U.S. Reports 2 Mpox Deaths. But the Risk of Fatality Is Still Low.

Two people have died in the United States after contracting mpox (formerly known as monkeypox), raising the question of whether the disease can be severe, or even fatal.

The first patient who died had multiple pre-existing conditions, but it was unclear whether mpox played a role in the person’s death. The second case is also under investigation. 

Ken Zweig, MD, an internal medicine physician at Northern Virginia Family Practice, said the risk of dying from mpox remains very low. So far, there have been over 21,500 confirmed cases of mpox in the U.S. and two known deaths.

“To put that in perspective, the rate of death from influenza—the common flu—was 10 times higher than that in 2020,” Zweig told Verywell. “And the rate of death from COVID is about 200 times higher. So the likelihood of dying from Monkeypox is extremely low.”

Who Is Vulnerable to Severe Illness from Mpox?

There are certain factors that might put someone at risk of a more severe infection or even death from mpox.

Individuals who have underlying medical conditions or who are immunocompromised are all at a higher risk of complications or serious outcomes from the virus, according to Donald Alcendor, PhD, an associate professor in microbiology and immunology at Meharry Medical College. 

Children younger than 8 also face a higher risk because of their underdeveloped immune system, Alcendor said. People with moderate-to-severe skin conditions such as eczema and pregnant people may also be more susceptible to severe illness from mpox.

While certain health and demographical factors might explain why someone could have serious complications from the virus, it’s not impossible for a completely healthy adult to get a severe case. In Spain, for example, two deaths in young men who had no underlying conditions have been reported.

Much is still unknown about what might cause an mpox case to become severe, especially in someone with no underlying health issues. But based on fatal cases in different parts of the world, Alcendor said the virus could cause other life-threatening illnesses such as sepsis, respiratory distress, bronchopneumonia, and encephalitis. 

According to Zweig, the chances of this happening are still extremely low.

“These cases illustrate the importance of getting this current outbreak under control with vaccines and avoiding high-risk situations for spread. However, they should not cause alarm," Zweig said.

The Importance of Vaccinations

The risks of complications from mpox, however low they might be, illustrate the need for a comprehensive vaccination program, Zweig said. 

The current Jynneos vaccine was designed to prevent smallpox but it was shown to be effective against mpox in animals. Although comprehensive data are lacking, it's reasonable to assume that the vaccine is effective based on existing studies, he added.

“We know from older studies that the smallpox vaccine, which is related to monkeypox, was shown to be about 85% effective at preventing monkeypox,” Zweig said. “Therefore it’s reasonable to assume that a vaccine that specifically targets monkeypox would be even more effective.”

Although the risks of dying or becoming severely ill are low, typical mpox symptoms include fever, headache, sore throat, fatigue, and muscle pain, often followed by a painful rash across the body. Those who are at risk of contracting the virus should get the shot as soon as possible, Zweig suggested.

“Even though you likely won’t end up in the hospital, monkeypox is not fun,” he said.

Stop the Stigma

While most recorded cases have been among men who have sex with men so far, Alcendor said we must avoid stigmatizing the queer community because anyone can get mpox if exposed.

Mpox is not considered a sexually transmitted infection (STI). But it can spread through intimate contact during sex, through kissing and hugging, or by touching fabrics and surfaces that are contaminated with the virus.

"Anyone who has multiple or anonymous partners is at risk for monkeypox," Zweig said. “If you are at risk for this infection, you should contact your local health department to receive a monkeypox vaccine."