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None of the patients, all California residents, had traveled abroad, suggesting the Clade 1 form was transmitted locally.
A type of mpox that causes severe illness has been identified in three California residents who had not traveled abroad, the first time the more virulent form has spread within the United States, health officials said on Friday.
The type, known as Clade 1, has been widely circulating in central and eastern Africa, causing tens of thousands of infections and hundreds of deaths. Clade 2, the form that swept the United States in 2022 and sickened 30,000 people, causes less severe illness.
Clade 2 continues to circulate in the United States at low levels, but infections have been rising in a number of cities since the summer. Los Angeles health officials have reported 118 cases of mpox, formerly monkeypox, so far this year.
California health officials say the three patients — one in Long Beach and two in Los Angeles — were hospitalized and are now recovering at home in isolation. They have not found a link among the three cases.
Officials in Long Beach announced the first case on Tuesday.
Dr. Kelly Johnson, an infectious disease specialist at the University of California, San Francisco, said that although the risk of infection was low for most people, she urged vigilance, especially among people with weakened immune systems and men who have sex with men.
“My concern is that person-to-person, community spread could be ongoing,” she said.
Sonali Kulkarni, medical director of the Division of H.I.V. and S.T.D. Programs at the Los Angeles County Department of Public Health, said that officials were increasing surveillance efforts and testing existing lab specimens to gain a better understanding of the spread. She said all three patients are in a high-risk group of gay and bisexual men.