A potentially more severe strain of mpox may be spreading in L.A. County
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Officials are concerned that a potentially more severe strain of mpox is starting to spread locally after a third case was confirmed in Los Angeles County on Friday.
The trio of cases, all reported publicly this week, represents the first time this particular type of mpox, known as “Clade I,” has been found in the United States among people who had no history of traveling overseas to high-risk areas.
The first case, reported publicly on Tuesday, involved a resident of Long Beach. The second and third cases, reported Thursday and Friday, occurred among other Los Angeles County residents. All three patients were hospitalized but are now recovering at home.
“At this time, no clear link has been identified between the cases,” the L.A. County Department of Public Health said.
Nonetheless, “the confirmation of a third case with no travel history raises concerns about possible local spread in Los Angeles County,” Dr. Muntu Davis, the L.A. County health officer, said in a statement. “We’re working closely with our partners to identify potential sources and understand how this potentially more serious type of the mpox virus may be spreading.”
“While the overall risk of ... exposure to the public remains low, we are taking this very seriously,” Long Beach Mayor Rex Richardson said in a statement. “This underscores the importance of continued surveillance, early response and vaccination.”
Los Angeles County reported 10 cases of mpox in a two-week period, up from prior weeks. Officials call for testing and vaccination to help curb its spread.
This type of mpox is different from the one that spawned a global outbreak in 2022, which is known as “Clade II.”
Clade I is potentially even more concerning, however, because it may cause more severe illness and spread more easily, “including through close personal contact,” such as massage or cuddling, in addition to sex, the L.A. County Department of Public Health said.
The California Department of Public Health said last year that Clade I has historically caused more severe illness than Clade II, but added that “recent infections from Clade I mpox may not be as clinically severe as in previous outbreaks, especially when cases have access to quality medical care.”
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Mpox, formerly known as monkeypox, is primarily spread through close, intimate contact, such as through body fluids, sores, shared bedding or shared clothing, as well as kissing, coughing and sneezing, health officials say.
“Casual contact, like one might have in an airplane, office or store, is unlikely to spread mpox,” the California Department of Public Health said.
Tell-tale symptoms “include rash or unusual sores that look like pimples or pus-filled blisters on the face, body and genitals, fever, chills, headache, muscle aches or swelling of lymph nodes,” the L.A. County Department of Public Health said. Other symptoms can include a sore throat.
“Anyone who develops an unexplained rash or lesions should avoid sex and intimate contact and seek medical evaluation as soon as possible,” the Long Beach Department of Health and Human Services said.
People should get tested if they have symptoms, officials said. Those who have symptoms should also avoid sex or close contact.
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Clade II mpox generally causes mild-to-moderate illness and has been circulating at low levels throughout the United States since 2022, according to the L.A. County Department of Public Health.
There have been 118 cases of Clade II mpox reported to the L.A. County Department of Public Health so far this year.
Before this week, there had been a total of six cases of Clade I mpox in the U.S. — all among people who had recently traveled to areas where this type of mpox is circulating, namely central and eastern Africa. None of those cases was linked to each other, according to the Centers for Disease Control and Prevention.
The CDC says there have been more than 40,000 cases of Clade I mpox in central and eastern Africa.
In the Democratic Republic of Congo, one of the countries with confirmed cases, multiple modes of Clade I mpox transmission have been documented, including “contact with infected dead or live wild animals” and “household contact often involving crowded households,” in addition to sexual contact, according to the CDC.
The risk to the general U.S. population in the U.S. from Clade I mpox is considered “low,” the CDC says. The agency classifies the risk to gay and bisexual men who have sex with more than one partner as “low to moderate.”
Travel-associated cases of Clade I mpox have also been found in a number of other regions globally, including Asia, Australia, Europe and South America.
The first Clade I mpox case in the U.S. was reported 11 months ago — in someone in California who had traveled to Africa and received care in San Mateo County, according to the CDC and California Department of Public Health. That person had mild illness, the San Mateo County health department said at the time.
Most people who are infected get better within two to four weeks, the Long Beach Department of Health and Human Services said, “but antiviral treatments may be considered for individuals with or at risk of developing severe illness.”
There is no evidence that the strain is spreading in California or the U.S., and the risk of contracting Clade I mpox in the U.S. remains low.
The two-dose Jynneos vaccine is also available to help prevent the spread of mpox.
Those who got only one dose can get their second doses “no matter how long it’s been since the first dose,” the L.A. County Department of Public Health said.
Vaccines are widely available, and can be found at pharmacies such as Walgreens and CVS. People can look up locations to get vaccinated through the vaccine’s manufacturer, Bavarian Nordic. The L.A. County Department of Public Health also maintains a list of vaccination sites.
The vaccine is available to people at higher risk for the illness, including those who were exposed to an infected individual over the last two weeks.
Mpox cases have fallen in California, but health officials are pushing for more vulnerable people to be vaccinated, including those in the LGBTQ+ community, ahead of summer.
Also eligible for vaccination are gay and bisexual people and other men who have sex with men; transgender, nonbinary or gender-diverse people; people with HIV; people who are eligible or are taking medicine to prevent getting HIV from sex or injection drug use; people traveling to sub-Saharan Africa or areas with Clade I mpox outbreaks; people who plan to attend a commercial sex event or venue, such as a sex club or bathhouse; people who have a sex partner at higher risk for getting infected; and anyone else who requests mpox vaccination.
Officials recommend people with occupational risks for infection, such as certain lab workers, also get vaccinated.
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