State health officials sound alarm as mpox returns

  • by John Ferrannini, Assistant Editor
  • Tuesday October 31, 2023
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California public health director Dr. Tomás J. Aragón is urging people to get vaccinated against the mpox virus. Photo: Courtesy CDPH
California public health director Dr. Tomás J. Aragón is urging people to get vaccinated against the mpox virus. Photo: Courtesy CDPH

With mpox cases continuing to rise in the Bay Area and statewide, the California Department of Public Health is encouraging all people — but gay, bisexual, and other men who have sex with men in particular — to get the full vaccination series for the disease if they have not already.

The increase in recent weeks has been precipitous. The Bay Area Reporter last reported October 13 that there'd been only one case reported in San Francisco that month. As of October 31, there've been 20 reported cases — the most of any month this year.

"We are beginning to see an uptick in mpox cases across the state. With this, we are reminding and encouraging all Californians to be aware of the signs and symptoms of mpox and to take preventive measures, including vaccination, to protect against severe illness," stated Dr. Tomás J. Aragón, the state's public health director.

"Mpox began circulating in California in the spring of 2022, and while cases have been low since its initial emergence thanks to education and community vaccination efforts, mpox can seriously impact individuals who test positive," added Aragón, who used to be the health officer for San Francisco before joining the state health department.

Statewide, reported cases had averaged less than seven per week in July and August, in spite of fears of a summer resurgence. Cases have now increased to "nearly 17 per week," according to a California DPH news release, which stated that a health advisory was sent to providers October 30.

San Diego County recently saw a spike in mpox cases, with 11 new cases reported in October, according to a county newsletter.

Two doses of the Jynneos vaccine given about a month apart provides the best protection against the disease, health officials said. According to the San Francisco Department of Public Health in a statement earlier this month, "no vaccine is 100% effective and people who have been vaccinated may still get mpox, but vaccination may decrease illness severity and reduce the risk of hospitalization."

Over 50,000 doses of Jynneos were distributed last year in San Francisco, the city's DPH stated, covering 42% of all people living with HIV in the city and 65% of people who had received PrEP at San Francisco City Clinic prior to June 2022.

Still, Dr. Stephanie Cohen, a straight ally who is the section director for HIV/STI prevention with the health department, previously told the B.A.R. that 40% of those who received the first dose of mpox vaccine didn't return for a second.

The city's DPH reiterated the need for vaccination in a statement to the B.A.R. October 31.

"The vaccine reduces the risk of infection, and significantly reduces the risk of severe disease, hospitalization, and death," the statement reads. "We encourage anyone who wants protection to complete the two-dose vaccine series. It's never too late to get your second dose."

The California DPH release stated that "while anyone can get mpox and preventive measures should be taken by all, vaccines are recommended for those at highest risk," and urged a number of groups to consider vaccination if they are not vaccinated already. These include people who know or suspect exposure to someone who has had the mpox virus; people whose sexual partners have been diagnosed with mpox in the last two weeks; and people who are gay, bisexual, or other men who have sex with men.

Additionally, transgender, nonbinary or gender-diverse people who've had a sexually transmitted infection in the last six months are recommended for the vaccine, as are people who, in the last six months, have had sex "at a commercial sex venue" such as a bathhouse, or "sex in connection with a large commercial event or in the San Francisco Bay Area or Los Angeles, where higher transmission is occurring."

Los Angeles County has seen five cases in October, according to its public health department.

The state also encouraged vaccination for those who've exchanged sex for "money or other items," people who have more than one sex partner regardless of sexual orientation, people who have HIV or are otherwise immunosuppressed, people who work in laboratory or other settings where they may be exposed to the mpox virus, people who have a sex partner who is in any of the aforementioned groups or scenarios, and people who "anticipate" being part of any of the aforementioned groups or scenarios.

The release stated that other prevention strategies in addition to vaccination include "having open conversations" with sexual partners and health providers about symptoms and possible exposure; "being aware" of new sores or rashes; not sharing bedding, towels, clothing, utensils or cups with someone who has mpox; not hugging, kissing, cuddling, or having sex with people who have mpox or were exposed within the last three weeks; washing hands frequently with soap and water or alcohol-based hand sanitizer; and using a mask, gown, and gloves while caring for people who have mpox.

Symptoms start between three and 21 days after exposure to the mpox virus. They can include flu-like symptoms and/or rashes on the face, body, genitalia, arms and legs.

Most reported U.S. cases were in California, New York, Florida, and Texas, according to Centers for Disease Control and Prevention data, which showed that there were 38 mpox deaths nationwide between May 2022 and March 2023, during which time there were 30,235 cases. For the 24 decedents who had HIV for whom data was available, all had a CD4 count of less than 50.

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