Epidemiological trajectory of Mpox in Brazil, 2022–2025: evidence of geographic consolidation and syndemic burden
Gabriel do Nascimento Soares, Camila Innocente-Alves, Ana Luiza Marques, Tatiane da Silva Dal Pizzol, Fabrício S. Campos, Lucélia Santi, Walter Orlando Beys-da-SilvaAbstract
Mpox has transitioned from outbreak to sustained transmission in Brazil, a country with high ecological and social connectivity. We analysed the epidemiological trajectory of mpox during 2022–2025 using 14 475 laboratory-confirmed cases reported by the Brazilian Ministry of Health. Our findings indicate geographical consolidation of transmission, with the highest incidence observed in the southeast and midwest regions. The epidemic disproportionately affects men (93.0%), particularly young adults, with transmission primarily associated with networks of men who have sex with men (69.1%). A substantial burden of co-infections was identified: 47.1% of reported cases occurred in persons living with HIV and 30.8% had syphilis. Clinically, most patients presented with cutaneous manifestations (91.3%). These findings highlight the convergence of epidemiological and social determinants shaping mpox transmission in Brazil. Strengthening integrated surveillance systems and ensuring equitable, stigma-free access to prevention and care are critical to reducing transmission and mitigating the risk of broader dissemination.