A second possible death from monkeypox in the U.S. is under investigation in Los Angeles County, officials said.

Chief Medical Director Rita Singhal of the county's Public Health Department said details were unavailable at this early stage of the investigation.

"This is one of two deaths in the United States that are under investigation to determine whether monkeypox was a contributing cause," she said at a public briefing Thursday.

In late August, the Texas Department of State Health Services reported that a person diagnosed with monkeypox in the Houston area had died. The patient was described in a statement as "severely immunocompromised."

The role of monkeypox in the patient's death was under investigation, Texas officials said at the time.

In California, 4,140 cases were reported last week; 1,694 were in Los Angeles County, health officials said.

The Centers for Disease Control and Prevention said Friday in a weekly report on monkeypox that a case analysis found that 61% of people in the U.S. who have developed the viral disease also had HIV or another sexually transmitted infection or disease.

People who had HIV and monkeypox were more than twice as likely to be hospitalized, the centers said, although the exact reason for treatment wasn't known.

According to the World Health Organization, 98% of monkeypox cases outside Africa have involved men who have sex with men, or MSM.

The CDC recommends that local public health officials "ensure equitable access to monkeypox screening, prevention, and treatment, particularly among MSM."

Monkeypox is often revealed through skin rashes, flu symptoms and aches and fatigue. It is transmitted through direct contact with patients, including sex, and through touching objects that have been used by those with monkeypox.

Deaths are rare — none are officially confirmed in the U.S. despite the reports from Texas and California — and the disease resolves in most patients within four weeks.

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