congo (DRC) is raising alarms, Medecins sans Frontieres (MSF) warned this week.

According to the DRC Ministry of Health, more than 58,000 cholera cases have been reported over the past 9 months, with 1,700 deaths. Twenty of the country's 26 provinces have been affected. 

Twenty-three countries in Africa have battled outbreaks of the highly contagious bacterial infection this year, reporting more than 172,000 cases since January 1, according to the most recent disease outbreak update from the World Health Organization (WHO). DRC, Sudan, and South Sudan have been the hardest hit, accounting for 75% of the region's cases and deaths, officials with the Africa Centres for Disease Control and Prevention said last month

Floods, conflicts, displacement fueling outbreak

MSF officials say the outbreak in the DRC has been fueled by floods, conflicts, and displacements, as well inadequate sanitation and water supply systems, while the response has been hampered by insufficient funding from the government, limited presence of humanitarian organizations, and a lack of medical supplies and vaccines. They also warn that the outbreak is likely to get worse as the rainy season approaches.

"The rapid spread of the epidemic across the country this year is of particular concern to us, especially during the rainy season," Jean-Gilbert Ndong, MSF physician and medical coordinator in DRC, said in an MSF press release. "We fear further outbreaks if urgent measures aren't taken."

Cholera spreads through water and food contaminated by the Vibrio cholerae bacterium, causing severe diarrhea and dehydration. The disease is easily treatable with antibiotics, oral rehydration solution, and intravenous fluids, but it can quickly become life-threatening if it goes untreated. 

Quick takes: Measles in Southwest, polio vaccination urged, international tomato Salmonella outbreak

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  • In what is now the second-largest US measles outbreak this year, measles cases have topped 120 in northwestern Arizona and southwestern Utah, with most cases linked to a tight-knit community in Colorado City, Arizona, and neighboring Hildale, Utah. The former town is in Mohave County, Arizona, which has recorded 80 cases, and the latter is in Washington County, Utah, with 44 cases. The Utah Department of Health & Human Services noted 1 new case in Washington County yesterday, so the outbreak has now reached 124 cases. Within the past few weeks, there have been three cases in nearby larger towns, such as Hurricane and St. George, Utah, NBC News reports. The largest outbreak so far this year was in West Texas, with 762 confirmed cases when it was declared over on August 18.
  • On World Polio Day and as officials confirm four new infections, the World Health Organization (WHO) warns that polio vaccine uptake in Europe is at its lowest since 2017, leaving more than 450,000 babies unprotected. "Gaps in immunization coverage leave children vulnerable and present a health security risk to our Region and beyond," said Ihor Perehinets, MPH, regional emergency director for the WHO's European office. The warning comes as Afghanistan and Papua New Guinea confirm new polio cases, according to the Global Polio Eradication Initiative. The two patients in Afghanistan were infected by wild poliovirus type 1 (WPV1) and had paralysis onset on October 2 and 3, increasing the country's 2025 WPV1 total to nine. Two cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) were reported this week in Papua New Guinea, in Central and Enga provinces, with onsets of paralysis in August. The country has confirmed three cVDPV2 cases so far this year.
  • The European Centre for Disease Prevention and Control (ECDC) today confirmed that a prolonged multi-country outbreak of Salmonella Strathcona has resulted in 437 confirmed cases in 17 European countries from January 1, 2023, to September 30, 2025. Italy, Germany, and Austria are the European nations most affected, but 24 cases have been reported in the United States, and 10 in Canada. "Recent investigations carried out in Austria in 2025 also identified small tomatoes from Sicily, Italy, as the source of infection, which is consistent with findings from earlier outbreaks in Italy (2024) and Austria (2023)," the ECDC said.

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