Monkeypox deaths in the US are rare, but hard to confirm, because:

CNN
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With more than 25,000 monkeypox cases in the United States during the current outbreak, monkeypox deaths are rare.

Among the few reported cases, it can be difficult to determine the role that monkeypox played in death.

“It’s like the old situation we had with Covid. Did you die from Covid or did you die from Covid? So it’s the same scenario. You died from monkeypox. Or did you die of monkeypox?” said Lori Tremmel Freeman, chief executive officer of the National Association of County and City Health Officials.

of First confirmed monkeypox death in the United States It was reported in Los Angeles County in September. A monkeypox patient died in Houston in August, but officials have not specified whether the virus was the cause. on thursday Ohio It reported the first death of a monkeypox patient, but said “the individual also had other health conditions.”

Many people infected with monkeypox in this outbreak have either compromised immune systems or underlying medical conditions such as HIV. It can be difficult for authorities to determine whether the death was actually due to monkeypox or whether the person died from an underlying medical condition that happened to have been infected with monkeypox.

Studies of other outbreaks have found that monkeypox deaths often affect infants, pregnant women, and people with weakened immune systems.

An expert must ask: impact with impact to the ability to survive? said Freeman.

Globally, Over 68,000 monkeypox cases According to the World Health Organization, 25 deaths have been confirmed in the current outbreak.

new Number of monkeypox cases in the United States Although there has been a steady decline in recent weeks, concerns remain about the potential for serious illness and death, especially in immunocompromised people. Alert Some monkeypox patients have “severe symptoms” of the disease, extended hospital stays, or “significant” health problems, according to the CDC, which was sent to health care providers on Thursday.

“Immune-compromised people with HIV or other diseases are at greater risk of severe monkeypox disease than immune-compromised people,” the CDC reports.

The deceased LA County resident “had been hospitalized with a severe immunocompromise,” he said. News release from the county public health department.

“It’s deadly for people who already have these conditions, even though we expect the disease to be a mild illness that can be overcome with vaccines, treatments and other mitigation efforts,” Freeman said. rice field.

“So it’s not a disease to worry about, especially if you know you have a weakened immune system or are dealing with other serious conditions,” she added. The few deaths, whether entirely due to monkeypox or those who died from monkeypox, would probably not have died without these underlying conditions or disabilities. I wouldn’t have.”

In August, authorities announced that a monkeypox patient was Harris County, Texasdied, but the role of the virus in its death has not yet been confirmed.

“A medical certifier (usually your doctor) determines the cause of death and its contributing factors recorded on the death certificate. In the case of the Harris County death, they gather more information before determining the cause of death. We have decided to perform an autopsy to investigate,” Lara Anton, spokesperson for the Texas Department of Health Services, wrote in an email to CNN.

In any case, forensic scientist Testing usually begins by collecting details about the patient’s medical history and cause of death. Next, an external and internal examination of the body is performed and tissue samples are collected for analysis under a microscope. This type of post-mortem examination is known as an autopsy.

“We learn a lot about infectious diseases from autopsies, but at the same time it is an evolving process. Diagnosis and conclusions are not easy. Certified Forensic Scientist in Rhode Island and was a clinical assistant professor of pathology and laboratory medicine at Brown University.

Determining whether someone has died from monkeypox not only requires the virus to be detected in the body, but forensic pathologists need to know how the infection causes death, including its effect on specific organs. You need to “connect the dots” about Taka. Said.

“Death from any infection is usually systemic, meaning that the whole body is affected, or vital organs such as the heart, lungs, liver, and brain are affected,” she said. It’s not that they die of an infection, that’s what causes it, that’s the differentiation you have to make, and it’s a pretty important differentiation, the limitation is whether it’s affected or which organ is I think it comes from identifying not only if you’re affected, but also to what extent.

Determining whether someone died of an infection or died of an infection is not always “black and white”. Emory University School of Medicine The director of the Department of Pathology and Laboratory Medicine’s Autopsy Service said in an email to CNN.

“It’s important to understand that the presence of a particular pathogen does not necessarily mean that that pathogen caused the patient’s death, but it usually warrants further investigation,” Mosunjac wrote.

“Every clinical case is different, and there are many conditions that overlap and may interfere with determining the exact cause of death for each patient,” he said. After scrutinizing all relevant factors in terms of correlation, it is obtained in a case-by-case scenario.”

Typically, to determine whether monkeypox caused or contributed to the death, a forensic pathologist examines how the symptoms specifically turned fatal. Look for clues.

“For example, with monkeypox, people usually think of it as a skin lesion, perhaps a general malaise or a flu-like symptom. How would that cause death? , there are some very rare methods. Forensic Commission.

“If an infection gets into the brain, it can cause encephalitis, an inflammation of the brain, which is very rare,” said Gill, who is also the chief medical examiner in Connecticut.

“A more common way that many viral infections ultimately lead to death is through secondary effects, secondary co-infections. For example, people develop skin infections from pneumonia or skin lesions. can cause bacterial infections and enter the bloodstream, causing sepsis.

Even when a monkeypox patient develops pneumonia or a blood infection and dies, monkeypox is still considered the cause of death because it is the starting point of the chain of events, Gill said.

“If they happen to have lymphoma or AIDS, they’re more likely to die from monkeypox than healthy people, so it’s probably listed as a causative disease,” Gill said.

In most cases, the person was hospitalized, and “most of those deaths would have been certified by hospital doctors,” he said.