The number of cumulative monkeypox cases has more than doubled in Los Angeles County in the past two weeks as authorities race to better track the virus and more widely vaccinate the most vulnerable communities.
There were 1,105 cumulative cases of monkeypox reported countywide on Friday, according to data from the Department of Public Health. As of this week, that total includes the region’s first cases in a prison and in a homeless shelter, according to health officer Dr. Muntu Davis. The median age of people with confirmed cases of monkeypox in LA County is 35.
Nearly half of the county’s cases for which geographic information is available were reported in the Health Services Planning Area for the central part of the county, which includes West Hollywood, Hollywood, Downtown Los Angeles, Eagle Rock, Highland Park, Echo Park, Silver Lake, Los Feliz, and Boyle Heights. About 12% of the county’s residents live in this area.
About 15% of LA County’s monkeypox cases are in an area that includes the San Fernando and Santa Clarita Valleys, County show health data. About 22% of the county’s residents live in this area.
Antelope and San Gabriel Valleys have reported the fewest cases.
The disease – characterized by a rash and lesions that may look like pimples, bumps or blisters – is mainly spread by prolonged skin-to-skin contact with these lesions, which may be in hard-to-see places or be confused with 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 continues to remain very low,” Davis said during a Thursday briefing.
About 98% of cases for which gender identity information is available are male, according to county figures. And 98% of cases where sexual orientation is known involve 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 in the epidemic, none of whom have been to the United States
“I want to reiterate that we continue to address this outbreak with the utmost urgency to slow its spread in California,” California director of public health and health officer Dr. Tomás Aragón said Friday.
Wastewater analysis, which continues to prove useful in estimating the spread of the coronavirus, is also now used to track monkeypox.
Late June — about a month after the first California case has been confirmed – monkeypox DNA has been detected in San Francisco sewage, according to the WastewaterSCAN coalition, a group of scientists who have been testing sewage for coronavirus since 2020.
“It helps to understand how widespread this is,” said Alexandria Boehm, a Stanford professor of civil and environmental engineering, one of the lead researchers on the WastewaterSCAN team.
The monkeypox virus has also been detected in LA County wastewater. Samples from the joint water pollution plant in Carson, which serves about 4 million residents and businesses in southern and eastern LA County, showed a small presence on July 31 and during three days during the first week of August, according to WastewaterSCAN The data. The virus has not been detected there since, despite rising case rates in the county.
By comparison, monkeypox DNA has been detected nearly every day since June 27 at two San Francisco sewage treatment plants — and at much higher levels than in LA County.
Still, Boehm said that doesn’t mean there’s no more monkeypox in Los Angeles County; it was just hard to detect among the massive sample size.
Because the LA County Wastewater Treatment Facility serves so many people, “you have to think about the sensitivity of detecting monkeypox versus the incident rate in the population,” Boehm said. “Just because you don’t detect monkeypox doesn’t mean there’s no one there. [in that waste watershed] with monkeypox.
It’s not immediately clear if the Los Angeles County Department of Public Health plans to expand sewage testing for monkeypox. The county has been monitoring wastewater for 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 some time to examine and assess the correlations between concentrations and the number of cases. … [But] we are excited to be part of a larger group looking to make the best use of wastewater data,” said LA County Public Health Director Barbara Ferrer.
As of last week, LA County received more than 43,000 doses of the Jynneos monkeypox vaccine. Almost all — 91% — of these have already been administered, with the county offering second doses of the two-shot series for the first time this week. People are eligible for their second injection 28 days after their first dose and are considered fully vaccinated two weeks after their 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 delivering doses intradermally – between layers of skin – instead of subcutaneously, in which the vaccine is injected into the fat under the skin. The new strategy now allows each dose to be one-fifth of the volume of the initially dimensioned doses, thus stretching the limited reserves.
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 prioritized for immunization.
Previous data from Africa suggests that the Jynneos vaccine is at least 85% effective in to prevent monkey pox. Because the vaccine is not 100% effective, health officials still advise taking steps to reduce the risk of infection. But if the infection were to still occur, “hopefully that will make the infection less severe,” Davis said.
Aragón said the state had positioned nearly 3,000 oral versions and 345 IVs 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 as the virus “struggles to find people who can infect.” This could happen if people develop immunity through vaccination or previous infection, or if they “change his behavior and they don’t have as many contacts, which means there are fewer opportunities for transmission.
“These three elements together are what will bring down the epidemic curve,” Aragón said.
The California Department of Public Health released this week updated tips recommending that people with a confirmed or suspected case of monkeypox self-isolate at home until infection has been ruled out or their lesions have completely healed, a new layer of skin has formed, and they have no other symptoms for at least 48 hours.
Residents can resume limited, low-risk activities if they have not had a fever, respiratory symptoms, or new lesions for at least 48 hours and if any lesions that cannot be covered, such as those on the face , are completely healed. In this case, residents should dress or cover any unhealed lesions, wear a properly fitted mask when around other people; and avoid crowded environments, sharing towels or personal items, and direct skin-to-skin contact.
People who have had monkeypox don’t need the vaccine because they are immune, according to the county public health department. People who received the first dose of vaccine and then became infected usually do not need the second dose; however, a second dose may be suggested by a healthcare provider.
County officials have begun making the vaccines available to high-risk people in the county prison system and among the homeless.
Officials have long said the risk of exposure to monkeypox is primarily due to intimate skin-to-skin contact, and transmission of the virus has not been observed in this outbreak through surfaces in gymnasiums or other public surfaces. .
However, in 2018 there was a single documented case of monkeypox transmission in Britain in which a health care worker was infected with monkeypox after changing “presumably contaminated bedding” without wearing a face mask or respirator. The worker had contact with the sheets during a period when the patient had skin lesions but had not yet been diagnosed with monkeypox and placed in isolation, according to medical journals.
Davis suggested that workers who clean surfaces in high-touch environments, such as gym equipment or laundering bedding, towels and uniforms, be sure to implement reasonable general preventative practices that also protect against COVID-19 and other diseases.
Workers should wear disposable gloves when cleaning, and workplaces should provide hand-washing facilities and hand sanitizer for employees and customers, Davis said.
“We are also encouraging businesses where workers provide personal care services – such as massage or skincare – to consider posting signs asking customers or customers to delay services if they have symptoms. or if they have new or unexplained rashes, bumps, pustules, blisters. or scabs that started out as blisters,” he said.
It is also recommended “that workers visually inspect the area of skin that will be affected. And, of course, under no circumstances should workers touch a rash,” Davis continued.
Residents can request the monkeypox vaccine through their regular healthcare provider or register online with the county public health department to request one. vaccination. 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 writer Melody Gutierrez contributed to this report.