Las Vegas Review-Journal (Sunday)
L.A. County monkeypox cases rise
Health officer says risk to public still low
LOS ANGELES — The number of cumulative monkeypox cases has more than doubled in Los Angeles County in the past two weeks as officials race to track the virus and more widely vaccinate more vulnerable communities.
There have been 1,105 cumulative monkeypox cases reported countywide as of Friday, according to data from the Department of Public Health. As of this week, that total includes the region’s first cases in a jail and in a homeless shelter, according to health officer Dr. Muntu Davis. The median age of people with confirmed monkeypox cases in L.A. County is 35.
Fewer than half the county’s cases for which geographic information is available have been reported in the health service 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 percent of the county’s residents live in this region.
About 15 percent of L.A. County’s monkeypox cases are in an area that includes the San Fernando and Santa Clarita valleys, county health data show. Roughly 22 percent of county residents live in that region.
The Antelope and San Gabriel valleys have reported the fewest cases.
The disease — characterized by a rash and lesions that can look like pimples, bumps or blisters — primarily spreads through prolonged skin-to-skin contact with those lesions, which may be in hard-to-see places or mistaken for other skin issues. The lesions can appear first 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 briefing Thursday.
About 98 percent of cases for which there is gender identity information available are among males, county figures show. And 98 percent of cases for which sexual orientation is known are among 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 outbreak, none of which has been in the U.S.
“I want to reiterate that we continue to approach this outbreak with the utmost urgency to slow its spreading in California,” Dr. Tomás Aragón, California’s public health director and health officer, said Friday.
Wastewater testing, which continues to prove useful in estimating the spread of the coronavirus, is also being employed to track monkeypox.
In late June — about a month after the first California case was confirmed — monkeypox DNA was detected in wastewater in San Francisco, according to the Wastewaterscan coalition, a group of scientists who have been testing sewage for the coronavirus since 2020.
“It helps understand how widespread this is,” said Stanford civil and environmental engineering professor Alexandria Boehm, one of the lead researchers on the Wastewaterscan team.
The monkeypox virus also has been detected in L.A. County wastewater. Samples from the Joint Water Pollution Plant in Carson, which serves about 4 million residents and businesses in southern and eastern L.A. County, showed a small presence on July 31 and for three days during the first week in August, according to Wastewaterscan data. The virus has not been detected there since despite the rising case rates in the county.
By comparison, monkeypox DNA has been detected almost every day since June 27 at two wastewater facilities in San Francisco — and at much higher levels than in L.A. County.
Still, Boehm said that doesn’t mean there’s not more monkeypox in Los Angeles County; it’s just been difficult to detect among the massive sample size.
Because the L.A. County wastewater facility serves such a large number of people, “you have to think about the sensitivity of detecting monkeypox relative to the incident rate in the population,” Boehm said. “Just because you don’t detect monkeypox, doesn’t mean there’s nobody (in that waste watershed) with monkeypox.”