The mpox public health emergency is over, but infectious disease groups say there's still plenty to learn

The mpox public health emergency has officially come to an end after being in effect for just under half a year.

The country has seen 30,093 cases of the viral, vaccine-preventable disease since last May, though the seven-day moving average of new daily cases has dropped to just three as of Jan. 25, according to the Centers for Disease Control and Prevention (CDC). There were 26 deaths attributed to the disease in the U.S., per the CDC.

Globally, cases of mpox have been reported among 110 countries, only seven of which historically reported mpox before last year’s outbreak, according to the World Health Organization (WHO). There have been 85,449 confirmed cases and 89 deaths as of Jan. 31, WHO reported.

The U.S. Department of Health and Human Services (HHS) declared a public health emergency Aug. 4 and renewed it once on Nov. 2. In December, HHS Secretary Xavier Becerra said in a statement that the low number of new cases made it unlikely that the department would need to renew the emergency declaration come Jan. 31.

“But we won’t take our foot off the gas—we will continue to monitor the case trends closely and encourage all at-risk individuals to get a free vaccine,” Becerra said at the time. “As we move into the next phase of this effort, the Biden-Harris Administration continues working closely with jurisdictions and partners to monitor trends, especially in communities that have been disproportionately affected.”

WHO still lists mpox among other global health emergencies such as COVID-19.  


The Biden administration’s response to the virus included the distribution of more than 1 million doses of smallpox vaccines, which also offered protection against mpox. These doses and antivirals were primarily provided to high-risk populations such as men who have sex with men and healthcare workers.

Partway through the response, the administration adopted a “fractional dose” strategy that split each vaccine dose by a fifth to make the most of a limited supply—though media reports suggest that packaging and other issues limited the effectiveness of that alternate approach.

In a Tuesday letter addressed to President Joe Biden, infectious disease experts and LGBTQ+ advocacy organizations said the country’s response to mpox can serve as a road map for how to better respond to an emerging public health crisis.

The National Mpox Working Group—which consists of nearly two dozen groups including the Infectious Diseases Society of America, National Coalition of STD Directors and APLA Health—wrote that the appointment of Bob Fenton and Demetre Daskalakis as response coordinators was “a turning point in the mpox outbreak” after an initial slow response. Their roles and reliance on interagency collaboration, community outreach and swift data sharing should “be used as models for future emergencies, but done so more quickly in future outbreaks,” the group recommended.

More attention, however, will be needed for other response shortcomings around messaging, racial and geographic health inequities, “insufficient” federal financial support and funding flexibility.

“The experiences and lessons learned from mpox demonstrate that, in spite of the successful efforts to lower the number of cases, we have emerged from yet another outbreak without having addressed the fundamental issues of an ill-equipped public health system,” the groups wrote to Biden.

“We recommend that the administration prioritize increasing investments in our public health system. Anything less sets a disturbing precedent for what we can expect in the next public health crisis," the groups wrote.