Two Californians recently diagnosed with mpox may represent the first U.S. cases stemming from the local spread of a distinct version of the virus, specifically Clade I mpox, health officials have indicated. The Long Beach Department of Health and Human Services confirmed the initial case this week through state lab testing. Los Angeles County health officials subsequently reported a second, similar case. While these are not the first U.S. cases of Clade I mpox, previous instances involved international travelers, who presumably became infected abroad. Officials currently assess the risk to the public as low.
Understanding Clade I Mpox: Severity and Transmission
Both infected individuals in California required hospitalization; happily, they are now recovering at home. Officials have not yet identified any association between the two cases during their investigations. Long Beach, though within Los Angeles County, operates its own city health department. Investigators there have not found a close contact who traveled internationally. Furthermore, they have not confirmed additional cases. A few close contacts of the infected person received a vaccine, according to Nora Balanji, Long Beach’s communicable disease coordinator. However, Balanji stated, “We don’t have any proof that there has been ongoing community transmission. It’s something we’re looking into. That’s something we’re concerned about.” Mpox, also known as monkeypox, is a rare disease stemming from a virus related to smallpox. It is endemic in parts of Africa.
Notably, experts consider Clade I mpox potentially more severe than Clade II mpox. Clade II was the cause of the 2022 global outbreak. Fatality rates for Clade I typically range from 1% to 10%, whereas Clade II rates are usually less than 1% to 4%. Furthermore, clinicians more commonly observe Clade I in children, especially in the Democratic Republic of Congo. This differs from Clade II. This variant spreads through various modes. These include close and intimate contact, household contact, and also contact with contaminated materials.
Clinical Presentation and Public Health Response to Clade I Mpox
Symptoms of mpox can range from milder signs such as fever, chills, and body aches to more severe manifestations like lesions on the face, hands, chest, and genitals. The incubation period can vary, generally starting within 3 to 21 days after exposure. The rash for Clade I may cover more of the body compared to Clade II. A newer form of the Clade I virus has spread widely in eastern and central Africa. The World Health Organization (WHO) previously declared this situation a public health emergency, though it later indicated that the problem had sufficiently waned. Nevertheless, Dr. William Schaffner, an infectious diseases expert, expressed concern about person-to-person transmission in the U.S.
The reporting of these cases coincides with a federal government shutdown, impacting the Centers for Disease Control and Prevention (CDC). Balanji confirmed that some CDC experts have assisted her department. Schaffner highlighted that prolonged shutdowns further impair public health responses to outbreaks. Despite these challenges, early detection, rigorous testing, and vaccination remain crucial for controlling the spread of mpox. The Jynneos vaccine protects against both Clade I and Clade II mpox; therefore, two doses offer the best protection.
Frequently Asked Questions
Q1: What is Clade I mpox, and how does it differ from Clade II?
Clade I mpox, a version of the mpox virus, generally shows more severe illness and higher fatality rates (1-10%) compared to Clade II mpox (less than 1-4%). Unlike Clade II, which caused the 2022 global outbreak and primarily affected men who have sex with men, Clade I has infected a broader range of people, including children, and can spread through various forms of close contact, not just sexual contact.
Q2: What are the symptoms of Clade I mpox?
Symptoms of Clade I mpox are similar to other mpox cases, including fever, chills, body aches, and the development of painful lesions or rashes on the face, hands, chest, or genitals. The rash for Clade I may cover more of the body compared to Clade II.
Q3: Is the public at high risk from the new Clade I mpox cases in California?
Health officials state that the overall risk to the general public remains low. However, they emphasize the importance of early detection, testing, and vaccination with the Jynneos vaccine, which offers protection against both Clade I and Clade II mpox.
References
- California mpox cases raise concerns. But health officials say the risk remainslow – ETHealthworld
- Modeling Household Transmission of Clade I Monkeypox in the United States | CFA – CDC
- How high is the risk of catching mpox and how can I protect myself?
- Mpox (monkeypox): What is it and how can it be prevented? – Mayo Clinic
- County Public Health Confirms Its First Case of Clade I Mpox – Case not linked to travel; Public health urges vaccination, testing, and prevention.
- Transmission of monkeypox virus clade I: overall risk remains low in the EU/EEA – ECDC
- Mpox strain that may be more severe appears to spread locally in U.S. for first time
- Mpox Outbreak Clade I vs Clade II – Johns Hopkins Bloomberg School of Public Health
- MPox Alert: New Clade I Outbreak Raises Concerns | New York State Nurses Association
- Mpox is a public health threat and the U.S. should be prepared
- New mpox strain may be spreading in L.A. County; 3rd case confirmed – Los Angeles Times
- Mpox – Wikipedia
- Mpox – World Health Organization (WHO)
- Mpox: Symptoms, testing, care and treatment – Canada.ca
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