Op-ed: LA County Public Health statement on monkeypox

Los Angeles County Department of Public Health (DPH) is working with state and national partners on an international outbreak of monkeypox. [On Thursday, May 19, 2022], the CDC confirmed a case of monkeypox in the United States in Massachusetts. In addition, the CDC is also tracking multiple clusters of monkeypox that have been reported within the past two weeks in several countries that don’t normally report monkeypox, including Portugal, Spain, and the United Kingdom. Currently there are no confirmed cases of monkeypox in Los Angeles County.

Monkeypox is usually found in Central and West Africa, and it does not occur naturally in the United States or Europe. However, cases have occurred in these countries that are associated with international travel or animals imported from areas where the disease is more common. The current clusters involve persons who have not traveled to areas where the disease is common or had exposure to animals. It’s not clear how people in those clusters were exposed to monkeypox, but cases include individuals who self-identify as men who have sex with men. CDC is currently working with international partners to better understand the risk factors associated with current cases and clusters.

Monkeypox is a rare but potentially serious viral illness that typically begins with flu-like illness and swelling of the lymph nodes and progresses to a rash on the face and body. Most infections last 2-to-4 weeks. In parts of Central and west Africa where monkeypox occurs, people can be exposed through bites or scratches from rodents and small mammals, preparing wild game, or having contact with an infected animal or possibly animal products. The virus does not spread easily between people; transmission can occur through contact with body fluids, monkeypox sores, items that have been contaminated with fluids or sores (clothing, bedding, etc.), or through respiratory droplets following prolonged face-to-face contact.

Illness could be clinically confused with a sexually transmitted infection like syphilis or herpes, or with varicella zoster virus.

CDC is urging healthcare providers in the U.S. to be alert for patients who have rash illnesses consistent with monkeypox, regardless of whether they have travel or specific risk factors for monkeypox. The Los Angeles County DPH will work with California Department of Public Health and the CDC on any reported cases and continue to receive updates.

What people should do

People who are concerned they may have been exposed or have symptoms of monkeypox, particularly the characteristic rash or lesions, should contact their healthcare provider for a risk assessment. Per CDC guidance, suspicion for monkeypox should be heightened if the rash occurs in a person who : 1) travelled to countries where monkeypox cases have been reported, 2) report having contact with a person with a similar rash or person who received a diagnosis of monkeypox, or 3) is a man who has sex with other men, and those who have close contact with them.

The CDC plans to issue public information soon on poxvirus infections which, when available, will be found here: https://www.cdc.gov/poxvirus/monkeypox/.

What healthcare providers should do

• If healthcare providers identify patients with a rash that looks like monkeypox, consider monkeypox, regardless of whether the patient has a travel history to central or west African countries.
• Do not limit concerns to men who report having sex with other men. Those who have known close personal contact with people with monkeypox could potentially also be at risk for the disease.
• Some patients have had genital lesions and the rash may be hard to distinguish from syphilis, herpes simplex virus (HSV) infection, chancroid, varicella zoster, and other more common infections.
• Isolate any patients suspected of having monkeypox in a negative pressure room, and ensure staff understand the importance of wearing appropriate personal protective equipment (PPE) and that they wear it each time they are near suspected cases.
• Standard cleaning/disinfectants may be used in accordance with the manufacturer’s instructions.
• Report all suspected monkeypox cases to the LA County DPH immediately.
• For healthcare professionals please refer to for consult and reporting: http://publichealth.lacounty.gov/clinicians/report/.

About the author: The Los Angeles County Department of Public Health oversees environmental health, disease control, and community and family health for all 10 million residents of Los Angeles County. 

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