Mpox (formerly called monkeypox) has two strains: Clade I mpox and Clade II mpox.
In 2022, there was a worldwide outbreak of clade II mpox that affected gay men or men who had sex with men. Mpox in gay men was transmitted by close contact, which could vary from kissing to sexual intercourse.
There were about 30,000 cases in the US of clade II mpox in 2022. Fortunately, clade II is relatively mild. It causes a painful skin rash at the point of contact, muscle aches, headache, fever and fatigue that can last 2-4 weeks but the symptoms are not usually severe enough to require hospitalization in otherwise healthy people. A more widespread outbreak was halted by a mass vaccination campaign that focused heavily on gay men who had never received the smallpox vaccine. People have largely forgotten this successful 2022 vaccination campaign orchestrated by the Biden Administration and the CDC.
In 2025, California has had 3 cases of clade I mpox. Clade I is a more serious disease and is closer to the virus' ancestral cousin, smallpox. While clade I mpox has been circulating in equatorial Africa, the 3 cases of clade I mpox in California had no connection to travel to Africa. Even worse, contact tracers in California have been unable to connect the cases to a common source. All three of the California cases of clade I mpox were severe and required hospitalization. All 3 cases were in male patients who had sex with men.
Until 2025, USAID and the CDC had experts monitoring the outbreak of clade I mpox in Africa. DOGE cuts have eliminated much of the staff who monitored global outbreaks. Normally, when there is an unusual outbreak of communicable disease in the US, the CDC coordinates the information collection and communication regarding the outbreak. In severe outbreaks, CDC used to send ground teams to areas where there was an outbreak to help provide expertise.
DOGE ended that. The mpox page on the CDC website has no information about the clade I outbreak in California. This is what appears on the CDC website:
You haven't heard anything about the clade I mpox cases in California? This is what happens when a group of extremists defund public health and put a clueless extremist in charge that the HHS. It doesn't help that the US mpox case- whether clade I or clad II- have hit the gay community, particularly men who have sex with men.
The 3 recent cases are unrelated, but the fact that all 3 people had not traveled internationally indicates that local person-to-person spread is likely.
www.cidrap.umn.edu
With 3rd case of locally acquired clade 1 mpox in California, officials warn of community spread
Officials with the California Department of Public Health (CDPH) and local health departments have confirmed a third case in Los Angeles County of the more severe clade 1 mpox infection that was locally acquired, according to a CDPH news release.
Officials say the three recent cases are unrelated. But the fact that all three people had not traveled internationally indicates that local person-to-person spread is likely. The New York Times reports that one patient is from Long Beach and the others are from Los Angeles, which is about 20 miles north.
All 3 patients required hospitalization
All three patients required hospital care and are recovering. "Local health departments and CDPH are conducting enhanced surveillance and contact tracing to identify any additional cases and prevent further transmission," the CDPH said. "At this time, the risk to the general public remains low."
The agency added, "These cases indicate that person-to-person community spread of clade I mpox is occurring in California, primarily impacting communities of gay and bisexual men, and other men who have sex with men, as well as their social networks. Prior cases of clade I mpox in the United States have been associated with international travel to areas where clade I mpox is circulating."
