Mpox emergence in Japan: risks of establishment in Asia and the global resurgence

In late January 2023, mpox cases without a travel history started to be frequently reported in Japan. As of 14 March 2023, the total number of cases reached 45 with an apparent sign of sustained local transmission. Compared with many of the previously affected countries, Japan is more closely connected with other Asian countries. In the current global mpox outbreak, Asia has been the least affected region so far with limited or no vaccine rollout. As a result, many countries in this region (including low- and middle-income countries) are left with a large susceptible population to mpox. If local transmission is established in these countries, the global spread of mpox may reemerge.