Mpox Cases Rise in Brazil: Symptoms, Transmission & Prevention (2026 Update)

As of February 18, 2026, Brazil has confirmed 48 cases of mpox (formerly known as monkeypox) in 2026, according to updated data from the Ministry of Health. The majority of these cases are concentrated in the state of São Paulo, with 41 occurrences, followed by Rio de Janeiro (3), Distrito Federal (1), Rondônia (1), Santa Catarina (1) and Rio Grande do Sul (1). No deaths have been reported.

The Ministry of Health reports that most cases are mild to moderate. Throughout 2025, the country recorded 1,079 cases and two deaths.

The Ministry of Health states that the country maintains active surveillance and that the Unified Health System (SUS) is prepared for the diagnosis and clinical management of patients, with contact tracing for 14 days to interrupt chains of transmission.

Individuals experiencing skin lesions, fever, and swollen lymph nodes are advised to seek medical attention and, if possible, practice social isolation until evaluated.

In São Paulo, which has the highest number of cases, the public consultation panel of the State Health Secretariat (Nies) reports 44 confirmed cases this year, three more than the total reported by the federal government. According to Nies, 185 notifications have been registered in 2026. Of these, 71 remain suspected, 57 have been ruled out, and one is classified as probable.

The São Paulo State Health Department, in a statement, affirms that it “continuously monitors the epidemiological scenario of mpox in the state and maintains constant coordination with municipal health departments and the care network. Health services perform early identification, notification, and investigation of suspected cases, with testing and clinical follow-up, as well as contact tracing and monitoring, according to technical protocols.”

The department reports that, as of Thursday, February 19, 2026, 44 cases of the disease had been recorded this year, compared to 126 cases in January and February of 2025.

What is Mpox?

Mpox was previously known as “monkeypox.” According to infectious disease specialist Flávia Falci, of the Santa Joana Group, it is an infection caused by the Mpox virus, which belongs to the orthopoxvirus genus, the same as the variola virus (which causes smallpox).

Initial symptoms include fever, headache, body aches, fatigue, and swollen lymph nodes. It can then progress to the eruptive phase, explains Dr. Falci, characterized by progressive skin lesions: they begin as reddish areas, develop into vesicles, become yellowish, and then form crusts. These lesions can occur on the face, genitals, perianal region, palms of the hands, soles of the feet, and mucous membranes; severe cases can evolve with neurological and ocular manifestations.

Mpox has existed for decades in countries in Africa, particularly in the Democratic Republic of the Congo. However, it became globally known starting in 2022 with the onset of the global outbreak that continues to this day, says infectious disease specialist Dyemison Pinheiro, master of collective health and assistant in the emergency room of the Emílio Ribas Institute of Infectology.

Dr. Pinheiro explains that the disease is caused by a virus that divides into two clades, which are groupings of similar species with a common evolutionary ancestor. Clades 1 and 2 are further divided into subclades 1a and 1b, 2a and 2b.

“This assessment indicates the circulation of the virus. Classically, for example, 1a circulates among countries in Central Africa and 2b was first detected in Nigeria, which continued to cause infection among humans and is the main responsible for the global outbreak of 2022 to date,” says Pinheiro. Symptoms caused by clade 1b tend to be more severe in people more vulnerable to the virus, with immune deficiencies, he adds.

How is the Disease Transmitted?

Transmission occurs primarily through direct physical contact with lesions before the period of healing, whether that contact is sexual or not, says Pinheiro. The incubation period can vary from a few days to about three weeks. “Isolation is recommended until complete healing of all lesions to avoid transmission to others,” he states.

The disease can also be transmitted even before any symptoms appear or by asymptomatic patients, explains Falci. Contact with body fluids, such as saliva, blood, semen, from mother to baby, or through contaminated objects is also common; infection through respiratory droplets can occur, but is less frequent. The doctor says there have been reports of transmission from animals to humans, particularly in previous outbreaks.

“The population at greatest risk includes men who have sex with men, people living with HIV/AIDS, immunocompromised individuals, young children, and pregnant women,” says Falci. “In the case of pregnant women, mainly also due to the risk of vertical transmission and complications for the fetuses.”

Although studies are evaluating specific treatments for mpox, says Pinheiro, they have not shown the expected effectiveness. Treatment today is done only with supportive therapy, without specific treatment options.

How to Prevent?

The doctors say that the best way to prevent the disease is vaccination. The vaccine is available in the SUS for people over 18 years of age who live with HIV/AIDS, PrEP users, and health professionals who have contact with the virus.

However, Pinheiro says that vaccines have been insufficient, resulting in low vaccination coverage. “We have observed in our daily practice an increase in the number of suspected and confirmed cases, including clade 1b, which is rarely identified in circulation in Brazil. Carnival, which commonly tends to present greater physical contact between people, puts us on alert,” he says.

He advises that if skin lesions are observed, associated with or without symptoms such as fever, body aches, and swollen lymph nodes, it is necessary to avoid contact with others and seek evaluation from an infectious disease specialist.

Other forms of prevention, indicates Falci, are behavioral changes regarding sexual partners. In hospital settings, she says it is important to use protective equipment by professionals, as well as rigorous hygiene of the environment where the patient was treated.