Generation Z and the changing epidemiology of the African Mpox outbreak

Abstract Introduction Mpox (formerly known as monkeypox) has re-emerged as a major global public health threat. The Mpox virus, which was previously confined to remote rural settlements, especially in Africa, has been spreading in urban populations. Sierra Leone became the latest country to confirm an Mpox outbreak on January 10, 2025. Since the global Mpox outbreak started in May 2022, over 142,151 laboratory-confirmed cases and 328 deaths have been reported from 133 countries as of May 2025. Africa alone accounted for most of the confirmed cases and deaths. Epidemiology and clade mutation of Mpox Mpox epidemiology has evolved, with two distinct viral clades: clade 1 (Central African) and clade 2 (West African). Both clades exhibit different virulence, transmissibility, and geographic spread. Recently, there has been a notable shift in Mpox epidemiology and transmission dynamics. Specifically, there has been an increase in the number of Mpox cases among commercial sex workers and immunocompromised people. Sexual transmission of Mpox Sexual transmission of Mpox, particularly among Generation Z individuals born between the early 1997 and 2012 poses additional challenges, exacerbating stigma and delaying treatment. Conclusion Children under 15 years have become increasingly affected, accounting for 75% of cases in the Democratic Republic of Congo. Effective Mpox containment requires heightened surveillance, cross-border collaboration, improved vaccination strategies, and education to address stigma and misclassification. The evolving epidemiology of Mpox underscores the need for robust public health responses to mitigate its global impact.