Mpox is on the rise in Berlin with gay men seen most at risk

BERLIN - A new spike in mpox cases in Berlin has sparked alarm among German health authorities and LGBTQ+ advocates, with local groups calling for an urgent vaccination campaign to protect gay and bisexual men most at risk from the outbreak.

The German capital registered four times more mpox cases in the first three months of 2025 than in the same period of 2023 and 2024, and unlike many of the cases reported across Europe this year, most of them are not travel-related.

Berlin health authorities expect the number to rise in the coming weeks. 

The city, which accounts for just 4.6% of Germany's population, has reported 68 mpox cases so far this year, more than a third of the 185 cases nationwide, the Robert Koch Institute said in an email. 

Here's what you need to know.

What does this latest outbreak in Germany look like?

Mpox can spread through close contact with an infected person, including skin-to-skin touching, through cuts, sexual activity or mouth-to-mouth contact. 

In some cases, infection can also occur by breathing in respiratory particles.

Several European countries, including Spain, France and Britain, have reported a small number of cases of the new mpox variant know as Clade Ib linked to travel to African countries. 

The new strain has infected thousands of people in central Africa since it emerged in the Democratic Republic of Congo in 2023, where it has killed more than 500 people, mostly children.

Berlin registered 43 mpox cases in the first three months of 2025, compared to nine and 10 in the same period of 2024 and 2023, respectively. According to local health authority LAGeSo, those affected are exclusively men with an average age of 35.

Unlike the Clade Ib cases reported in other European countries, German officials believe most of these infections are not travel related and all occurred in Berlin, with seven patients believed to have contracted the disease through sex.

The European Centre for Disease Control said Stockholm had also reported a similar outbreak since the beginning of the year, driven mostly by local transmission in Sweden. 

All those mpox cases are Clade II, which affects mostly men who have sex with men, an epidemiological term referring to gay and bi men, whether they openly identify as such or not. 

Why are mpox cases on the rise, and will they keep surging?

LAGeSO could not isolate a specific reason for the latest uptick, but said big LGBTQ+ events, as well as gaps in Berlin's vaccination efforts that have targeted gay and bisexual men since 2022, could be behind the current outbreak.

"The proportion of cases among vaccinated people is currently lower than in the two previous years, which may indicate that new infections are particularly affecting people who have not yet been reached by vaccination campaigns," said LAGeSO spokeswoman Stephanie Reisinger. 

That could include people who moved to the German capital after 2022, she said.

However, the outbreak remains much less severe than that of 2022, when Berlin registered more than 1,300 cases between June and July.

"I consider the risk of an outbreak as large as the one in 2022 to be very low," Leif Erik Sander, director of the infectious diseases clinic at the city's Charité hospital, told the Berliner Morgenpost newspaper, citing more awareness of mpox.

The World Health Organization said the cluster of cases in Berlin was concerning, but does not signal a larger outbreak.

What do LGBTQ+ campaigners and health authorities say?

LAGeSO said it was working to raise awareness among those most at risk of infection and to make mpox vaccines available irrespective of insurance status, which LGBTQ+ groups say has been an obstacle for uninsured, or inadequately insured patients in the past two years.

Advocates believe that, given the stigma gay and bi men often face, LGBTQ+ charities providing free sexual health services in German cities are best placed to earn the trust of those most at risk, but they need financial support.

"The message should be: We see you, you are important, your needs and behaviour are fine, and we will do everything we can to ensure your wellbeing," said Stephan Jäkel, who leads the team fighting HIV and other sexually transmitted infections at Schwulenberatung, an LGBTQ+ non-profit.

(Reporting by Enrique Anarte; Editing by Jon Hemming.)