Two people in Los Angeles County got sick this week with a disease that shouldn’t be here. Neither traveled overseas. Neither visited the African countries where this particular infection normally spreads. Yet both ended up hospitalized with a strain of mpox that health officials had been desperately trying to keep out of the United States.
For months, authorities tracked this more dangerous version as it tore through central and eastern Africa, infecting over 40,000 people. Six cases reached American soil before this week, but every single one involved someone who’d traveled to outbreak zones and likely got infected abroad. Contact tracing could follow clear paths back to known sources.
Now that pattern has broken. Two California residents contracted Clade I mpox without leaving the country. Somewhere in Los Angeles County, this virus is spreading from person to person. Investigators haven’t connected the two cases yet. They don’t know who infected these patients or how many others might already be carrying the disease.
“While the overall risk of mpox clade I exposure to the public remains low, we are taking this very seriously,” Long Beach Mayor Rex Richardson said Tuesday after the first case came to light. Two days later, county officials confirmed a second case. Nobody knows if these will be the last.
Long Beach Resident Got Sick First on Tuesday
Long Beach Department of Health and Human Services announced the first case publicly on Tuesday. A resident had tested positive for Clade I mpox and required hospitalization. By the time authorities made the announcement, the patient was already home, isolated and recovering.
Long Beach maintains its own health department separate from Los Angeles County. City officials immediately launched contact tracing procedures, reviewing the patient’s social history, travel patterns, and potential exposure sources. So far, they’ve identified no additional cases in Long Beach. A few close contacts received preventive vaccination.
Mayor Richardson’s statement acknowledged the seriousness while trying to prevent panic. Continued surveillance, early response, and vaccination would be critical to preventing spread. But questions remained: where did this person get infected? Who else might be sick?
LA County Adult Confirmed Positive Thursday
Two days after Long Beach’s announcement, the Los Angeles County Department of Public Health confirmed its own case. An adult resident with no recent international travel had tested positive for Clade I mpox. Like the Long Beach patient, this person required hospitalization but was now recovering at home.
Dr. Muntu Davis, Los Angeles County health officer, issued a statement expressing concern. “The identification of cases of clade I mpox, which may cause more severe illness than the more common clade II, is concerning,” he said. “Early detection, testing and vaccination are vital to controlling the spread of this virus.”
Investigators haven’t found any connection between the two cases. Different areas of LA County. Different social circles, presumably. Separate exposure sources. That fact may actually be worse than if they’d infected each other, as it suggests multiple introduction points for the virus rather than a single outbreak they can contain.
Six Previous US Cases All Had Traveled to Africa
Before this week, six people in the United States had contracted Clade I mpox. Every single case involved international travel. Patients had visited central or eastern Africa, encountered the virus there, and brought infections home. None of those six cases is connected. Each represented a separate importation event.
Clade I mpox first reached American soil 11 months ago when someone who’d traveled to Africa sought care in San Mateo County, California. That patient experienced mild illness and recovered. Authorities contained the situation. No domestic transmission occurred.
Five more travel-related cases followed over subsequent months. Health departments tracked each one, identified contacts, and prevented spread. As long as only travelers got sick, officials could manage the threat. They knew where infections came from and could predict where they might go next.
These two new California cases shattered that containment strategy.
Clade I Differs From the 2022 Outbreak Strain
Most Americans who remember mpox recall the 2022 outbreak, when cases surged to nearly 500 daily. That outbreak involved a different strain called Clade II. Clade II causes mild to moderate illness. Patients suffered painful skin lesions for weeks, but deaths were extremely rare. Mortality rates ranged from less than 1% to 4%.
Clade II has circulated at low levels throughout the United States since 2022. Los Angeles County has recorded 118 Clade II cases this year alone. Last year brought 220 cases total, with a sharp uptick during the fall months. People got sick, received treatment, and recovered. Life went on.
Clade I presents a different threat. Mortality rates range from 1% to 10% potentially ten times deadlier than Clade II. Historically, Clade I has been associated with more severe illness and easier transmission. California Department of Public Health noted that recent infections may not be as severe when patients have access to quality medical care, but the potential for serious complications remains higher.
Close Personal Contact Spreads the Virus Fastest
Mpox transmits through multiple routes, all involving close contact. Sexual activity represents a major transmission pathway. Body fluids and sores carry high viral loads. Intimate activities like massage, cuddling, hugging, and kissing can spread infection. Respiratory droplets from coughing and sneezing also transmit the virus, though less efficiently.
Shared items pose risks, too. Bedding that touched infected skin. Clothing worn by symptomatic people. Towels used by someone with lesions. Personal belongings can harbor virus particles and infect new victims who handle them.
In the Democratic Republic of Congo, one of the hardest-hit African nations, researchers documented multiple transmission modes. Contact with infected animals caused some cases. Crowded household transmission occurred frequently, with family members passing the virus back and forth. Sexual contact remained a major route, but not the only one.
Rash and Pus-Filled Blisters Are Tell-Tale Signs
Mpox symptoms can initially resemble flu. Fever arrives first, often accompanied by chills and headache. Muscle aches develop. Lymph node swelling is a distinctive feature that helps distinguish mpox from similar illnesses. A sore throat may appear.
Then comes the characteristic rash. Unusual sores that look like pimples or pus-filled blisters erupt across the body. Face, chest, hands, and genitals develop lesions. Sores can be painful, especially on sensitive areas or mucous membranes.
Anyone developing an unexplained rash should avoid sexual activity and intimate contact immediately. Seek medical evaluation as soon as possible. Healthcare providers need to test suspected cases promptly. Early detection helps prevent transmission and gets patients the appropriate treatment faster.
Gay and Bisexual Men Face Higher Risk
Centers for Disease Control and Prevention classifies the risk for the general US population as low. For gay and bisexual men who have sex with multiple partners, the risk rises to low to moderate. Transgender, nonbinary, and gender-diverse individuals also face elevated risk.
Importantly, anyone can contract mpox regardless of sexual orientation, gender identity, race, or ethnicity. Virus spreads through specific behaviors, not specific types of people. But certain communities face disproportionate exposure based on social networks and sexual practices.
People with HIV carry a higher risk, as do those taking or eligible for HIV pre-exposure prophylaxis (PrEP) medication. Immunocompromised individuals of any type face greater danger from infection. Anyone exposed to an infected person within the last 14 days should seek vaccination and monitor for symptoms.
Central and Eastern Africa Report Over 40,000 Cases
Clade I mpox has ravaged parts of Africa throughout 2024 and 2025. Over 40,000 cases have been documented in central and eastern African countries. Democratic Republic of Congo, Burundi, Uganda, Kenya, Rwanda, and several other nations have confirmed outbreaks.
World Health Organization declared the situation a public health emergency as cases mounted. Transmission patterns in Africa differ somewhat from what researchers observe elsewhere. Animal-to-human transmission still occurs in some areas. Crowded living conditions facilitate household spread. Limited healthcare access means many cases go untreated.
Recently, the WHO announced the situation had improved enough to no longer constitute an international emergency. Case numbers were declining in several countries. Interventions were working. But thousands of people remain infected, and the virus continues spreading to new regions.
Travel-related cases have appeared on every inhabited continent. Asia, Australia, Europe, and South America have all reported infections among people who visited African outbreak zones. Now the United States has its first cases with no travel history.
Most People Recover Within Two to Four Weeks
Despite the scary headlines and historical mortality rates, most mpox infections resolve on their own. Patients typically get better within two to four weeks without specific treatment. The immune systems clear the virus. Lesions heal. Symptoms disappear.
Antiviral treatments are available for people at risk of severe illness. Those with compromised immune systems, pregnant women, young children, and people with extensive skin lesions may benefit from medication. Healthcare providers can prescribe antivirals when complications seem likely.
Access to quality medical care dramatically improves outcomes. Hospitalization allows close monitoring and aggressive treatment if problems develop. Both California patients required hospital stays initially, suggesting their cases were serious enough to warrant inpatient care. Both recovered sufficiently to continue isolation at home.
Jynneos Vaccine Protects Against Both Strains
Vaccination remains the most effective prevention tool. Jynneos vaccine, manufactured by Bavarian Nordic, protects against both Clade I and Clade II mpox. Two doses provide the best protection. People who received only one dose can get their second shot regardless of how much time has passed since the first.
Full protection takes about six weeks to develop after the two-dose series. People planning to attend high-risk events should get vaccinated well in advance. Those traveling to outbreak areas need time to build immunity before departure.
Boosters’ third doses are not currently recommended. Two doses provide sufficient protection for most people. Pharmacies across Los Angeles County carry the Jynneos vaccine. CVS and Walgreens stock it at many locations. People should call ahead to confirm availability before visiting.
Free Vaccines Available at LA County Clinics
Los Angeles County Department of Public Health maintains sexual health clinics that offer free mpox vaccination. Uninsured and underinsured individuals can access shots through these clinics. People enrolled in the PrEP Assistance Program or the AIDS Drug Assistance Program can receive free vaccination.
Most health insurance plans cover the Jynneos vaccine for eligible individuals. Medi-Cal, Medicare, and private insurance should pay for doses. Residents should contact their insurance providers to confirm coverage before getting vaccinated. Out-of-pocket costs can be substantial without insurance coverage.
Bavarian Nordic maintains a vaccine locator webpage showing which pharmacies and clinics have Jynneos in stock. California also offers a statewide mpox vaccine finder at EmpoweredAgainstMpox.com. Appointments are strongly recommended to ensure vaccine availability, especially with heightened demand following these new cases.
Health Officials Conducting Contact Tracing Now
California Department of Public Health is collaborating closely with both the Los Angeles County and Long Beach health departments. CDC has also joined the investigation. Enhanced surveillance aims to identify any additional cases quickly and determine infection sources.
Contact tracing procedures are underway for both confirmed patients. Investigators interview patients about recent contacts, sexual partners, places visited, and items shared. Anyone identified as a potential exposure gets contacted, offered testing and vaccination, and told to watch for symptoms.
Pattern recognition will be critical. If investigators can link these two cases to each other or to a common source, they can focus containment efforts. If the cases remain unconnected, the virus may be spreading through multiple pathways that will be harder to disrupt.
Scientists Worry About Person-to-Person Transmission Here
Dr. William Schaffner, infectious diseases expert at Vanderbilt University, expressed the concern many specialists share. “It’s concerning if this virus has come here and now is starting to be transmitted from person to person,” he said.
Travel-related cases are manageable. Imported infections can be contained through isolation, contact tracing, and vaccination of exposed individuals. Domestic transmission represents a different challenge. Once a virus establishes community spread, containment becomes exponentially harder.
Two cases don’t necessarily mean widespread transmission. They could represent isolated incidents with limited onward spread. But they could also signal the beginning of something larger, an outbreak that health officials will struggle to control without aggressive intervention.
Prevention Requires Avoiding Sick Partners
Individual prevention starts with basic precautions. Don’t have sex or close contact if you or your partner shows symptoms. New or unexplained rashes should trigger immediate isolation until medical evaluation rules out mpox. Reducing the number of sexual partners, especially those with unknown recent sexual histories, lowers exposure risk.
Exchange contact information with new sexual partners. If either person develops symptoms later, they can notify each other quickly. Limiting attendance at sex parties, circuit parties, or venues with intimate contact among multiple people reduces transmission opportunities.
Use condoms during sexual activity. Latex or polyurethane condoms may protect the mouth, penis, anus, or vagina from exposure. Condoms alone won’t prevent all transmission since rashes can appear on body parts condoms don’t cover, but they reduce risk. Gloves can protect hands during insertive contact.
Never share towels, bedding, clothing, fetish gear, sex toys, or toothbrushes with anyone who might be infected. Wash your hands thoroughly and frequently. Clean all items that touch skin after each use. These simple hygiene measures can break transmission chains.
Risk remains low for most county residents. But vigilance matters now more than ever. Early detection, prompt testing, and widespread vaccination offer the best defense against an outbreak that nobody wants to see spread beyond these first two cases.
