Monkey Pox outbreak in Democratic Republic of Congo officially declared to have ended.

An outbreak of Monkey Pox in the Democratic Republic of Congo which has been raging since 2023 has officially been declared to have ended by the Ministry of Public Health. During the course of the epidemic, 161 000 people are thought to have been infected with the disease in the Democratic Republic of Congo, with 37 000 cases confirmed by laboratory testing. A total of 2286 deaths have been attributed to the disease within the country, although only 127 of these were confirmed by laboratory testing. At the height of the epidemic the disease spilled over into several neighbouring, and internationally connected, countries, causing the World Heath Organization to declare a global emergency.

A patient with Monkey Pox waiting at the Kamituga General Hospital in South Kivu Province, Democratic Republic of Congo, in September 2004. Moses Sawasawa/AP.

Monkeypox (or Mpox) is caused by a double-stranded DNA virus of the genus Orthopoxvirus, which is the same genus as the Viruses which cause Smallpox and Cow Pox. It causes a Chickenpox-like disease, with a distinctive rash with large blisters or sores on all parts of the body, as well as a fever, headaches, muscle and back aches, joint pain, chills, exhaustion, and swollen glands. Most patients recover within a few weeks, however it can cause more dangerous secondary symptoms, including pneumonia, sepsis, encephalitis, and blindness. Older and younger patients are particularly at risk, as are patients who have weakened immune systems or are pregnant. The disease typically has a case fatality ratio of about 1%.

Monkeypox is a zoonotic disease, with a wild reserve of the Virus found in several species of Primates and Rodents. Outbreaks usually start with an Animal-to-Human infection, although Humans at the blistering stage of the disease are capable of spreading it to other Humans. The Virus was first detected in Crab-eating Macaques, Macaca fascicularis, in a laboratory in Denmark in 1958, an outbreak which gave the disease its name (it is now thought to be more prevalent in Rodents than Primates). The first known Human infection with Monkeypox was reported from the Democratic Republic of Congo in 1970.

Monkeypox Virus size and structure in comparison to HIV, SARS-COV-2 and Poliovirus. Membranes and membrane-bound proteins are in purple, capsids are in dark blue, and genomes and nucleoid-associated proteins are in turquoise. PDB-101.

There are two main clades of Monkeypox, Clade I, which is predominantly found in Central Africa, and Clade II, which is predominantly found in West Africa. However, in May 2022 a cluster of cases was found in London, England, which is thought to have been brought to the country by a patient from Nigeria. These infections were caused by a new strain, which was apparently transmitted from Human-to-Human more readily than previously encountered variants, and was given the identifier Clade IIb (because it was a new clade derived from Clade II, which subsequently became referred to as Clade IIa. Notably, the spread of this strain has been linked to sexual activity. Clade IIb subsequently spread to 121 countries over the next two years, infecting more than 99 500 people and causing over 200 deaths.

In September 2023, another new and apparently more virulent variant, later named Clade Ib, was identified in the mining town of Kamituga in South Kivu Province, Democratic Republic of Congo. This spread from Human-to-Human more readily than previously known forms of the disease, and had a case fatality ratio of 3-4%, making it much deadlier than previously encountered variants. Unlike Clade IIb, Clade Ib appeared to spread largely among children, with 70% of reported cases and 85% of reported deaths being under the age of 15, although it has been suggested that this is in part because the disease has spread through several large refugee camps, where large numbers of children are also suffering from malnutrition, as well as other infectious diseases such as Cholera and Measles. 

Clade Ib has subsequently been reported in 25 countries, although in most cases this has been single patients who developed symptoms of the disease after returning from travel to Central Africa. However, in neighbouring countries such as Burundi, Rwanda, and the Central African Republic, as well as Indonesia and the Philippines, the clade has begun to spread locally, leading to public health campaigns to contain it.

Fortunately, because Monkeypox is closely related to Smallpox, vaccines against that disease have been shown to be effective against its spread. Because the last recorded case of Smallpox was in 1977, and the disease was declared officially globally eradicated in 1980, few countries maintain a stock of the vaccine, and active vaccination programs against Smallpox have not been carried out for decades. However, the technology to produce these vaccines still exists, and manufacturers in the United States, Spain, and Denmark have been distributing the vaccines since 2024.

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Denmark officially recognised as having ended mother-to-child transmission of HIV and Syphilis.

Denmark has been officially recognised as having eliminated mother-to-child transmission of HIV and Syphilis according to a press release issued by the World Health Organization on 27 February 2026. In doing so it becomes the first member of the European Union and the third European country to achieve this status (behind Moldova and Belarus, both of which were confirmed as having ended mother-to-child transmission of both diseases in 2016). 

Flag of Denmark. Tomasz Sienicki/Wikimedia Commons.

The World Health Organization is aiming for all countries to achieve the triple elimination of mother-to-child transmission of three critical diseases, HIV, Syphilis, and Hepatitis B, although to date only a single country has passed this milestone, the Maldives in October 2025. Denmark's progress makes it one of 23 countries to have ended mother-to-child transmission of at least one of these diseases, alongside Anguilla, Antigua and Barbuda, Armenia, Belarus, Belize, Bermuda, Brazil, Botswana, Cayman Islands, Cuba, Dominica, Jamaica, Malaysia, Maldives, Montserrat, Namibia, Oman, Republic of Moldova, Saint Vincent and the Grenadines, Sri Lanka, St. Kitts and Nevis, and Thailand.

The confirmation of Denmark's status comes following assessments by the World Health Organization's Regional Validation Committee for Europe, and Global Validation Advisory Committee in 2025. In order to be confirmed, it was necessary to demonstrate that 95% of all pregnant women in Denmark were tested for the diseases, and that new infant infections were below 50 in 100 0000 births. Denmark currently has 5950 people living with HIV, with less than 0.1% of pregnant women affected. It is possible to completely suppress the disease with antiretroviral treatments, preventing development of symptoms and all forms of transmission, including mother-to-child. In 2024, Denmark reported 626 cases of Syphilis, 524 in men and 102 in women; infections with this disease can be eliminated with antibiotics. Denmark is still working towards ending mother-to-child transmission of Hepatitis B.

Human Immunodeficiency Virus, or HIV, is a form of Lentivirus which causes infections in Humans, spread through sexual intercourse or exchange of blood. Notably, the Virus infects the cells of the Human immune system, where it is hard for that immune system to attack, and eventually leads to a breakdown of the immune system known as AIDS (Acquired Immune Deficiency Syndrome), during which the body becomes vulnerable to a wide range of infections, including many by micro-organisms which are not usually pathogenic. 

Untreated, HIV invariably leads to AIDS, and AIDS is invariably fatal, but, as with Syphilis, HIV infections can go through long phases of dormancy, leaving infected people unaware that they have the disease. Neither an effective vaccine nor a cure for HIV has yet been developed, however, it is possible to suppress the infection with a combination of anti-viral drugs, allowing patients to lead relatively normal lives, as long as their supply of antivirals is not interrupted. Children born to mothers with HIV are not automatically infected, as the Virus is usually unable to cross the placenta, but there is a high chance of infection during birth if the mother is not receiving treatment.

Scanning electron microscope image of an HIV virion. Hockley et al. (1988). 

Syphilis is a sexually transmitted disease caused by the Spirochaete Bacterium Treponema pallidum. The symptoms of Syphilis can be variable, and it can go through long periods of dormancy, making the disease difficult to diagnose without modern testing methods. Syphilis infection in pregnant women leads to a raised risk of miscarriage, and infants born with the disease are prone to physical deformities, damage to the liver and spleen, and neurological problems. Syphilis can be treated with a range of antibiotics, including penicillin, although the development of a vaccine has proved difficult.

Scanning electron microscope image of Treponema pallidum, the causative agent of Syphilis. Centers for Disease Control and Prevention/Wikimedia Commons.

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Maldives becomes the first ever nation to eliminate mother-to-child transmission of three critical diseases.

The Republic of Maldives has become the first ever country to achieve the end of mother-to-child transmission of Hepatitis B, HIV, and Syphilis, according to a press release issued by the World Health Organization on 13 October 2025. Mother-to-child transmission of HIV and Syphilis in the country was achieved in 2019, with the conformation this month that mother-to-child transmission of Hepatitis B has been eliminated making the Maldives the world's first county to achieve 'triple-elimination' of these diseases.

A mother is using traditional Maldivian cooking utensils to prepare a meal for her children. Ibrahim Asad/WHO Maldives.

Maldives forms part of the WHO Southeast Asia Region, which (confusingly) also includes most South Asian countries, and is based in New Delhi. It is estimated that across this region, more than 24 000 pregnant women were infected with Syphilis, an and over 8000 babies were born with the congenital form of the disease. In the same year, more than 25 000 pregnant women received treatment to prevent them passing on HIV to their babies. Figures relating to mother-to-child transmission of Hepatitis B are not available, but more than 24 million people across the region are living with the disease.

Syphilis is a sexually transmitted disease caused by the Spirochaete Bacterium Treponema pallidum. The symptoms of Syphilis can be variable, and it can go through long periods of dormancy, making the disease difficult to diagnose without modern testing methods. Syphilis infection in pregnant women leads to a raised risk of miscarriage, and infants born with the disease are prone to physical deformities, damage to the liver and spleen, and neurological problems. Syphilis can be treated with a range of antibiotics, including penicillin, although the development of a vaccine has proved difficult.

Scanning electron microscope image of Treponema pallidum, the causative agent of Syphilis. Centers for Disease Control and Prevention/Wikimedia Commons.

Human Immunodeficiency Virus, or HIV, is a form of Lentivirus which causes infections in Humans, spread through sexual intercourse or exchange of blood. Notably, the Virus infects the cells of the Human immune system, where it is hard for that immune system to attack, and eventually leads to a breakdown of the immune system known as AIDS (Acquired Immune Deficiency Syndrome), during which the body becomes vulnerable to a wide range of infections, including many by micro-organisms which are not usually pathogenic. Untreated, HIV invariably leads to AIDS, and AIDS is invariably fatal, but, as with Syphilis, HIV infections can go through long phases of dormancy, leaving infected people unaware that they have the disease. Neither an effective vaccine nor a cure for HIV has yet been developed, however, it is possible to suppress the infection with a combination of anti-viral drugs, allowing patients to lead relatively normal lives, as long as their supply of antivirals is not interrupted. Children born to mothers with HIV are not automatically infected, as the Virus is usually unable to cross the placenta, but there is a high chance of infection during birth if the mother is not receiving treatment.

Scanning electron microscope image of an HIV virion. Hockley et al. (1988). 

Hepatitis B is Viral infection of Humans, primarily targeting the cells of the liver. It can be transmitted through sexual intercourse, blood-to-blood infections, or from mother-to-child during pregnancy. Hepatitis B is seldom fatal, but untreated it can cause recurring bouts of debilitating nausea, accompanied by jaundice, vomiting, stomach cramps, and exhaustion. Untreated Hepatitis B can leave patients vulnerable to cirrhosis and liver cancer, which can prove fatal. Not all people infected with Hepatitis B ever develop symptoms, though children born with the infection are both more prone to symptoms and more prone to severe symptoms. An effective vaccine has been available for Hepatitis B since 1991. Most adults infected with Hepatitis B fight of the infection on their own, although it can be treated with a range of anti-viral drugs.

Hepatitis B Virus cells. Graham Beards/Wikimedia Commons.

Maldives has achieved its 'triple elimination' through a combination of extensive free anti-natal care, testing for all three diseases, and vaccinations against Hepatitis B, with around 95% of pregnant women in the country thought to have been reached. These policies form part of a system of free universal healthcare for all residents of the islands, including migrants, with over 10% of the country's GDP being invested in healthcare. 

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Four Horses dead in Equine Herpes outbreak in the New Forest, England.

Four Horses have now died in an outbreak of Equine Herpes Virus at a dressage and showjumping centre in the New Forest, England this week. The first cases were reported at the Crofton Manor Equestrian Centre, near Stubbington in Hampshire, on Tuesday 7 January 2020, after a Horse fell ill at the beginning of the month. The centre has now been placed under quarantine, as have several other sites in Hampshire, Sussex, and Kent, which have had Horses visit Cofton Manor since December 2019.

Crofton Manor Equestrian Centre, near Stubbington in Hampshire, where Horses are under quarantine following an outbreak of Equine Herpes Virus. BBC News.

Equine Herpes Virus is a form of Herpesvirales, the group which also includes the Human Herpes Virus, as well as a range of other Viruses infecting Humans, Mammals, Birds, Turtles, Amphibians, Bony Fish, and Molluscs. There are at least two strains of Equine Herpes Virus, with the more common one being relatively benign and causing only minor symptoms, if any symptoms at all, but the other is prone to causing spontaneous abortions and sometimes lethal brain infections. The Herpesvirales are double-stranded DNA Viruses, with isohedral capsids (protein shells), a group that also includes the Smallpox and Swine Fever Viruses.

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African Swine Fever reported in South Korea.

South Korea has reported its first case of African Swine Fever, after the disease was detected at a Pig farm near the city of Paju in Gyeonggi Province, close to the border with North Korea, where the disease was detected four months ago. Authorities in South Korea have imposed a temporary moratorium on all movements of Pigs, as well as ordring the culling of 4000 Pigs at the farm where the outbreak was detected and two neighbouring farms.

Pigs being rounded up for culling at a farm near Paju in South Korea, following the detection of the African Swine Fever Virus. Yelim Lee/AFP/Getty Images.

The African Swine Fever Virus is a Double Stranded DNA Virus and the sole member of the Asfivirus Family. It is indigenous to tropical Africa, where it infects Warthogs and Bushpigs as well as domestic Pigs, and is transmitted by Ticks of the genus Ornithodoros. The disease presents no threat to Humans, but produces a lethal haemorrhagic fever in Pigs. Infected animals will develop a high fever within a few days of contracting the Virus, this is acompanied by a loss of appatite and reddening of the skin of light-skinned breeds, caused by the rupturing of blood vessels. Pigs will then develop difficulties in standing, and huddle together in groups, shivering and coughing, and within a few days will become comatose and eventually die.

A transmission electron microscope image of a single African Swine Fever Viron. Institute for Animal Health/Wikipedia.

Occasional outbreaks of African Swine Fever have been recored outside of Africa for decades, but the current epidemic has spread from China, where the disease was detected in August 2018, since when it has spread rapidly within the country's large number of intensive Pig farms. Since then around 100 million Pigs have died in China, and it is feared that as many as 350 million may die before the outbreak is contained (25% of the global population). The outbreak has spread to the Philippines, Vietnam, North Korea, and now South Korea, and there are concerns that it could spread to other parts of East Asia and the world. The outbreak has also provoked China to wave all tariffs on imported pork, a major foodstuff in the country, provoking an increase in intensive Pig farming in other parts of the world - something which may also make the countries where this expansion has occured more vulnerable to the disease.

Pigs that have died after becoming infected with African Swine Fever in South Korea. Pig World.

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