Today in Morbidity and Mortality Weekly Report, authors describe the distribution of the antiviral drug tecovirimat (Tpoxx) in Los Angeles County during the 2022-23 global mpox outbreak, which was spread largely among men who have sex with men.
Los Angeles was one of the epicenters of the mpox outbreak in the United States, and public health officials quickly developed a hub-and-spoke distribution model to deliver the antivirals to those who had been exposed to the virus, consisting of 44 hub facilities serving 456 satellite sites across the county, with two-thirds being clinics or pharmacies.
This strategy was built on the COVID-19 vaccine rollout.
"This strategy was built on the COVID-19 vaccine rollout, for which clinics and pharmacies were crucial to vaccine distribution networks," the authors said.
Median time to treatment was 2 days
Thirty-nine percent of all California mpox cases occurred in Los Angeles County, the most populous county in the state. By January 31, 2023, 2,281 patients with mpox were reported in the county, and approximately one-third (735; 32%) had been treated with tecovirimat.
"120 (16%) patients who received tecovirimat were treated at pharmacies, 227 (31%) at hospitals, and 388 (53%) at community clinics," the authors wrote. The median interval from specimen collection to treatment was 2 days, and the average patient age was 38.
"Overall, the distribution strategy was effective and sufficient to meet increasing needs. Similar strategies might benefit tecovirimat distribution in different jurisdictions as would other prepositioned therapeutics for mpox or future emerging infections," the authors concluded.