Officials in New York and Nevada said Thursday that they had identified their first deaths in people who had tested positive for monkeypox, as officials in Maryland confirmed they are waiting for “final documentation” of the state’s potential first monkeypox death.
Only four deaths have been officially tallied so far by the Centers for Disease Control and Prevention, out of 27,635 infections around the country. The first confirmed death was in California and a second was later reported in Ohio. Officials have not yet confirmed a death in Texas was connected to monkeypox.
Two residents “recently passed away” in New York City who had tested positive for the virus, according to Jeffrey Hammond, a spokesperson for New York’s health department. Both were facing “underlying conditions that placed them at high risk of severe outcomes from monkeypox infection.”
The exact causes of death remain under investigation. The state health department is in talks with the city health officials and the Centers for Disease Control and Prevention about the fatalities, Hammond said.
“We are deeply saddened by the two reported deaths and our hearts go out to the individuals’ loved ones and community. Every effort will be made to prevent additional suffering from this virus through continued community engagement, information-sharing and vaccination,” the city’s health department said in a statement.
New York City’s health department declined to provide additional information about the deaths, citing patient confidentiality.
In Nevada, authorities also announced Thursday that a man in the Las Vegas area had died after being diagnosed with monkeypox.
“The patient was a male over the age of 50 with underlying medical conditions whose death was attributed to other causes,” the Southern Nevada Health Department said in a release.
In Maryland, a spokesperson confirmed Thursday that they were also “awaiting final documentation” of a potential death of a Maryland resident from monkeypox.
Two additional deaths were tallied just days apart on the CDC’s nationwide dashboard this past week, although it is unclear which states the new fatalities are attributed to.
The CDC did not respond to multiple requests for comment.
Officials said several other deaths linked to the virus are also being investigated around the country.
A previously reported death of a Texas patient believed to have monkeypox remains unconfirmed, according to a spokesperson for the Houston area’s Harris Health System, pending results from the CDC.
The new deaths come as the pace of new infections has largely plummeted around the country. New York City, once an early hotspot of infections, is averaging only a handful of new infections per day on average.
Overall, cases are still overwhelmingly being reported among men who have sex with men. However, some demographics have shifted since early in the outbreak: Federal data suggest a majority of new cases are now in non-White patients.
Federal health officials have also warned that the agency had seen a growing number of severe infections and hospitalizations as the virus had spread into more vulnerable groups, including homeless communities.
“There have been cases identified, several hundred actually, including severe cases. Anecdotally, those seem to be in people experiencing unsheltered homelessness. And we are working to try to understand the exposures that have occurred,” the CDC’s Agam Rao said Wednesday at the ID Week conference.
Rao said the agency had also fielded a growing number of requests from doctors treating severe monkeypox infections in people with underlying conditions, like advanced untreated HIV.
“When people are severely immunocompromised, then they don’t have the ability to clear the virus on their own,”
Rao said some severe cases had received treatment with tecovirimat, an experimental antiviral drug being used to treat severe monkeypox cases.
“That slows down the replication. But the immune system still needs to be the one to clear the actual virus,” said Rao.