Clade I Mpox in Central and Eastern Africa

Level 4 - Avoid All Travel
Level 3 - Reconsider Nonessential Travel
Level 2 - Practice Enhanced Precautions
Level 1 - Practice Usual Precautions

Key points

  • There is an outbreak of clade I mpox in Central and Eastern Africa. There is ongoing person-to-person transmission of mpox in Burundi, Central African Republic, Democratic Republic of the Congo (DRC), the Republic of the Congo, Rwanda, and Uganda (see map).
  • Person-to-person transmission has occurred during this outbreak, including through sexual contact, day-to-day household contact, and within the healthcare setting (in the absence of appropriate personal protective equipment). There has also been transmission from contact with live or dead wild animals.
  • Mpox vaccination is now recommended for people, regardless of gender identity or sexual orientation, who anticipate the following sexual activities during travel to countries with ongoing person-to-person transmission of clade I mpox:
    • Sex with a new partner
    • Sex at a commercial sex venue (e.g., sex club or bathhouse)
    • Sex in exchange for money, goods, drugs, or other trade
    • Sex in association with a large public event (e.g., rave, party, or festival)
  • All people should avoid situations that might increase their risk for mpox, but especially people with risk factors for infection and/or who are at risk for severe disease (e.g., pregnant people, infants younger than 1 year, people with eczema or active skin conditions, and people who are immunocompromised).
  • If you travel to affected countries, learn more about which activities may increase your risk for mpox and how you can reduce your risk of mpox, including getting vaccinated if you’re eligible.
  • Avoid close contact with people who are sick with signs and symptoms of mpox, including those with skin or genital lesions.
  • Avoid contact with contaminated materials used by people who are sick (such as clothing, bedding, or materials used in healthcare settings) or that came into contact with wild animals.
  • Avoid contact with wild animals (alive or dead), such as small mammals, including rodents (rats, squirrels), and non-human primates (monkeys, apes).
  • Avoid eating or preparing meat from wild animals (bushmeat) or using products (creams, lotions, powders) derived from wild animals.
  • For those eligible for mpox vaccination, get two doses of the JYNNEOS vaccine at least 28 days apart.
    • If you are at risk for mpox and have only received one dose, get a second dose as soon as possible.
    • It takes about two weeks for maximum protection against mpox. Be sure to plan ahead.
    • Whether or not you’re fully vaccinated when you travel, protect yourself from mpox.
  • Seek medical care immediately if you develop new, unexplained skin rash (lesions on any part of the body), with or without fever and chills, and avoid contact with others.
    • Tell your doctor or healthcare provider where you traveled during the last 21 days before developing symptoms.
  • If you are sick and could have mpox, follow isolation and infection control measures at home and during travel. See additional information about what to do if you are sick with mpox.

Traveler Information

Clinician Information

Orange shading indicates areas with confirmed and suspect cases of mpoxView larger
What is Mpox?

Mpox is a disease caused by infection with Monkeypox virus. Mpox is endemic in forested areas of Central and West Africa.

There are two types of Monkeypox virus. Historically, clade I has been associated with a higher percentage of people with mpox developing severe illness or dying, compared to clade II. 

People usually get mpox through contact with the skin lesions or bodily fluids of infected wild animals in Africa (alive or dead) or humans, including respiratory secretions, or through contact with materials contaminated with the virus such as bedding, clothing, and sex toys. Transmission also occurs through intimate or close contact, including sex, with an infected person.

Symptoms often include fever (≥100.4°F), rash, headache, muscle aches, and swollen lymph nodes. Fever is not always present. 

There is a vaccine available for mpox for those with certain risk factors.