Mpox in Brazil
Brazil had the largest mpox caseload in the Americas during the 2022 global outbreak, with over 10,000 cases concentrated in major urban centers.
Key Data
| Metric | Data |
| Total cases 2022 | >10,000 |
| Americas ranking | Largest caseload in the Americas in 2022 |
| Most affected states | São Paulo, Rio de Janeiro, Minas Gerais |
| National reference lab | Fiocruz (Fundação Oswaldo Cruz) |
| Vaccine | JYNNEOS (Imvanex/MVA-BN) |
| Health authority | Ministério da Saúde / SVS Brazil |
Brazil's 2022 Outbreak
Brazil's first confirmed mpox case was detected in São Paulo in June 2022. Case numbers climbed rapidly, driven by Brazil's high international connectivity and large urban networks. São Paulo state alone accounted for the majority of cases. Brazil's Fiocruz — the national reference laboratory and one of Latin America's most respected public health research institutions — led genomic surveillance, rapidly sequencing cases to confirm Clade IIb and characterize transmission chains. Fiocruz published regular epidemiological bulletins throughout the outbreak. Brazil's case fatality rate was higher than in the US or Europe, partly due to cases occurring in individuals with advanced HIV who faced more severe disease.
Vaccination Challenges
Brazil faced significant challenges securing mpox vaccines during the 2022 outbreak due to global shortage of JYNNEOS doses. Brazil's SUS (Unified Health System) eventual rollout prioritized gay and bisexual men, transgender individuals, and those living with HIV. Brazil also conducted mpox seroprevalence studies through Fiocruz to understand population-level exposure. Brazilian researchers published important clinical data on mpox presentation, severity correlates (particularly in people with HIV), and treatment with tecovirimat, contributing to the global evidence base on mpox management.
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FAQ
Brazil's mpox death rate was higher than in Europe or North America. The main factor was a higher proportion of cases in individuals with advanced, untreated HIV — who face significantly greater risk of severe mpox (disseminated skin lesions, encephalitis, pneumonitis). Brazil's HIV epidemic, while well-managed overall, includes a population with untreated or inadequately controlled HIV who were disproportionately affected. Better HIV treatment access and earlier mpox diagnosis and treatment are key interventions.
Mpox risk for typical tourists to Brazil is low. The 2022 outbreak was primarily transmitted through close sexual contact in specific social networks. Travelers with multiple sexual partners should be aware of mpox risk and consider vaccination if eligible. The current global risk for Clade Ib importation to Brazil is being monitored; check the Brazil Ministry of Health website for current guidance before travel.
Sources: Brazil Ministério da Saúde mpox bulletins; Fiocruz mpox genomic surveillance; PAHO Americas mpox data; Lancet Infectious Diseases Brazil mpox analyses.
Related: Mpox overview · USA mpox · DRC mpox