Although the monkeypox (MPX) outbreak has slowed in California, a new CDC report highlights the potential severity of MPX infection in people with a weakened immune system, particularly in those with untreated HIV.

This CDC report serves as a reminder that consequences of MPX can be severe for immunocompromised people. While new clinical data evolves, vaccination is considered an important intervention to reduce severity of illness. Ensuring people at risk for MPX infection, including all people with HIV, get vaccinated is critical.

The California Department of Public Health is urging health care providers to consider prompt MPX treatment with tecovirimat for all patients with probable or confirmed MPX who have severe MPX disease or involvement of anatomic areas that might result in serious sequelae that include scarring or strictures. Additionally, treatment should be considered for patients who are at risk for severe disease, including: pediatric populations (particularly patients younger than 8 years of age), pregnant or breastfeeding people, people with a condition affecting skin integrity, and people currently experiencing severe immunocompromise – especially those with untreated HIV.

Health care providers are also strongly encouraged to test all patients with suspected MPX for HIV and bacterial sexually transmitted infections at the time of testing for MPX, as well as provide HIV treatment as soon as possible.

For More Information

• CDPH Webpage: MPX Information for Health Care Professionals
• CDPH Provider Guidance: Severe Monkeypox (MPX) Infection in People with Untreated HIV and a Weakened Immune System
• CDC Report: Severe Monkeypox in Hospitalized Patients