2023–2024 mpox epidemic

Global disease outbreak since September 2023

This article is about the epidemic. For other uses, see Mpox outbreak.

2023–2024 mpox epidemic

Countries with 10,000+ cases

Countries with 1,000–9,999 cases

Countries with 100–999 cases

Countries with 1–99 cases

Test pending for possible clade Ib case

No confirmed clade Ib cases

Disease| Mpox (clade Ib)
Location| Primarily Central Africa, limited local transmission elsewhere
Date| September 2023 – present (11 months)

* * *

Public health emergency of international concern: 14 August 2024 – present (1 week and 6 days)
Confirmed cases| 21,300+[1]

Deaths

| 590+[1]

An epidemic of a new variant of clade I mpox (formerly known as monkeypox), known as clade 1b,[2] began in Central Africa at least as early as September 2023.[3][4] As of August 2024, more than 21,000 cases have been reported, with over 500 fatalities (~3% fatality rate),[1][5] nearly all in the Democratic Republic of the Congo.[6] According to the European CDC: "The size of these outbreaks could be larger than reported due to under-ascertainment and under-reporting."[7]

On 14 August 2024, the World Health Organization declared the epidemic a public health emergency of international concern (PHEIC).[2][8][9]

## Background

[edit]

Main article: 2022–2023 mpox outbreak

Mpox is an infectious viral disease that is endemic among small mammals in central areas of Africa; it can also infect humans.[10] Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes.[10] The illness is usually mild, and most infected individuals recover within a few weeks without treatment.[11] However, cases may be severe, especially in children, pregnant women, or people with suppressed immune systems.[12]

In May 2022, the World Health Organization (WHO) declared a prior mpox outbreak, involving a clade IIb of the virus, a global health emergency. The disease had infected 87,000 individuals and caused 140 deaths when the WHO ended its global emergency in May 2023, citing a combination of vaccination and public health information as successful control measures.[13][14] Cases of clade IIb which can be traced to this outbreak are continuing to be detected worldwide, although at a relatively low level.[15]

In September 2023, cases of mpox started increasing in the Democratic Republic of the Congo and continued into 2024, with the Africa Centres for Disease Control and Prevention (ACDC) reporting a 160% increase in cases from the previous year. Most of these cases were determined to be caused by clade I of the virus.[3][16]

## Outbreak

[edit]

### Reported cases and casualties

[edit]

As of 22 August 2024
Reported cases in countries which have positively identified clade Ib  | Location  | Cases (Lab confirmed)[5][17] | Deaths (Lab confirmed)[5][17] | First confirmed clade Ib case

|
|
|
|

| Democratic Republic of the Congo | 17,794 (1,888)[18] | 535 (8)[18] | September 2023[4]
| Burundi | 572 (171)[19][20] | 0  | July 2024[2][5]
| Kenya | 33 (2)[21] | 0  | July 2024[5]
| Rwanda | 4[5] | 0  | July 2024[2][5]
| Uganda | 4[22] | 0  | July 2024[2][5]
| Sweden | 1[23] | 0  | 15 August 2024[23]
| Thailand | 1[24] | 0  | 22 August 2024[24]
Total | 18,409 | 535 |

Reported cases since September 2023 in countries with only clade II or clade Ia

Awaiting test for possible clade Ib case

| Location  | Cases ([a])[5][17] | Deaths ([b])[5][17] | Status
| United States | 1,800+[25] | ~5[25] | Clade IIb; one suspected clade Ib awaiting test results[26][27]
| Australia | 319[28] | 0  | Clade IIb[29]
| Central African Republic | 263 (28)[30] | 0  | Clade Ia[30][31]
| United Kingdom | 200+[32] | 0  | Clade unspecified
| Canada | 164+[33] | 0  | Clade IIb[33]
| Republic of the Congo | 158 (21)[34] | 1  | Clade Ia[31]
| Germany | 85+[35] | 1  | Clade unspecified[35]
| Nigeria | 39[30] | 0  | Clade IIa[36][37]
| Cameroon | 35 (5)[31] | 2  | Clade IIa and clade Ia[31][37]
| Ivory Coast | 28[38] | 1  | Clade IIa[36][37]
| South Africa | 24[39] | 3  | Clade IIa[36][37]
| Indonesia | 14[40] | 0  | Clade II[40]
| Singapore | 13[41] | 0  | Clade II[41]
| Argentina | 10+[42] | 0  | Clade IIb[42]
| Ireland | 6+[43][44] | 0  | Clade II[43]
| Philippines | 6+ (6+[45])  | 0  | Clade unspecified (December 2023),[46] Clade II (2024)[47][48]
| Liberia | 5[49] | 0  | Clade IIa[36][37]
| Ghana | 4[31] | 0  | Clade II[31]
| Pakistan | 4[50][51] | 0  | Clade II[51]
| Taiwan | 4[52] | 0  | Clade unspecified[52]
| Portugal | 3[53] | 0  | Clade IIb[53]
| Malawi | 2[54] | 0  | Clade unspecified[54]
| Mozambique | 1[55] | 0  | Clade unspecified[55]
| Gabon | 1[56] | 0  | Clade unspecified[56]

1. ^ Number of cases confirmed in laboratory.
2. ^ Number of deaths confirmed in laboratory.

### Timeline

[edit]

Main article: Timeline of the 2023–2024 mpox epidemic

Mpox cases from clade Ib infections were growing in the Democratic Republic of the Congo (DRC) by September 2023,[3][4] with several of them being identified in Kamituga, a mining town in the province of South Kivu.[57][3][58] A nationwide outbreak was reported in January 2024.[3][59]

On 12 August 2024, the Africa Centres for Disease Control and Prevention declared that the growing mpox outbreaks in Africa had become a public health emergency, with over 517 deaths being reported. As a result, the organization requested the help and intervention of the international community to control the spread of the virus and treat infected patients.[6][60] The ACDC stated that the fatality rate of the strain of virus causing the outbreak was 3–4%, significantly higher than the less than 1% fatality rate recorded during the 2022–2023 mpox outbreak.[6] On 14 August, the World Health Organization declared the epidemic a public health emergency of international concern (PHEIC) or global health emergency.[2][8]

As of 16 August 2024, fifteen countries were reported to have identified cases of mpox;[5] and over 96% of all reported cases and fatalities from the disease were confirmed in the DRC, with 16,839 reported cases and 501 reported deaths.[6] The ACDC reported that 70% of reported cases in the DRC were in children under 15, as that demographic represented 85% of reported deaths.[6] Epidemiologist Jacques Alonda expressed concern over the disease's spread in refugee camps in the DRC and its neighbor countries, especially due to the amount of pressure already applied to the national healthcare system by concurrent outbreaks of cholera and measles, as well as widespread malnutrition.[6]

Also on 16 August, the European Centre for Disease Prevention and Control (ECDC) officially raised the risk level of clade I to the general European population from "very low" to "low" due to the likelihood of more imported cases being identified across the continent, although the agency reiterated that the risk of sustained transmission of the virus strain in Europe was still considered to be minimum.[61][62] The ECDC also advised travellers to consider getting vaccinated against mpox should they visit African countries affected by the outbreak.[61][63]

### Countries with widespread transmission

[edit]

#### Democratic Republic of the Congo

[edit]

Further information: Mpox in the Democratic Republic of the Congo

As of August 2024, a cumulative total of 16,839 suspected cases of mpox (at least 1,888 of which were laboratory confirmed)[5][17] and 570 deaths[64] (at least 8 of which were laboratory confirmed)[5][17] have been reported in the Democratic Republic of the Congo (DRC).[64]

On 19 August, the DRC's Ministry of Public Health, Samuel-Roger Kamba Mulamba [fr], said in a press conference that all of the country's provinces, including the capital city of Kinshasa, had been affected by the outbreak,[64] while announcing that the national government would launch a €45 million response plan including awareness campaigns, medical team deployment and patient care, but not vaccines.[64][65]

Various media reported that the impact of the mpox outbreak across the DRC, and especially in eastern provinces, had been significantly worsened by factors such as widespread conflicts in the region, including an offensive by the Rwanda-backed March 23 Movement in North Kivu— which had displaced thousands of civilians, most of whom had been forced to gather in refugee camps around Goma or in the city itself— , widespread extreme poverty, poor access to healthcare services, and the circulation of the infection within sex workers in illicit mining industries.[66][67][68] Medair's health advisor in the DRC, Pierre Olivier Ngadjole, said that around 70% of the new mpox cases registered in the Goma area between June and August 2024 had involved people living in displacement camps, while the director of the Bulengo refugee camp, Mahoro Faustin, expressed concerns over the lack of testing kits available in the area.[66][68]

### Countries with limited local transmission

[edit]

As of August 2024, fifteen countries have reported cases of mpox;[5] the WHO reported that new cases of the mpox strain, all of which linked to the outbreak in the DRC,[6] had been identified for the first time in four East African nations: Burundi, Kenya, Rwanda, and Uganda.[6][5] Ivory Coast also reported new cases for the first time.[5]

#### Central African Republic

[edit]

On 30 July 2024, the Minister of Health of the Central African Republic, Pierre Somsé, declared an outbreak of mpox in Bangui, following a period of time when the disease was mostly restricted to rural areas.[69] Somsé reported that some families in the country were hiding infected relatives in fear of being stigmatized, thus increasing the risk of transmission of the disease.[69]

#### Sweden

[edit]

On 15 August 2024, Sweden's Public Health Agency reported the first case outside Africa, which involved a person who had contracted clade I mpox during a stay in an area of Africa affected by the outbreak.[23][70][71] In a public statement, the agency said that, while the case in itself did not represent a higher risk to the general population,[23][71] occasional imported cases "may continue to occur".[23][72]

#### Taiwan

[edit]

On 18 August 2024, the Public Health Bureau of the city council of Tainan, Taiwan, announced that, as of 16 August, three cases of mpox—all of which involving men who had had close contact with unspecified people—had been confirmed in the city since the start of the year; further details about the patients' traveling history and the variant were not disclosed.[73][74]

#### Thailand

[edit]

On 21 August 2024, Thailand's Department of Disease Control confirmed a mpox case, involving a 66-year-old European man who was a resident of Thailand,[24][75] and had returned from an African country affected by the outbreak, with his flight transiting through an undisclosed Middle Eastern country.[24][75][76] The strain was later confirmed to be clade 1b.[77] The patient who tested positive for clade Ib was a European male who arrived in Bangkok last week from Africa, according to the Department of Disease Control of Thailand’s health ministry.[24]

### Clade II cases

[edit]

Some countries have reported contemporary mpox cases that then turned out to be infections with clade II variants, presumably unrelated to the clade Ib outbreak. There is a global outbreak of clade II infections that began in 2022.

#### Pakistan

[edit]

On 15 August 2024, Pakistan's National Command and Operation Center (NCOC) reported a suspected case of mpox in the province of Khyber Pakhtunkhwa,[4] involving a resident of Mardan who had recently returned from an Arab Gulf state;[78] the person was later confirmed to have been diagnosed with mpox by the Pakistani Ministry of Health, although sequencing of viral samples was still ongoing in order to determine the nature of the variant.[78][79][80]

On 17 August, the health department of Khyber Pakhtunkhwa confirmed that two patients had tested positive for mpox, while another one was waiting for confirmation; all of the patients had recently returned to Pakistan from the United Arab Emirates.[50]

On 19 August, another suspected mpox case was reported, involving a resident of Azad Kashmir who had just returned from a Middle Eastern country; however, the Ministry of Health stated that none of the reported cases in the country had been caused by clade 1b of the virus.[51]

#### Portugal

[edit]

On 16 August, Portugal's Directorate-General of Health (DGS) confirmed that three new cases of mpox had been confirmed in the country between May and July 2024;[53][81] the agency reported that all of the cases had been detected in the North Region, with two of them having travelled abroad during the incubation period of the disease.[82] However, the DGS said that all of the three patients had contracted clade IIb mpox,[53] whereas no clade I cases had been reported.[53][81]

#### Indonesia

[edit]

On 17 August 2024, Indonesia's Independence day, the national Ministry of Health (Kemenkes) reported a total of 14 confirmed mpox cases from January to April 2024.[40] This brought the cumulative total to 88 cases in Indonesia when combined with the previous outbreak's 73 cases reported in 2023, as well as one case from 2022.[40][83] The latest outbreak, which initially began in Jakarta, then spread to the Riau Islands. Among the total cases, 87 patients had been declared cured, with 54 of those cases involving the clade IIb variant. The distribution of cases by region included 59 in Jakarta, 13 in West Java, nine in Banten, three in East Java, three in the Special Region of Yogyakarta (DIY), and one in the Riau Islands.[84]

#### Philippines

[edit]

On 19 August 2024, the Philippines' Department of Health (DOH) announced that a 33-year old male from Metro Manila, with no prior history of traveling overseas, had tested positive for mpox the day prior.[51][85] The patient was later determined to have contracted clade II mpox.[47]

## Virology

[edit]

Mpox is caused by the monkeypox virus. The virus is transmitted through close contact with infected animals or people,[86] including in-person communication and other kinds of physical contact,[87][88] contaminated bedsheets,[87] clothing or needles,[88] sexual contact,[86][87] and consumption of contaminated meat.[87][88]

In April 2024, researchers identified a novel subgroup of clade I of mpox in Kamituga, a mining town in South Kivu, Democratic Republic of the Congo.[3][89] Epidemiologists reported that the new variant—later named "clade Ib"[87][88] or "clade 1b"[88]—had the potential to spread with greater ease compared to other mpox strains.[3] The researchers theorized that the strain had undergone genetic mutations, allowing it to spread more easily through human transmission, due to the mining town's remote location greatly limiting contact with animals that naturally carry and spread the disease.[3]

Placide Mbala-Kingebeni of DRC's National Institute of Biomedical Research reported that the results of the analysis marked "a new phase of mpox" from the prior outbreak in 2022 and 2023, since the new variant reportedly produced lesions predominantly on the genitals, making the disease more difficult to diagnose compared to strains that caused chest, feet, and hand lesions. Mbala-Kingebeni also noted that the new variant could result in a higher likelihood of silent transmission due to its different manifestations.[3] The research team determined the detected form to be a Clade I type strain,[3] which historically has caused more severe symptoms in comparison to the Clade II type that was predominant during the 2022–2023 mpox outbreak.[3][88]

## Prevention and mitigation

[edit]

Until June 2024, mpox vaccines were not approved by any African government, and the efficacy of vaccines had not been attested by the Strategic Advisory Group of Experts. The director of the WHO's Health Emergencies Programme, Michael J. Ryan, noted in an interview with NPR that the Democratic Republic of the Congo was simultaneously facing several other endemic diseases, including measles and cholera. Up to that point, only two labs in the DRC were able to perform polymerase chain reaction testing for mpox.[90]

Also in June 2024, authorities in the DRC had approved the vaccines Jynneos, manufactured by Bavarian Nordic, and LC16, manufactured by KM Biologics, for emergency use.[91] Jynneos was later approved in Nigeria, also for emergency use.[92][93] Both countries officially started vaccination campaigns for mpox by the end of August of the same year.[94]

Also in August 2024, the chief executive officer of GAVI, Sania Nishtar, said the organization had already allocated up to $500 million as part of their "First Response" fund—which had originally been set up during the COVID-19 pandemic, mostly through donations by governments and global health funders, but was later kept in place in order to respond to new health emergencies.[4] However, Nishtar said that GAVI and UNICEF still had to wait for official requests from the countries affected by the outbreak, as well as definitive approval of mpox vaccines from the World Health Organization, in order to start ordering the doses and distributing them to affected nations.[4] In response, the WHO announced the launch of a process that would enable access to vaccines for emergency use in countries whose national approval was still pending.[92]

On 14 August, the U.S. Department of Health and Human Services (HHS) announced that the national government would donate 50,000 doses of the Jynneos vaccine to the DRC.[92][95] The HHS also said that the U.S. had previously provided US$17 million to "support clade I mpox preparedness and response efforts in Central and Eastern Africa".[95]

On 16 August, Bavarian Nordic announced in a press statement that it had submitted clinical data to the European Medicines Agency to support the extension of the approval of Jynneos/Imvanex to include adolescents aged 12 to 17 years;[93][96] the company cited as evidence the early results of a trial—sponsored by the NIH's National Institutes of Allergy and Infectious Diseases (NIAID)[96][97]—in 315 adolescents included in the aforementioned age range and 211 adults aged 18 to 50 years,[98] which showed that both the immune responses and the safety profile were similar between the two age groups after vaccination with two standard doses.[96][97][98] In the same statement, Bavarian Nordic also stated that a study of the vaccine in children aged 2 to 12 years would take place in the DRC and Uganda later in 2024.[96]

Also on 16 August, China's General Administration of Customs declared that national authorities would deploy screening measures for people and goods entering the country from areas affected by the outbreak for the following six months.[97][99] By 17 August, Pakistan had started screening travellers at all airports and at border crossings with surrounding countries.[100]

On 17 August, the Africa CDC announced that they had pledged to distribute 10 million doses of the mpox vaccine by 2025, and that Bavarian Nordic had agreed to enhance vaccine manufacturing capabilities across Africa,[94][101] in order to increase local supplies and reduce production costs.[94] The association's Director General, Jean Kaseya, later pleaded with foreign countries not to implement travel bans against African nations, as it had previously happened during the COVID-19 pandemic.[94]

On 19 August, the DRC's Minister of Public Health, Samuel Roger Kamba Mulamba, said in a press conference that the DRC needed about 3.5 million doses of mpox vaccines, with roughly 215,000 doses set to be donated by Belgium and up to three million doses being donated by Japan, and further donations being expected by the United States.[64][65]

On 21 August, Germany's Federal Ministry of Health said that the federal government had previously accumulated 117,000 doses of the Jynneos vaccine, which had then been transferred to the Bundeswehr;[102][103] on 26 August, the German government publicly announced that it would donate 100,000 vaccines to the DRC and Burundi,[104] as well as other neighbouring African countries.[104][105] The government's spokesman, Steffen Hebestreit [de], also said that Germany would lend financial support both to the WHO and partners in Africa, in the latter case through the GAVI Vaccine Alliance,[105][106] while also collaborating with the African Union to enhance local vaccine production.[106]

### Global access to mpox vaccines

[edit]

On 23 August 2024, the World Health Organization announced that partners like GAVI and UNICEF could start purchasing mpox vaccines before they received official approval from the agency, in order to expedite vaccine distribution across the African countries affected by the outbreak.[103] The WHO, which had already invited vaccine manufacturers to submit an Expression of Interest for Emergency Use Listing (EUL) of their products on 9 August,[107] was expected to grant an emergency license to the Jynneos and LC16 vaccines in September 2024.[103][108] Writing for The New York Times, journalist Stephanie Nolen noted that the delayed approval of the mpox vaccines by the WHO—which she deemed as a "Byzantine process"—would mainly affect the low-income and middle-income countries depending on the agency for the pre-qualification process for vaccines and treatments, while the U.S. FDA and the European Union's EMA had already issued emergency license for the same vaccines during the previous outbreak in 2022 and 2023.[108]

On 24 August, the United States were set to donate 10,000 mpox vaccines to Nigeria the following week; the U.S. Agency for International Development (USAID) said that it would also donate a further 50,000 doses to the Democratic Republic of the Congo, without specifying the arrival date, since Bavarian Nordic and the Congolese government were still discussing pre-shipment requirements for storage and handling of the vaccines.[109] Helen Rees, a member of the Africa Centres for Disease Control and Prevention's emergency committee for mpox, stated that the delay in granting Africa access to vaccines was "really outrageous", as the continent had already experienced similar struggles during the COVID-19 vaccination programme.[109][110]

## See also

[edit]

* Mpox in the Democratic Republic of the Congo
* Mpox in Nigeria
* 2022–2023 mpox outbreak

## References

[edit]

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### Cited works

[edit]

* Mpox Situation in Africa (PDF) (Report). Africa Centres for Disease Control and Prevention. 30 July 2024. Archived (PDF) from the original on 21 August 2024. Retrieved 16 August 2024.
* WHO African Region Mpox Bulletin – 11 August 2024 – Democratic Republic of the Congo (PDF) (Report). World Health Organization. 11 August 2024. Retrieved 16 August 2024 - via ReliefWeb.
* Murhula Masirika, Leandre; Kumar, Anuj; Dutt, Mansi; Toloue Ostadgavahi, Ali; Hewins, Benjamin; Bubala Nadine, Maliyamungu; Kitwanda Steeven, Bilembo; Kumbana Mweshi, Franklin; Mutimbwa Mambo, Léandre; Bengehya Mbiribindi, Justin; Belesi Siangoli, Freddy; A Kelvin, Alyson; Claude Udahemuka, Jean; Kelvin, Patricia; Flores, Luis; Kelvin, David; Sganzerla Martinez, Gustavo (April 2024). "Complete Genome Sequencing, Annotation, and Mutational Profiling of the Novel Clade I Human Mpox Virus, Kamituga Strain". Journal of Infection in Developing Countries. 18 (4): 600–608. doi:10.3855/jidc.20136. PMID 38728644. Retrieved 14 August 2024.

* v
* t
* e

Pandemics, epidemics and notable disease outbreaks

* List of epidemics and pandemics

Local|

| Ancient|

* Hittite plague (c. 1330 BC)
* Plague of Athens (429–426 BC)
* Antonine Plague (165–180 AD)
* Plague of Cyprian (250–266)

|

Post-
classical|

* Plague of Justinian (541–542)
* Roman Plague (590)
* Plague of Sheroe (627–628)
* Plague of Amwas (638–639)
* Plague of 664 (664–689)
* Japanese smallpox (735–737)
* Black Death (1346–1353)
* Sweating sickness (1485–1551)

Early
modern|

| 16th century|

* Influenza pandemic (1510)
* Mexican smallpox (1520)
* "Cocoliztli" epidemics in colonial Mexico (1545, 1576)
* Influenza pandemic (1557–1559)
* London plague (1563–1564)
* Maltese plague (1592–1593)
* London plague (1592–1593)

|

17th century|

* London plague (1603)
* Maltese plague (1623)
* Italian plague (1629–1631)
* Massachusetts smallpox (1633)
* Great Plague in the late Ming dynasty (1633–1644)
* Great Plague of Seville (1647–1652)
* Maltese plague (1655)
* Naples Plague (1656)
* Great Plague of London (1665–1666)
* Maltese plague (1675–1676)
* Great Plague of Vienna (1679)

18th century|

* Iceland smallpox epidemic (1707–1708)
* Great Northern War plague (1710–1712)
* Great Plague of Marseille (1720–1722)
* Great Plague of 1738 (1738)
* Russian plague (1770–1772)
* Persian Plague (1772)
* North American smallpox (1780–1782)
* Philadelphia yellow fever (1793–1798)

Modern|

| 19th century|

* Ottoman plague (1812–1819)
* Maltese plague (1813–1814)
* Caragea's plague (1813)
* Groningen epidemic (1829)
* Great Plains smallpox (1837–1838)
* Typhus (1847–1848)
* Copenhagen cholera (1853)
* Stockholm cholera (1853)
* Broad Street cholera (1854)
* Guam smallpox (1856)
* Pacific Northwest smallpox (1862–1863)
* Barcelona yellow fever (1870)
* Buenos Aires yellow fever (1871)
* Hong Kong plague (1894)

|

20th century|

* San Francisco plague (1900–1904)
* Manchurian plague (1910–1911)
* LA pneumonic plague (1924)
* Croydon typhoid (1937)
* NYC smallpox (1947)
* Wrocław smallpox (1963)
* Yugoslav smallpox (1972)
* London flu (1972–1973)
* Indian smallpox (1974)
* Surat plague (1994)
* Malaysian Nipah virus (1998–1999)

21st century|

* SARS (2002–2004)
* Midwest monkeypox (2003)
* Bird flu (2003–2005)
* Singaporean dengue (2005)
* Indian dengue (2006)
* Chikungunya outbreaks (2006)
* Pakistani dengue (2006)
* Iraqi cholera (2007)
* Zimbabwean cholera (2008–2009)
* Madagascar plague (2008–2017)
* Bolivian dengue (2009)
* Gujarat hepatitis (2009)
* Western African meningitis (2009–2010)
* Haiti cholera (2010–2019)
* Pakistani dengue (2011)
* Darfur yellow fever (2012)
* MERS (2012)
* Singaporean dengue (2013)
* Swansea measles (2013)
* Chikungunya (2013–2014)
* Western African Ebola (2013–2016)
* DR Congo Ebola (2014)
* Madagascar plague (2014)
* Odisha hepatitis (2014)
* Polio declaration (2014)
* Indian swine flu (2015)
* South Korean MERS (2015)
* Zika (2015–2016)
* Angolan yellow fever (2016)
* Yemeni cholera (2016–2022)
* Gorakhpur Japanese encephalitis (2017)
* Saudi Arabian MERS (2018)
* Kerala Nipah virus (2018)
* Équateur province Ebola (2018)
* Kivu Ebola (2018–2020)
* Madagascar measles (2018)
* Samoa measles (2019)
* Philippine measles (2019)
* Pacific NW measles (2019)
* New York measles (2019)
* Kuala Koh measles (2019)
* Tonga measles (2019)
* DRC measles (2019–2020)
* New Zealand measles (2019–2020)
* Singaporean dengue (2020)
* Uganda Ebola (2022–2023)
* Jamaica dengue (2023)
* Bangsamoro measles (2023–present)
* 2024 Latin American dengue
* Argentina (2024)

Global|

* First plague pandemic (541–767)
* Second plague pandemic (1348–19th century)
* Influenza pandemic (1510)
* Influenza pandemic (1557–1559)
* First cholera pandemic (1816–1826)
* Second cholera pandemic (1829–1851)
* Third cholera pandemic (1852–1860)
* Third plague pandemic (1855–1860)
* Fourth cholera pandemic (1863–1879)
* Fifth cholera pandemic (1881–1896)
* Russian flu (1889–1890)
* Sixth cholera pandemic (1899–1923)
* Spanish flu (1918–1920)
* encephalitis lethargica epidemic (1919–1930)
* Asian flu (1957–1958)
* Seventh cholera pandemic (1961–1975)
* Hong Kong flu (1968–1970)
* Russian flu pandemic (1977–1979)
* HIV/AIDS (1981–present)
* Swine flu (2009–2010)
* COVID-19 (2019–present*)
* Mpox (clade II) outbreak (2022–2023)
* Mpox (clade Ib) epidemic (2023–2024)

*[v]: View this template
*[t]: Discuss this template
*[e]: Edit this template
*[c.]: circa
*[*]: Peaked during 2020-23