Epidemiologic Characteristics of Mpox among People Experiencing Homelessness, Los Angeles County, California, USA, 2022

In Los Angeles County, California, USA, public health surveillance identified 118 mpox cases among persons experiencing homelessness (PEH) during July-Septem-ber 2022. Age and sex were similar for mpox case -pa-tients among PEH and in the general population. Seven-ty-one (60%) PEH mpox case-patients were living with HIV, 35 (49%) of them virally suppressed. Hospitalization was required for 21% of case-patients because of severe disease. Sexual contact was likely the primary mode of transmission; 84% of patients reported sexual contact <3 weeks before symptom onset. PEH case-patients lived in shelters, encampments, cars, or on the street, or stayed briefly with friends or family (couch surfed). Some case -patients stayed at multiple locations during the 3-week incubation period. Public health follow-up and contact tracing detected no secondary mpox cases among PEH in congregate shelters or encampments. Equitable ef-forts should continue to identify, treat, and prevent mpox among PEH, who often experience severe disease.

Automated summary

During July-September 2022, 118 cases of mpox were identified among persons experiencing homelessness (PEH) in Los Angeles County, California, USA. The age and sex distribution of mpox cases among PEH were similar to that of the general population. Among PEH mpox case-patients, 60% were living with HIV, with 49% of them having viral suppression. Approximately 21% of case-patients required hospitalization due to severe disease. Sexual contact was likely the primary mode of transmission, as 84% of patients reported sexual contact less than 3 weeks before symptom onset. No secondary mpox cases were detected among PEH in congregate shelters or encampments through public health follow-up and contact tracing. Equitable efforts should be continued to identify, treat, and prevent mpox among PEH, who often face severe disease.