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First US death linked to monkeypox reported in immunocompromised adult in Texas

A sign announcing monkeypox vaccination is set up in Tropical Park by Miami-Dade County and Nomi Health on August 15, 2022, in Miami.
Enlarge / A sign announcing monkeypox vaccination is set up in Tropical Park by Miami-Dade County and Nomi Health on August 15, 2022, in Miami.

A severely immunocompromised adult who tested positive for monkeypox has died in Texas, marking the first US death connected to the global outbreak, state health officials said Tuesday.

Such deaths have been a rarity in the public health emergency. While the global case count is nearing 49,000, the World Health Organization has only recorded 15 monkeypox-related deaths. In the US, the Centers for Disease Control and Prevention have tallied 18,101 cases as of August 29. The death in Texas is the first linked to the cases.

For now, health officials are not yet sure if monkeypox was the cause of the person’s death. The adult died on August 28 in Harris County, which includes Houston. Harris County officials said in a news release that an autopsy is in process, and the results will be released in the next few weeks.

A separate release from the state health department noted that the adult was “severely immunocompromised” and that there is an “investigation to determine what role monkeypox played in the death.”

“Monkeypox is a serious disease, particularly for those with weakened immune systems,” John Hellerstedt, commissioner of the Texas Department of State Health Services, said in the release. “We continue to urge people to seek treatment if they have been exposed to monkeypox or have symptoms consistent with the disease.”

In a White House press briefing Tuesday afternoon, Jennifer McQuiston, deputy director of CDC’s Division of High Consequence Pathogens and Pathology, highlighted the uncertainty around the death and rarity of fatalities from monkeypox in this outbreak.

“It’s our understanding this patient also had underlying health conditions and had a number of things going on,” McQuiston said. “I think that additional investigation is needed to know what role monkeypox may or may not have played in their death.” In the meantime, she emphasized that death “remains very rare” and “we have mitigation efforts in place to prevent monkeypox.” These include vaccination, testing, and treatment.

Of the international deaths reported, some have involved people with compromised immune systems, but others have not. A 41-year-old man in Brazil who died with monkeypox reportedly had lymphoma and was immunocompromised. But, two people who died in Spain from monkeypox-associated encephalitis (inflammation of the brain) were not thought to be immunocompromised and were considered previously healthy.

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