We have been following the spread of the virulent new monkeypox variant (i.e., mpox clade I) that is at the center of a significant outbreak in the Democratic Republic of Congo (DRC) and neighboring countries.
At the end of 2024, I reported that California had reported its first case of this strain. As a reminder, Clade I is easier to spread and causes more serious effects than the Clade II version that was responsible for the global outbreak in 2022. This case was travel-associated, with the individual recently returning from an area experiencing clade I transmission.
Forward to the autumn of 2025: Health officials in Los Angeles County have confirmed and are investigating possible local transmission of this more severe strain of “mpox“.
The trio of cases, all reported publicly this week, represents the first time this particular type of mpox, known as “Clade I,” has been found in the United States among people who had no history of traveling overseas to high-risk areas.The first case, reported publicly on Tuesday, involved a resident of Long Beach. The second and third cases, reported Thursday and Friday, occurred among other Los Angeles County residents. All three patients were hospitalized but are now recovering at home.“At this time, no clear link has been identified between the cases,” the L.A. County Department of Public Health said.Nonetheless, “the confirmation of a third case with no travel history raises concerns about possible local spread in Los Angeles County,” Dr. Muntu Davis, the L.A. County health officer, said in a statement. “We’re working closely with our partners to identify potential sources and understand how this potentially more serious type of the mpox virus may be spreading.”
Public health officials are quick to note that the risk of spread to the general public remains low.
The first local case was reported in Long Beach on Oct. 14, while two more were reported in other areas of LA County on the 16th and 17th. All three people were hospitalized before being sent home to quarantine and recover, officials said. No further details about the patients were released, and no clear link between the cases has been identified.The risk to the public remains low, the Los Angeles County Department of Public Health said in a statement. It is recommended, however, that people at higher risk get vaccinated against the illness if they have not already.
As of this report, the Centers for Disease Control and Prevention (CDC) reports that the U.S. has confirmed a total of nine clade I monkeypox cases so far this year, including three cases described above and six travel-associated cases linked to Central and Eastern Africa.
The CDC also notes that clade II mpox continues at low levels nationally, with sporadic clusters linked to travel from West Africa.Daily reports throughout 2025 show a steady but low number of cases nationwide, with most weeks averaging between two and ten confirmed infections per day. This indicates ongoing low-level transmission of clade II throughout the year without large-scale outbreaks.
Health officials are recommending vaccinations for those at risk of contracting the virus.
Mpox can spread through direct contact with infectious sores or body fluids, sexual or intimate contact, and touching contaminated items such as bedding or clothes. Most people recover within 2-4 weeks, but antiviral treatments may be considered for individuals with or at risk of developing severe illness, health officials said.Despite the low risk of infection, health officials recommended vaccines for people who may be at increased risk, such as people who are gay or bisexual, men who have sex with men, transgender and non-binary people, people who are immunocompromised, someone who was exposed to a person with mpox, those with occupational exposure, and people planning to travel to areas with ongoing mpox outbreaks.
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