Michael Ruggiero, 26 of Old Bridge, receives the Monkeypox vaccine in Paramus, N.J. on Thursday Aug. 4, 2022. Monkeypox vaccines released from the U.S. Strategic National Stockpile are given to eligible New Jersey residents at Bergen New Bridge Medical Center in Paramus to help prevent the spread of the once-rare disease. Monkeypox Vaccinations
Long Beach, California – California health officials are investigating two mpox infections that may mark the first U.S. cases of locally transmitted clade I mpox — a more virulent version of the virus previously seen only in travelers returning from abroad.
The first case was confirmed earlier this week by the Long Beach Department of Health and Human Services through testing at a state lab. A second case, reported by Los Angeles County health officials on Thursday, shares a similar genetic profile. Both patients were hospitalized but are now recovering at home.
The two cases do not appear to be linked. “At this point in our investigations, we have not identified any association between the two cases,” said Jennifer Ann Gonzalez, acting public affairs officer for the Long Beach health department. “The risk to the public remains low.”
That assurance, however, hasn’t quieted concerns within public health circles. Until now, all six previously identified U.S. cases of clade I mpox were tied to international travel. If these California cases prove to be locally acquired, it could suggest the virus has begun circulating domestically — a scenario that experts have long warned could emerge if global surveillance faltered.
A Virus With a History
Mpox, once known as monkeypox, is a viral disease related to smallpox. It causes fever, fatigue, and in some cases, painful skin lesions. The milder version, clade II, triggered an international health crisis in 2022 that spread rapidly among men who have sex with men. At its peak, the United States was seeing nearly 500 new infections per day.
That outbreak eventually waned thanks to public awareness campaigns and the Jynneos vaccine, which helped protect high-risk populations. Clade I, however, is a different story. It has circulated for decades in parts of central and eastern Africa, where it’s known to spread not just through sexual contact but also through more general forms of person-to-person transmission — even among children.
“This version of the virus has always worried us more,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University. “It’s concerning if this virus has come here and is now starting to be transmitted from person to person.”
Limited Federal Oversight Amid Shutdown
The timing of the new cases has also raised logistical alarms. The federal government’s shutdown has left hundreds of staff at the Centers for Disease Control and Prevention furloughed, including those typically responsible for outbreak coordination and genomic sequencing.
Local investigators say they have been in limited contact with CDC experts. “A few CDC people have been available to talk to us,” said Nora Balanji, communicable disease coordinator for Long Beach. “But we’re still waiting for confirmation on the sequencing results and guidance.”
In the meantime, officials in both Long Beach and Los Angeles are conducting contact tracing and have provided vaccines to several close contacts. So far, they have found no clear evidence of community transmission.
“We don’t have proof that this has spread beyond these cases,” Balanji said. “But it’s something we’re watching very closely.”
