A more serious strain of mpox may be spreading locally in Los Angeles County, a version of the virus with a higher death rate than the one that swept through the LGBTQ community three years ago.
Investigators are examining three cases — two in Los Angeles County and one in Long Beach — involving patients with no recent travel history and no apparent connection to one another.
“The confirmation of a third case with no travel history raises concerns about possible local spread in Los Angeles County,” said Dr. Muntu Davis, the county’s health officer, in a press release. “We’re working closely with our partners to identify potential sources and understand how this potentially more serious form of the mpox virus may be spreading.”
California health officials said all three patients were hospitalized and are now recovering at home in isolation, according to The New York Times.
Last year, California reported the nation’s first known case of clade I mpox in a person who had recently traveled to Africa. The patient was treated in San Mateo County, outside San Francisco, and no additional cases were linked to that infection.
Before this week, all six previously confirmed U.S. cases of clade I mpox — including the San Mateo case — involved people who had recently traveled to parts of Africa where the strain is more prevalent, reports ABC News.
The lack of travel history among the three California patients may suggest the virus is spreading through casual sexual contact — and could spread further across the United States, particularly among people who have not been vaccinated against mpox.
Mpox is caused by infection with the monkeypox virus, which is similar to the virus that causes smallpox. It can spread from infected animals to humans and from person to person through close contact, respiratory secretions, skin lesions, or contaminated objects such as clothing or bedding.
Infected individuals typically develop a rash on their hands, feet, chest, face, mouth, or near the genitals, and may experience fever and swollen lymph nodes. Those with symptoms should seek medical attention and get tested. While the infection is unpleasant, most people recover within two to four weeks without specific treatment.
The mpox strain identified in Los Angeles, known as clade I, is more lethal than its sister strain, with a death rate ranging from 1.4% to 10%. By comparison, clade II’s death rate ranges from less than 1% to 4%.
According to the Centers for Disease Control and Prevention, clade I is primarily found in Central and Eastern Africa. It includes two subclades: Ia, seen mostly in Central Africa, is transmitted through contact with infected wild animals or infected people, with many cases occurring in children under 15; and Ib, found in eastern Democratic Republic of the Congo, has primarily spread through intimate adult sexual contact, including heterosexual transmission among sex workers.
The mpox IIb subclade was responsible for more than 114,000 confirmed infections worldwide and 220 reported deaths since 2022. Early in the outbreak, the strain was especially prevalent among men who have sex with men who attended or frequented LGBTQ festivals, leather and BDSM events, and bathhouses.
The virus’s spread was significantly slowed by changes in sexual behavior, such as abstinence, which caused global case numbers to decline. Still, the virus continues to circulate at a decreased rate, with only about 9,000 clade II infections reported in 2024.
The JYNNEOS vaccine — a two-dose immunization approved by the Food and Drug Administration to prevent smallpox and mpox — is currently the only vaccine used to curb the virus’s spread. It is effective against both clade I and clade II strains.
Health officials recommend the vaccine for people who have traveled to parts of Africa where the virus is prevalent, men who have sex with men, and anyone who has had multiple sexual partners in a short period, had intimate contact with someone infected with mpox, or engaged in sex at commercial venues such as bathhouses and saunas.
People can lower their risk of mpox infection by avoiding sexual contact when they have new or unexplained rashes or sores, limiting their number of casual sexual partners, avoiding sex parties, using condoms or gloves during oral sex, anal sex, or penetration, and thoroughly washing hands, towels, bedding, and sex toys after use.
The Trump administration has agreed to settle a lawsuit by restoring webpages containing health- and science-related information, including resources on HIV and LGBTQ health issues, that had been deleted to comply with a series of executive orders issued by President Donald Trump.
Those orders sought to erase transgender identity from federal law, prohibited agencies from using the term "gender" in policy, and targeted diversity, equity, and inclusion programs across government and the private sector.
Other Trump orders targeted diversity, equity, and inclusion programs in both government and the private sector, and threatened to strip federal funding from events or organizations accused of promoting so-called "gender ideology."
On September 5, the World Health Organization declared that Africa's mpox outbreak is no longer considered an international health emergency.
The announcement was a relief for many in the LGBTQ community, as one variant, Clade II, spread rapidly among men who have sex with men (MSM). At the virus's peak, the United States reported nearly 500 cases per day.
The virus causes flu-like symptoms and, most notably, painful rashes, lesions, and scabbing. With an incubation period of 3 to 17 days, many people don't realize they are infected until visible symptoms appear.
Whitman-Walker will host its 39th annual Walk & 5K to End HIV at Anacostia Park on Saturday, Sept. 20.
The event, which has served as the health organization's chief fundraiser for nearly four decades, brings together thousands of residents and local businesses -- some as corporate sponsors or fund-matching partners -- to raise money for Whitman-Walker's patient services.
This year marks the fourth time the event has been held east of the Anacostia River, in Southeast D.C., where many of Whitman-Walker's patients live and where HIV rates remain among the highest in the city.
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