Monkey pox cases more than double in LA County

The cumulative number of monkeypox cases has more than doubled in Los Angeles County in the past two weeks as officials race to better track the virus and more widely vaccinate the most vulnerable communities.

According to data from the Department of Public Health, there have been 1,105 cumulative cases of smallpox countywide as of Friday. As of this week, that total includes the region’s first cases in a jail and a homeless shelter, according to health official Dr. Mount Davis The average age of people with confirmed cases of smallpox in LA County is 35.

Nearly half of the county’s cases for which geographic information is available were reported in the Mid-County Health Service Planning Area, which includes West Hollywood, Hollywood, Downtown Los Angeles, Eagle Rock, Highland Park, Echo Park, Silver Lake. , Los Feliz and Boyle Heights. Around 12% of the county’s inhabitants live in this region.

About 15 percent of LA County’s smallpox cases are in an area that includes the San Fernando and Santa Clarita valleys, county health data show. Approximately 22% of the county’s residents live in this region.

The Antelope and San Gabriel valleys have recorded fewer cases.

Characterized by a rash and lesions that may look like bumps, bumps or blisters, the disease is spread primarily through prolonged skin-to-skin contact with these lesions, which may be in hard-to-see places or be mistaken for other skin problems . Lesions may first appear in the genital area and rectum before spreading to other parts of the body.

“Although cases are increasing in Los Angeles County, the risk of infection in the general population remains very low,” Davis said during a briefing Thursday.

About 98 percent of cases for which gender identity information is available are male, county figures show. And 98 percent of cases for which sexual orientation is known are among people who identify as gay or bisexual, Davis said.

Although the disease can be quite painful, it is rarely fatal. Globally, there have been five deaths from the outbreak, none of which have been in the US

“I want to reiterate that we continue to address this outbreak with the utmost urgency to slow its spread in California,” Dr. Tomás Aragón, California’s director of public health and health officer, said Friday.

Sewage tests, which continue to be useful in estimating the spread of the coronavirus, are now also being used to track monkeypox.

In late June, about a month after California’s first case was confirmed, monkeypox DNA was detected in San Francisco’s wastewater, according to the WastewaterSCAN coalition, a group of scientists who have been testing wastewater from the coronavirus since 2020.

“It helps to understand how widespread this is,” said Stanford civil and environmental engineering professor Alexandria Boehm, one of the lead researchers on the WastewaterSCAN team.

Monkeypox virus has also been detected in sewage in LA County. Samples from the Carson Joint Water Pollution Plant, which serves about 4 million residents and businesses in south and east L.A. County, showed a small presence on July 31 and for three days during the first week of August, according to data from WastewaterSCAN. The virus has not been detected there since then, despite increased case rates in the county.

By comparison, monkeypox DNA has been detected almost every day since June 27 at two sewage facilities in San Francisco, and at much higher levels than in LA County.

Still, Boehm said that doesn’t mean there won’t be more smallpox in Los Angeles County; it has just been difficult to detect among the massive sample size.

Because the LA County wastewater facility serves such a large number of people, “you have to think about the sensitivity of detecting monkeypox in relation to the incidence rate in the population,” he said. said Boehm. “Just because you don’t detect monkey pox doesn’t mean nobody has it [in that waste watershed] with monkey pox”.

It’s not immediately clear if the LA County Department of Public Health plans to expand wastewater pox testing. The county has been monitoring wastewater from the coronavirus for months, including at the joint water pollution plant, as well as the Hyperion water reclamation plant in Playa del Rey and facilities near Lancaster and Malibu .

“It will take time to look and assess the correlations between concentrations and case counts. … [But] We are excited to be part of a larger group that is figuring out how to best use wastewater data,” said LA County Public Health Director Barbara Ferrer.

As of last week, LA County had received more than 43,000 doses of the Jynneos smallpox vaccine. Almost all, 91 percent, have already been administered, and the county is offering the second doses of the two-shot series for the first time this week. People are eligible for their second dose 28 days after the first dose and are considered fully vaccinated two weeks after the second dose.

An additional 29,000 doses of the vaccine have just been received, Davis said Thursday. The latest vaccines will be used in the new method of administering doses intradermally — between layers of skin — instead of subcutaneously, in which the vaccine is injected into the fat under the skin. The new strategy allows each dose to now be one-fifth the volume of original-sized doses, thus increasing limited supplies.

People eligible for the monkeypox vaccine in LA County include gay or bisexual men and transgender people who have had multiple or anonymous sexual partners in the past 14 days. Immunocompromised residents, including those with advanced or controlled HIV infection, are given priority for immunization.

Earlier data from Africa suggest that the Jynneos vaccine is at least 85% effective in preventing monkeypox. Because the vaccine is not 100% effective, health officials still advise taking steps to reduce the risk of infection. But if infection still occurs, “hopefully the infection will be less severe,” Davis said.

Aragon said the state has placed nearly 3,000 oral and 345 IV versions of Tpoxx treatments. Vaccines are distributed to communities based on the number of cases reported by a county, he said.

He noted that the trend line of cases will begin to flatten or decline when the virus “has trouble finding people susceptible to infection.” This could happen if people develop immunity through vaccination or previous infection, or if they “change their behavior and are not having as much contact, so there is less opportunity for transmission.”

“These three things coming together is what will lower the curve of the epidemic,” Aragon said.

The California Department of Public Health released updated guidance this week recommending that people with a confirmed or suspected case of smallpox should self-isolate at home until infection has been ruled out or their injuries are completely healed , a new layer of skin has formed and they have been free of other symptoms for at least 48 hours.

Residents can resume limited, lower-risk activities if they have been free of fever, respiratory symptoms or new injuries for at least 48 hours and injuries that cannot be covered, such as those on the face, are completely healed. In this case, residents should bandage or cover unhealed injuries, wear an appropriate mask when around others; and avoid crowded environments, sharing towels or personal items, and direct skin-to-skin contact.

People who have had monkeypox do not need the vaccine because they are immune, according to the county Department of Public Health. People who received the first dose of vaccine and then became infected generally do not need the second dose; however, a doctor may suggest a second dose.

County officials have begun making the vaccines available to high-risk people in the county jail system and among the homeless.

Officials have long said the risk of exposure to smallpox comes primarily through intimate skin-to-skin contact, and transmission of the virus has not been seen in this outbreak through gym surfaces or other surfaces. public

However, in 2018, there was a single documented case of transmission of monkeypox in Britain in which a healthcare worker became infected with monkeypox after changing “suspectedly contaminated bedding” without wearing a mask or a respirator. The worker had contact with the sheets during a time when the patient had skin lesions but had not yet been diagnosed with monkeypox and isolated, according to medical journals.

Davis suggested that workers who clean surfaces in high-touch environments, such as gym equipment, or wash bedding, towels and uniforms, take care to implement sound general prevention practices that also protect against COVID- 19 and other diseases.

Workers should wear disposable gloves when cleaning, and workplaces should have hand washing and hand sanitizer facilities for employees and customers, Davis said.

“We also encourage businesses where workers provide personal care services, such as massages or skin treatments, to consider posting signs asking clients or customers to delay services if they have symptoms or if they have rashes, bumps, new or unexplained pustules or blisters. or crusts that started as blisters,” she said.

It is also recommended that “workers visually inspect the area of ​​skin that will be touched. And, of course, workers should not touch any rash,” Davis continued.

Residents can request the monkeypox vaccine through their regular health care provider or register online with the county Department of Public Health to request a vaccine. They can also call the health agency at (833) 540-0473, seven days a week between 8 a.m. and 8:30 p.m.

Times staff writer Melody Gutiérrez contributed to this report.

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