Los Angeles County reports first confirmed MPX death in the nation

Public health officials said Monday that a Los Angeles County resident has died of MPX disease — the first confirmed death linked to the disease in the country.

Officials first announced the death Thursday, but said the exact cause was still being investigated at that point. Additional investigation from the county Department of Public Health and the U.S. Centers for Disease Control and Prevention determined that the death was due to MPX, also known as monkeypox, according to the statement.

Another possible death – a severely immunocompromised adult diagnosed with MPX – was reported in Texas in late August. However, officials there have not definitively determined whether this death was caused by the disease.

The Los Angeles County Department of Public Health noted that local residents were “severely immunocompromised and were hospitalized,” but otherwise did not disclose any other details — such as the person’s age, gender or city of residence — citing privacy concerns.

“People with severely compromised immune systems who suspect they have monkeypox are encouraged to seek medical care and treatment early and to remain under the care of a caregiver while they are sick,” the department wrote in a statement.

California health officials recently began using the name MPX — pronounced mpox — in place of monkeypox due to widespread concerns that the older name was stigma and racism. The World Health Organization is in the process of officially renaming the disease, which will take several months.

As of Friday, Los Angeles County health officials are reporting 1,836 MPX cases. However, hospitalizations associated with this disease are still rare.

The rate of newly reported MPX cases also continues to slow. For the seven-day period that ended Thursday, Los Angeles County reported 187 new cases, down 30% from the previous week’s number of 269.

Officials attributed the slowdown in part to vaccination efforts and nationwide survey data indicating that gay and bisexual men have reduced the number of their sexual partners and one-time sexual encounters in light of the outbreak.

Because MPX doesn’t transmit easily — it typically requires close skin-to-skin contact for infection to occur, and it’s nowhere near as transmissible as the coronavirus — officials say the disease’s spread is likely to fade relatively quickly compared to infectious diseases.

MPX disease is characterized by a rash and virus-filled lesions that can look like blisters, bumps, or blisters. It can first appear in the genital area and rectum before spreading to other parts of the body, and because the rash can be confused with other skin problems, the virus can spread easily during intimate encounters. The risks are higher for people who have multiple sexual partners.

We will likely continue to see cases for a long time to come. At least the current large number that we’re seeing, we’re hopeful we’ll see is going down, Dr. Rita Singhal, chief medical officer of the Los Angeles County Department of Public Health, said during Thursday’s briefing.

In an advisory issued last week, county health officials note that severe MPX disease has been found in people with HIV who are not adequately treated, underscoring how important it is for people at higher risk to seek treatment.

“People with advanced or uncontrolled HIV are at risk of developing life-threatening diseases. In previous outbreaks, the majority of monkeypox deaths were reported among this group,” health officials said in an advisory released Friday.

Los Angeles County health officials are specifically urging health care providers to use a drug called tecovirimat — known as Tpoxx — in patients who have or are at risk of developing severe MPX disease.

An earlier county report released a month ago said that “patients with lesions or pain that interfere with activities of daily living and patients at risk for severe disease” should be considered for treatment with Tpoxx.

There is no shortage of Tpoxx, but the drug has been difficult to obtain for patients, in part because it has not been formally approved by the U.S. Food and Drug Administration for the treatment of MPX.

If patients are unable to take the drug orally, Tpoxx should be given intravenously. Other treatment options include cidofovir, an antiviral medication given intravenously, and Vaccinia Immune Globulin.

The Associated Press reports that US officials are also considering expanding recommendations on who should be vaccinated against MPX to men with HIV or those recently diagnosed with other sexually transmitted diseases.

Health officials said doctors are required to report all cases of MPX to the Los Angeles County Department of Public Health. If patients admitted to the hospital have worsening symptoms, such as a need for intensive care, hospitals are asked to contact county health officials for advice and further treatment options.

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