# Mpox — WATCH (worsening)
id mpox · Global Health · horizon acute · checked 2026-11-01T11:52Z · at this level since 2026-10-31T11:26Z · stale after 2026-11-02T23:52Z
Assessed by an AI model (Anthropic Claude) against published rubrics; not a forecast or advice · CC BY 4.0 · https://canary.danleech.com/s/mpox

Value: Clade I local spread in US
Rated on: Clade I spreading outside Africa or a regional surge.

Clade I mpox now spreading locally in the US

Why it's at this level: Clark County, Nevada reported its first clade I mpox case with no travel link (20 Oct), and Stanislaus County, California has confirmed two clade I cases, signs of local transmission of the more severe strain outside Africa. No new US clusters were reported as of 1 Nov.

What this means for you: Risk to the general public is low. Vaccination is available for those at higher risk via sexual health services.

Why it matters: Clade I mpox is more severe and has spread beyond Central Africa.
What moves it: Case growth, vaccine access, travel-linked spread.

Rubric — Alert: PHEIC in effect with accelerating growth. | Watch: Clade I spreading outside Africa or a regional surge. | Normal: Cases declining; no PHEIC.

Sources:
- KOLO — First clade I mpox case reported in Clark County resident (2026-10-20) https://www.kolotv.com/2026/10/20/first-clade-i-mpox-case-reported-clark-county-resident/
- Medscape — Mpox clade I shows domestic side () https://www.medscape.com/viewarticle/mpox-clade-i-shows-domestic-side-2026a10011po