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The Incubation Periods of Mpox Virus Clade Ib

Javier Perez-Saez1, Patrick Musole Bugeme2, Megan O'Driscoll1

  • 1Geneva Centre for Emerging Viral Diseases, University Hospitals of Geneva, Geneva, Switzerland (J.P.-S., M.O.).

Annals of Internal Medicine
|December 8, 2025
PubMed
Abstract

Insights

The mpox virus (MPXV) clade Ib has a median incubation period of 13.6 days, potentially varying by transmission route. This finding impacts global monitoring and prophylaxis recommendations for mpox outbreaks.

Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Virology

Background:

  • Mpox virus (MPXV) clade Ib emerged in the DRC in September 2023, leading to international spread and a WHO emergency declaration.
  • Limited data exist on MPXV clade Ib's incubation period, crucial for understanding outbreak dynamics and response strategies.

Purpose of the Study:

  • To estimate the incubation periods of mpox clade Ib.
  • To investigate potential differences in incubation periods based on exposure route and demographic factors.

Main Methods:

  • Bayesian analysis of clinical surveillance data.
  • Data collected from clinically attended individuals with confirmed mpox clade Ib infection between June and October 2024 in South Kivu, DRC.
  • Analysis included demographic characteristics, exposure history, symptom onset, and transmission route.

Main Results:

  • The median incubation period from exposure to rash was 13.6 days (95% CrI, 9.6-19.0 days) among 37 confirmed cases with high viral load.
  • Estimated incubation periods ranged from 3.1 days (5th percentile) to 32.3 days (95th percentile).
  • A shorter median incubation period was observed for sexual transmission (10.3 days) compared to nonsexual transmission (13.5 days), though credible intervals overlapped.

Conclusions:

  • MPXV clade Ib may exhibit longer incubation periods than other MPXV clades, with variations influenced by transmission route.
  • Shorter incubation associated with sexual transmission aligns with patterns observed in clade IIb outbreaks.
  • Findings inform global recommendations for postexposure monitoring and prophylaxis periods.

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