King County, Washington, reported an increase in mpox cases in September 2023, with at least 46 individuals diagnosed. This figure marks a significant rise compared to previous months, prompting public health officials to intensify their vaccination campaigns. According to Public Health — Seattle & King County, although the current count is lower than the peak of 200 cases recorded in August 2022, it serves as a reminder that mpox, formerly known as monkeypox, remains a concern locally and nationwide.
Dr. Tim Menza, co-director of the county’s sexual health clinic, noted that seasonal peaks in mpox cases during late summer have become common. The general public’s risk remains low, but the recent surge is noteworthy, and officials suspect the number of cases might be underreported. “This is not necessarily a red alert,” Dr. Menza stated. “It’s sort of like a ‘don’t panic’ moment, but be aware. And there are ways one can protect themselves.”
A comparison of data reveals that King County recorded 21 mpox cases in September 2022 and only nine in September 2023. Since the outbreak began in 2022, approximately 730 cases have been confirmed in King County, with around 23 requiring hospitalization. Statewide, about 935 mpox cases have been reported, with no fatalities attributed to the virus.
The reason behind this year’s September increase remains uncertain, but Dr. Menza speculated it may relate to large social gatherings during the summer months. Most mpox cases in King County are traced to sexual and intimate contact among men who have sex with men, as well as nonbinary and transgender individuals who engage in sexual activity with men. Despite these associations, the disease can affect anyone.
Dr. Menza emphasized the importance of vaccination as a primary protective measure. “Mpox is still here,” he said. “But vaccination and thinking about behavior changes are the big ways in which people can take this information and use it to protect themselves.” The mpox vaccine consists of two doses administered approximately 28 days apart and has proven highly effective at preventing severe illness. It is available to those at higher risk, including individuals recently exposed to the virus, gay and bisexual men, transgender and nonbinary individuals who have sex with men, and those involved in commercial or transactional sex.
Vaccination can be accessed for free at the sexual health clinic located at Harborview Medical Center and at Kelley-Ross Pharmacy’s Capitol Hill and First Hill locations, among other community health centers throughout Seattle.
In addition to vaccination, public health officials recommend temporary behavior adjustments to lower infection risk. Suggestions include reducing the number of sexual partners, avoiding venues with direct skin-to-skin contact, and being vigilant about potential symptoms while engaging in open discussions with partners regarding risks.
Mpox exists in two variants: clade I and clade II, both primarily transmitted through close physical contact. While most cases result from sexual or intimate interactions, the virus can also spread through direct contact with sores, body fluids, or shared clothing. Notably, mpox does not transmit through the air.
Infections typically result in a painful rash and, in some cases, flu-like symptoms. Clade II, which is prevalent in King County and has circulated at lower levels across the United States, is rarely fatal, with most individuals recovering in two to four weeks. Conversely, clade I infections, while less common outside eastern and central Africa, are more severe. Last month, authorities in California confirmed clade I infections in three residents, marking the first identification of this variant in the U.S. among individuals without travel history to high-risk regions.
Although no clade I infections have been confirmed in Washington State, health officials detected signs of the variant in wastewater testing in Pierce County in September. This suggests that a person with a clade I infection may have recently been in the area, but no cases have been officially identified.
Public health officials continue to monitor the situation closely, emphasizing the importance of vaccination and awareness to mitigate the spread of mpox in the community.
