An adult in Texas with several illnesses who is thought to have had monkeypox has died. The patient, who has not been publicly identified, had “various severe illnesses” and was “presumptive positive” for monkeypox (meaning, it’s thought they had the virus, but test results haven’t come back yet), officials from Harris County Public Health shared in a press release.
The patient’s official cause of death is not known at this time, health officials said, and they’re working to see what role—if any—monkeypox may have played in the person’s death. An autopsy is in the works, with a final report available in a few weeks.
“We are sharing this information to err on the side of transparency and to avoid potential misinformation about this case,” Harris County Judge Lina Hidalgo said in a statement. “The best way for us to fight this virus is through vaccines. Our goal is still to get as many people who qualify vaccinated as quickly as possible. I have always felt that vaccines are the key to reducing spread.”
To date, 15 people around the world have died from monkeypox during the 2022 outbreak, according to data from the Centers for Disease Control and Prevention (CDC). And, while details in this case are scarce, it would mark the first death in the U.S. from monkeypox if it's confirmed that the patient had the virus.
Naturally, this raises some questions. Here’s what you need to know.
How common is it to die from monkeypox?
Not very. For what it’s worth, the death rate from monkeypox in the 2022 outbreak is about 0.03%, based on CDC data. “In this outbreak, there have been about 48,000 cases and 15 deaths—and a bunch of them are from countries where the healthcare system isn’t equivalent to ours,” says Thomas Russo, M.D., professor and chief of infectious disease at the University at Buffalo in New York. “This is much less lethal of a disease than other infectious entities.”
William Schaffner, M.D., infectious disease specialist and professor at the Vanderbilt University School of Medicine, agrees. “Monkeypox is very, very rarely fatal,” he says. “It’s an illness that usually cures itself.”
Who is most likely to die from monkeypox?
The CDC specifically notes that people with weakened immune systems are more likely to get seriously ill. (Because of that, these people qualify for antiviral medications like tecovirimat (TPOXX).) “Those who are immunosuppressed would be most likely to suffer a fatal case, though it appears to be a rare event, even in this population,” says infectious disease expert Amesh A. Adalja, M.D., senior scholar at the Johns Hopkins Center for Health Security.
There’s also “some speculation” that children who are unvaccinated against smallpox—a virus related to monkeypox—may be at risk for more severe illness and even death, Dr. Russo says. “There is data out of Africa that suggests these children had bad outcomes when they got ill,” he says. “But there’s uncertainty about children in this country.” (One study suggests that the death rate of monkeypox in children is as high as 15%.)
How does someone die from monkeypox?
Again, monkeypox is rarely fatal. But, there could be a few situations in which someone could die from monkeypox.
They develop encephalitis. Encephalitis is inflammation of the brain that can be life-threatening, and it can be caused by bacterial infections, insect bites, and viral infections like monkeypox, the Mayo Clinic says.
Their airways become blocked. Monkeypox can cause swollen lymph nodes and could possibly block a person’s airways, making breathing difficult, Dr. Russo says.
They could develop sepsis. It’s possible for monkeypox lesions to develop a bacterial infection, which could then progress to sepsis, a life-threatening complication of an infection, Dr. Russo says. This is more likely in a person who is immunocompromised, Dr. Schaffner says.
How concerned should people be about dying from monkeypox?
Overall, experts say this isn’t something the average person should stress about. While a few people around the world have died from monkeypox, there aren’t a lot of details about those deaths, including what happened in the case in Texas. “We really need more information about this case,” Dr. Schaffner says. “This person may have died with monkeypox rather than of monkeypox.”
“The level of concern should remain low,” Dr. Russo says. “However, people should still be vigilant. If there’s any question you may have monkeypox, you should present to your healthcare provider to get it sorted out.”
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