The 2022–2023 mpox outbreak in the United States is part of the larger
outbreak of
human mpox caused by the West African
clade of the
monkeypox virus. The
United States was the fourth country outside of the African countries with endemic mpox, to experience an outbreak in 2022. The first case was documented in
Boston,
Massachusetts, on May 17, 2022.[3] As of August 22, mpox has spread to all 50 states in the
United States, as well as
Washington, D.C., and
Puerto Rico.[4] The United States has the highest number of mpox cases in the world.
California has the highest number of mpox cases in the United States.
An ongoing
outbreak of mpox was confirmed on May 6, 2022, beginning with a
British resident who, after travelling to
Nigeria (where the disease is
endemic), presented symptoms consistent with mpox on April 29, 2022. The resident returned to the United Kingdom on May 4, creating the country's
index case of the outbreak.[7] The origin of several of the cases of mpox in the United Kingdom is unknown. Some monitors saw
community transmission taking place in the
London area as of mid-May,[8] but it has been suggested that cases were already spreading in Europe in the previous months.[9]
Transmission
A large portion of those infected were believed to have not recently traveled to areas of Africa where mpox is normally found, such as
Nigeria, the
Democratic Republic of the Congo as well as
central and
western Africa. It is believed to be transmitted by close contact with sick people, with extra caution for those individuals with
lesions on their skin or genitals, along with their bedding and clothing. The CDC has also stated that individuals should avoid contact and consumption of dead animals such as rats, squirrels, monkeys, and apes along with wild game or lotions derived from animals in Africa.[10]
In addition to more common symptoms, such as fever, headache, swollen lymph nodes, and rashes or lesions, some patients have also experienced proctitis, an inflammation of the rectum lining. CDC has also warned clinicians to not rule out mpox in patients with sexually transmitted infections since there have been reports of co-infections with
syphilis,
gonorrhea,
chlamydia, and
herpes.[11]
The CDC has stated that, among mpox cases with available data, 99% occurred in men, 94% of whom reported recent male-to-male sexual or close intimate contact.[12]
Cases transited through the United States
This section needs to be updated. Please help update this article to reflect recent events or newly available information.(September 2022)
California
The 2022–2023 mpox outbreak in
California. As of July 2022, the virus has infected 4,886 people in the U.S. state of California, with 1 death. The state has the highest number of recorded cases in the country.[13]
Florida
Florida currently has 2,444 people infected by the virus, with no deaths. It started on May 23, 2022, in
Fort Lauderdale and quickly started spreading across the State.[14][15]
New York
The 2022–2023 mpox outbreak in
New York currently has no deaths. This state has the second highest number of recorded cases in the country with 3,679 cases.[16]
In New York the outbreak began on June 10, 2022, with the first mpox case recorded in
Ithaca.[16] On July 29, Governor
Kathy Hochul declared a public state disaster emergency in New York State.[17] New York is currently the state with the highest recorded number of cases in the US.[16]
The World Health Organization in New York reports its first mpox case outside New York City on June 7.[18]
On July 13, New York becomes the epicenter of the outbreak. With 489 cases only behind
California with 266 cases.[19]
On July 27, New York reaches 1,228 cases, with an increase of 739 cases in only 14 days.[20]
On August 1, Mayor Eric Adams declares a state of emergency over the mpox outbreak.[21]
The first known case was detected on May 18, 2022, in a man from
Boston, Massachusetts, who had traveled to Canada, where a case of the virus was reported the following day.[23][24] The person was hospitalized in Boston.[25] There, he tested positive for mpox, becoming the first case in the United States.[23]
Two days after the man tested positive for the virus, other states began reporting cases, with
New York reporting its first case on May 21.[26] On May 22, President Biden gave a speech at
Osan Air Base in
South Korea during which he indicated the disease was "something that everybody should be concerned about".[27] On May 26, Virginia reported its first case in a woman who had traveled to
Africa,[28] followed by California and Hawaii on June 4, 2022.[29][30] As of June 3, the United States had 21 confirmed cases,[31] a number which had risen to 460 as of July 1.[32]
On May 23, 2022, Florida reported a case of mpox. On the same day, the Tampa Bay Times reported that the Florida Department of Health had announced the case on a man that had been isolated since the day before.[14]WESH later on also confirmed the case, which was in
Broward County.[33] The following day,
WESH reported another mpox case as being "investigated".[34] The case was then confirmed to be in the same county as the first case, adding up the total in the county to two. Later, a third case was also investigated, this time being reported by
CBS Miami to also be in the same county as the first and second case.[35] This case added up the total in the United States to 18. A fourth case was reported by the Sun-Sentinel, although the state of Florida did not disclose the county where it was detected.[36]
In early June 2022, a man in
Washington, D.C., was reported to test positive for
orthopox, potentially mpox.[37]
On July 26, 2022, the United States had more mpox cases than any other country.[38] At the end of August 2022, there were early signs that the mpox spread in the U.S. may be slowing.[39]
Graphs are unavailable due to technical issues. There is more info on
Phabricator and on
MediaWiki.org.
On 18 May 2022, Bavarian Nordic announced that
BARDA, part of the
Department of Health and Human Services (HHS), exercised a $119 million option, under a $299 million contract, to supply a freeze-dried version of JYNNEOS vaccine, converting existing bulk vaccine.[94] The United States spent $119 million to purchase doses of the
Modified vaccinia Ankara-based two-shot[95]Jynneos vaccine from
Bavarian Nordic in May 2022.[96] The contract also allows the United States to purchase an additional $180 million worth of the vaccine at a later date.[97] The vaccine,
JYNNEOS (also known by the brand names
Imvamune and
Imvanex), was approved by FDA in 2019 to prevent both smallpox and mpox. As of June 14, the United States had around 70,000 doses of JYNNEOS in its stockpile, and the federal government placed an order for 500,000 more on June 10, 2022. Dawn O'Connell, assistant secretary for preparedness and response at
Department of Health and Human Services (HHS), said around 300,000 doses would be delivered in June–July 2022, and the remainder would be delivered later in that year.[11][98]
As of June 28, the Biden administration was allocating tens of thousands of vaccine doses from the
Strategic National Stockpile to clinics nation-wide.[100][101] The rollout of vaccines and testing was criticized as too slow, as well as for having similar problems to the rollout of vaccines and tests during the
COVID-19 pandemic in the United States.[102]
As of June 29, HHS has received requests from 32 states and jurisdictions, deploying over 9,000 doses of JYNNEOS vaccine and 300 courses of ST-246 (
tecovirimat)[105][106] antiviral smallpox treatments.[107] The United States expanded deployment of JYNNEOS vaccines, allocating 296,000[108][109] doses over the coming weeks, 56,000 of which will be allocated immediately. Over the coming months a combined 2.5 million[110][111][95] additional doses will become available.[112]
As of November 2022, New York state ended its state of emergency, mobile mass vaccination sites set up since summer in New York city closed, but vaccinations were moved to outpatient and sexual health clinics.[113]
Precautionary measures
Hospitals have begun making their own preparations to help control the current mpox outbreak, including screening patients, increasing decontamination and cleaning procedures,[114][115][116] and wearing appropriate safety gear[117][118] when interacting with infected patients.
^CDC (July 15, 2022).
"Monkeypox in the U.S."Centers for Disease Control and Prevention.
Archived from the original on June 16, 2022. Retrieved July 16, 2022.