What to know
- There are two types of monkeypox, clade I and clade II.
- The ongoing global outbreak that started in 2022 is caused by clade II.
- Clade II cases continue to be reported at low levels in many countries.
- Clade II monkeypox is endemic to West Africa.
- Regardless of clade, monkeypox is spread, prevented, and treated the same way.
Clade II monkeypox around the world
Historical outbreaks
Prior to the 2022 global outbreak, clade II monkeypox was found in West Africa. There have been occasional travel-related cases in other parts of the world, including a 2003 U.S. outbreak linked to imported prairie dogs.
Ongoing outbreak that began in 2022
Since January 1, 2022, there have been a total of more than 114,000 clade II monkeypox cases worldwide, with more than 220 reported deaths. Overall, the number of cases worldwide have gone down steadily since the peak in 2022. In 2025, there were nearly 19,000 cases of clade II monkeypox around the world, including 9,000 outside of Africa.
Since the outbreak began, clade II monkeypox has been seen in many countries where monkeypox had not previously been reported. Clusters of cases continue in many of these same countries. CDC continues to work with international partners, global health organizations, and ministries of health on monkeypox preparedness, surveillance, and testing.
Ongoing capacity-building during and after the peak of the outbreak to improve case tracking means cases can be found quickly. In late summer 2024, there were outbreaks in South Africa and Cote d'Ivoire that were quickly contained.
Since January 1, 2022, there have been a total of more than 114,000 clade II monkeypox cases worldwide, with more than 220 reported deaths. Overall, the number of cases worldwide have gone down steadily since the peak in 2022. In 2024, there were nearly 9,000 cases of clade II monkeypox around the world.
West African 2025 outbreak
In summer 2025, Sierra Leone, Liberia, and other countries in West Africa experienced outbreaks of clade II monkeypox. CDC tracked a small uptick of U.S. cases of clade II across several different states linked to these outbreaks. Unlike the ongoing global outbreak, this outbreak has affected males and females about equally.
Person-to-person transmission mostly through sexual or other intimate contact has occurred during this outbreak. CDC collaborates with several U.S. laboratories and in-country contacts to better understand the situation.
CDC has vaccination recommendations for people traveling to countries with new clade II outbreaks. As of January 22, 2026, this includes Liberia.
Get more information about CDC travel recommendations to countries with confirmed or suspected community transmission.
Monkeypox in the United States
Here's what we know about clade II monkeypox in the United States:
- In July and August 2022, the United States experienced a peak in cases. The national 7-day average was more than 450 cases a day (or more than 11,000 per month). U.S. case counts have remained consistent at about 200 or fewer a month since October 2024.
- From 2023-2025, about 1,700-2,800 cases were reported annually.
- Clade II monkeypox is still mostly being spread through sexual and intimate contact, and gay, bisexual, and other men who have sex with men are at the highest risk of getting monkeypox.
What you should do
Help prevent monkeypox spread
During the height of the clade II outbreak that began in 2022, sexual behavior and other everyday changes by people at higher risk for monkeypox helped reduce the spread of the disease.
If you're at risk and haven't gotten both doses of the vaccine yet, get vaccinated (or complete the 2-dose series if you have not) to protect yourself and others.
Whether or not you've been fully vaccinated, other ways to protect yourself include avoiding close contact with people who are sick with signs and symptoms of monkeypox, including those with skin or genital lesions. In some cases, symptoms may be mild. If you or a sexual partner has or recently had monkeypox symptoms, or you have a new or unexplained rash anywhere on their body, see a healthcare provider. People who have monkeypox symptoms should not have sex or other close contact with people while they are ill, and until their rash is completely healed, which means scabs have fallen off and a fresh layer of skin has formed.
Also, avoid contact with contaminated materials used by people who are sick (such as clothing, bedding, toothbrushes, sex toys, or materials used in healthcare settings).
What CDC is doing
- Since 2022, CDC has increased our capacity to detect cases of monkeypox in the United States through existing surveillance systems, including wastewater testing.
- CDC, public health, and commercial laboratories have increased testing capacity to find U.S. cases of monkeypox quickly.
- CDC is working with state, tribal, local, territorial, and commercial partners to closely monitor for monkeypox cases so health officials can quickly respond.
- CDC works with key partners in the United States to get the word out about vaccination and reducing monkeypox risk.
- CDC prioritizes health equity and continues to work with partners in the community to support vaccine uptake among the communities disproportionately affected by monkeypox. You can see some of this work in social media videos with Dashaun Wesley in collaboration with CDC Foundation.
- CDC funds studies to better understand why people decide to get vaccinated against monkeypox or not. Partner organizations, including the National Coalition of STD Directors and National Coalition for Sexual Health, used this research to develop equity-centered and free communications materials and a communication toolkit.