The effort is led by Dr. David Talan, a professor of emergency medicine and infectious diseases in the UCLA Department of Emergency Medicine at the David Geffen School of Medicine at UCLA.
Summer 2022 saw an outbreak of the disease that infected people in several countries across the globe. That outbreak receded by the following fall after widespread public attention and vaccination of high-risk individuals, prompting the World Health Organization on May 11, 2023 to declare an end to mpox as a global health emergency.
But a recent outbreak among 20 people in Chicago, including some vaccine breakthrough cases, and increased cases in other countries, has raised concerns among public health officials about a resurgence of mpox in the U.S. On June 23, for instance, the Los Angeles County Department of Public Health announced six new mpox cases in the previous week, up from an average of fewer than one case over the previous four months.
The surveillance project is called CRASHED (Cause of RASHes in Emergency Department). Talan, an attending emergency physician at Ronald Reagan UCLA Medical Center, since 1995 has directed EMERGEncy ID NET, a CDC-supported network for the study of emerging infections.
“Our approach is to base mpox surveillance on any patient presenting with a compatible rash,” Talan said. “Mpox has been labeled a sexually transmitted infection when in fact it can spread by any skin-to-skin contact. Our concern is that mpox cases may have only been suspected among the previously identified high-risk group, who are men who have sex with men, while infection in others such as women, children, and the homeless, may have been missed. Vulnerable people tend to use emergency departments, where we hope to determine if this infection is resurgent and broader-reaching or remains rare.”
The CRASHED surveillance project will be run in 13 geographically-diverse emergency departments at academic centers across the U.S. These include Ronald Reagan-UCLA Medical Center, Cedars-Sinai Medical Center, and Olive View-UCLA Medical Center in California; Baystate Medical Center in Massachusetts; Hennepin County in Minnesota; Johns Hopkins University in Maryland, Temple University in Pennsylvania; Valleywise Health in Arizona; Oregon Health Sciences University; University of Iowa; University of New Mexico Health Sciences; University of Mississippi; and University Health-Kansas City in Missouri.
The research is being conducted in collaboration with Omai Garner, associate clinical professor and section chief of clinical microbiology in the UCLA Department of Pathology and Lab Medicine. Dr. William Mower, professor of emergency medicine at the Geffen School, will direct the Data Coordinating Center at UCLA.
Additional funding was also awarded for three surveillance projects, conducted through EMERGEncy ID NET:
A study on past exposure to mpox of men in Los Angeles and Chicago who have sex with men, co-led by Pamina Gorbach, professor of medicine in the division of infectious diseases at the David Geffen School of Medicine at UCLA and of epidemiology at the UCLA Fielding School of Public Health; Anne Rimoin, professor of epidemiology, Gordon-Levin Endowed Chair in Infectious Diseases and Public Health, and director of the Center for Global and Immigrant Health at the Fielding School; and Steven Shoptaw, professor of family medicine and of psychiatry and biobehavioral sciences at the Geffen School,
Research on men who have sex with men who had reported engaging in exchange sex in the prior year and are seeking care at sexual health clinics and who may have contracted mpox, led by Gorbach and Dr. Robert Bolan, medical director of research and education health services at the Los Angeles LGBT Center, and
An investigation into the immunogenicity of Jynneos, the mpox vaccine, among individuals seeking care at AIDS Project Los Angeles (APLA) clinics, led by Rimoin and Dr. Jay Gladstein, chief medical officer of APLA.