Top 5 Takeaways

  1. Among 57 patients hospitalized for severe monkeypox during the study period, most were Black men with AIDS, highlighting the severe impact of monkeypox in immunocompromised individuals.
  2. Twelve patients died, with monkeypox being a cause or contributing factor in five cases. Delays in initiating monkeypox-directed therapies were noted.
  3. A high percentage of the patients (82%) had HIV infection, and most received intensive care; early treatment with available therapeutics is advised for those at risk.
  4. The study reveals inequities in healthcare access and emphasizes the need for public health outreach, especially in marginalized communities.
  5. The report urges clinicians to start early treatment for suspected or confirmed monkeypox, particularly in patients with severe immunocompromise, and to test all sexually active patients with suspected monkeypox for HIV.


This MMWR Article was created prior to the conventional renaming of Monkeypox to its more standard and appropriate name, Mpox. To avoid confusion, Monkeypox is retained when writing this article, but all future works should use Mpox.


Original Article Author and Citation

Corresponding Author

Maureen J. Miller,

Suggested Citation

Miller MJ, Cash-Goldwasser S, Marx GE, et al. Severe Monkeypox in Hospitalized Patients — United States, August 10–October 10, 2022. MMWR Morb Mortal Wkly Rep 2022;71:1412–1417, DOI:


This report focuses on 57 hospitalized patients with severe monkeypox manifestations. Predominantly, these patients were Black men with AIDS. The report underscores the gravity of monkeypox in immunocompromised individuals, particularly those with AIDS. The study period spanned from August to October 2022.


The CDC provided clinical consultations for these patients. Data on demographics, clinical course, and outcomes were gathered. The report includes detailed histories for three representative cases, illustrating the severity of monkeypox in these patients.


The findings highlight critical public health concerns, including delays in initiating monkeypox treatment, and the disproportionate impact of the disease on Black men with AIDS and those experiencing homelessness. These reflect broader healthcare inequities and the necessity for improved public health outreach and resource allocation.


The report concludes that early and aggressive treatment for monkeypox is vital, especially for those at high risk like AIDS patients. It also emphasizes the need for equitable healthcare access and the importance of HIV care engagement to mitigate the impact of monkeypox.



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