U.S. local health departments confirmed that six people who tested positive for monkeypox – two in New York City, two in Chicago, one in Nevada and one in Maryland – have died.

The New York City Department of Health (DOH) and Mental Hygiene said it was "deeply saddened by the two reported deaths, and our hearts go out to the individuals' loved ones and community."

The NYC DOH also vowed to make every effort to prevent additional suffering from the monkeypox virus through continued community engagement, information-sharing and vaccination.

In addition, the Chicago Department of Health confirmed the two Chicagoans who died after testing positive for monkeypox had multiple other health conditions including weakened immune systems.

The Maryland Department of Health (MDH) said that monkeypox was a contributing factor in the death of a Maryland resident who was immunocompromised and experiencing a severe case.

MDH Deputy Secretary for Public Health Services Dr. Jinlene Chan said people who are eligible, such as those who are immunocompromised or at-risk, should be vaccinated as it is the best way to protect oneself against serious illness from monkeypox.

Hard to determine monkeypox deaths

The first confirmed U.S. monkeypox death was reported in Los Angeles County this September, while officials have not determined whether the virus caused the death of a person with monkeypox in Houston in August.

In late September, Ohio reported its first death of a person with monkeypox but noted that "the individual also had other health conditions."

According to Dr. Priya Banerjee, a board-certified forensic pathologist in Rhode Island and clinical assistant professor of pathology and laboratory medicine at Brown University, it can be difficult to determine if someone has died of monkeypox. 

"It's not that they die with the infection; it's because of it. So that's the differentiation you have to make, and that’s a pretty significant differentiation. I think limitations come in with not just identifying if or what organ is affected but to what extent – and no one is going to call it a cause of death unless that’s confirmed," she was quoted as saying.

Monkeypox cases in the U.S.

There were 28,061 confirmed monkeypox cases in the U.S. as of Tuesday, according to the U.S. Centers of the Disease Control and Prevention (CDC).

Since the U.S. CDC confirmed the first monkeypox case of a Massachusetts man on May 18, the country has seen continuous surge of cases.

Three months into the monkeypox outbreak in the U.S., the federal government finally declared monkeypox a health emergency on August 4.

"But the decision may have come too late," said a report of VOX, an American news and opinion website.

New monkeypox cases in the U.S. have been steadily dropping in recent weeks but concern remains about the possibility of severe illness or death, especially in immunocompromised people.

Read More:

Some officials now say monkeypox elimination unlikely in U.S.