A second person in the United States infected with monkeypox has died in California.
As in the earlier case in Texas, public health officials are investigating what role the virus may have played in the death of this second patient.
“We will be doing an autopsy. So, it does take time for those results to come back. So, it may be as soon as a few days, or it may take a few weeks,” Los Angeles County’s Dr. Rita Singhal told reporters on Thursday. The autopsy was planned for Friday.
An estimated 18 people have died around the world in this monkeypox outbreak, including eight in “locations that have not historically reported monkeypox,” according to the U.S. Centers for Disease Control and Prevention.
California has more monkeypox cases than any other state, with 4,140 people known to be infected so far. More than 21,500 people have been infected in the United States, the CDC says.
Most people recover from the virus with minimal treatment, public health officials have said.
Those who are considered to be at higher risk of severe outcomes are young children under 8, pregnant women, people who are immunocompromised and those with a history of eczema, according to the CDC.
Some people with HIV, especially those with untreated HIV, may be at higher risk of hospitalization. A large portion of cases in the outbreak have been in people with HIV, CBS News reported.
The Texas patient who died was “severely immunocompromised,” though additional details about the case were not provided by officials, who said it was “early in the investigation.”
Meanwhile, a vaccination campaign is credited with slowing new U.S. cases.
The CDC issued a technical report last week that the outbreak was expected to “grow very slowly” over the coming month, “likely with a declining growth rate.”
Monkeypox vaccine is more widely available now because of the Biden administration’s dose-sparing “intradermal” strategy; 70% of doses are administered this way. Intradermal dosing stretches one dose to five by injecting the vaccine under the first layer of the skin.
“So, now that supply is less of an issue, we need to make sure we focus on maintaining demand by making sure that people know that an effective and safe vaccine is available for those that could benefit,” Bob Fenton, the White House’s top monkeypox official, said Wednesday, CBS News reported.
An issue to work through is a recent “significant” mutation in the monkeypox virus. That mutation is still considered rare, but it did lead to false negatives in three California tests. The CDC has warned labs to update tests to avoid false results. In other cases, “false positives” have been noted.
The CDC has asked the head of its National Center for HIV, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) to now manage the response.
“Monkeypox poses new concerns to health and safety. It requires that all of us step up with our expertise, tools, partnerships, programs and talent,” NCHHSTP head Dr. Jonathan Mermin wrote in a letter announcing his new role leading the monkeypox response.
“Many people within CDC and NCHHSTP are currently working on the monkeypox response, and many public health colleagues throughout the nation are being asked to take on additional responsibilities,” Mermin said. “I look forward to joining them in this effort.”