MPXV Clade I Update: Recommendations for California Health Care Providers
The California Department of Public Health (CDPH) is issuing this California Health Alert Network (CAHAN) Health Advisory to notify clinicians and local health departments (LHD) about the occurrence, geographic spread, and sexually associated human-to-human transmission of Clade I Monkeypox virus (MPXV) in the Democratic Republic of the Congo (DRC). MPXV has two distinct genetic clades (subtypes). Clade I MPXV infections have historically been more transmissible and more severe and resulted in higher case fatality rates compared with those attributable to Clade IIb, which is currently circulating in the United States. Cases of Clade I MPXV have not been reported in the United States at this time. However, clinicians should be aware of the possibility of Clade I MPXV in travelers or close contacts (including sexual contacts) of travelers who have been in DRC.
Clinicians should notify their Local Health Department (LHD) if they have a patient with mpox-like symptoms, which may include rash, sores, fever, and/or lymphadenopathy, in a traveler to or close contacts (including sexual contacts) of travelers returning from the DRC. The CDPH VRDL offers MPXV testing that will discriminate between Clade I and Clade II. Health care providers are advised to contact their Local Health Department and CDPH VRDL to coordinate MPXV testing. Please refer to the VRDL Test Order page for mpox virus testing guidance and contact CDPH VRDL at: (510) 307-8585 or VRDL.Submittal@cdph.ca.gov.