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MPOX (Monkeypox)
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MPOX (Monkeypox): What We Know
MPOX (Monkeypox) is a rare disease that is caused by infection with the  virus and is related to the smallpox virus. While generally less severe and much less contagious than smallpox, MPOX can be a serious illness. It spreads from infected humans, animals, and materials contaminated with the virus but primarily through close, personal, often skin-to-skin contact with people who have symptoms, such as rash and sores.

Should I be worried about MPOX?
There is a recent increase in reported cases where monkeypox is not commonly seen, including in the United States and California. While it’s good to stay alert about any emerging public health outbreaks, the current risk of getting MPOX in the general public is very low.

Is MPOX a new disease?
No, it is not a new disease. It was first discovered in 1958. The first human case of MPOX was recorded in 1970 in the Democratic Republic of Congo. It is endemic (regularly found) in west and central African countries.
Is MPOX related to COVID-19? 
No, it is a completely different disease and is not related to COVID-19. MPOX is much less contagious and spreads differently than COVID-19. This is partly because people with MPOX are generally thought to be contagious to people with whom they’ve had very close contact over a long period of time, and when they have symptoms like a rash. This is different from COVID-19, which spreads through the air and when people do not have symptoms.
How is MPOX transmitted?
MPOX spreads primarily through direct contact with infectious sores, scabs, or body fluids, including during sex, as well as activities like kissing, hugging, massaging, and cuddling. It can spread through touching materials used by a person with monkeypox that hasn’t been cleaned, such as clothing and bedding. It can also spread by respiratory secretions (talking, coughing, sneezing, breathing) during prolonged, close, face-to-face contact.

MPOX can be spread through: 

  • Direct skin-skin contact with rash lesions
  • Sexual/intimate contact, including kissing
  • Living in a house and sharing a bed with someone
  • Sharing towels or unwashed clothing
  • Respiratory secretions through prolonged face-to-face interactions (the type that mainly happen when living with someone or caring for someone who has MPOX)

Who can get MPOX?

Anyone can get the virus after having close and prolonged physical contact with someone who has the infection, especially contact with infected lesions (sores), bodily fluids, or other contaminated surfaces. However, the current risk to the general public is very low.

Symptoms, Prevention & Vaccines
What are the signs and symptoms of MPOX?
It might start with symptoms like the flu, fever, low energy, swollen lymph nodes, and general body aches. Within 1 to 3 days (sometimes longer) after the appearance of fever, the person can develop a rash or sores. The sores will go through several stages, including scabs, before healing. They can look like pimples or blisters and may be painful and itchy.

The rash or sores may be located on or near the genitals (penis, testicles, labia, and vagina) or anus but could also be on other areas like the hands, feet, chest, and face. They may also be limited to one part of the body.

People with MPOX may experience all or only a few of these symptoms. Most people will get the rash or sores. Some people have reported developing the rash or sores before (or without) the flu-like symptoms.

When is MPOX contagious?
Symptoms usually start within 2 weeks (but can be up to 3 weeks) after exposure to the virus. Usually, people are only thought to be contagious (infectious) when they have symptoms, and until all sores, including scabs, have healed and a fresh layer of skin has formed. This can take several weeks. Researchers are still trying to understand if the virus can spread from someone who has no symptoms.

How is MPOX prevented? 
There are a number of ways to prevent the spread, including:

  • Always talk to your sexual partner/s about any recent illness and be aware of new or unexplained sores or rashes on your body or your partner’s body, including on the genitals and anus
  • Avoiding close contact, including sex, with people with symptoms like sores or rashes
  • Avoiding contact with infected animals and materials contaminated with the virus
  • Isolation of infected persons until their symptoms, including rash, have gone away completely
  • Using appropriate personal protective equipment (PPE) (like a mask, gown, and gloves) when caring for others with symptoms
  • Practicing good hand hygiene

What should someone do if they are exposed to MPOX or have symptoms? 

Contact a healthcare provider as soon as possible and let them know you have symptoms or have been exposed. Healthcare providers can provide testing and care for people who are diagnosed with MPOX.

Healthcare providers and local health departments may also recommend a vaccine for those who are exposed to help prevent infection or decrease the seriousness of the illness.

Additionally, the person should clean and disinfect surfaces such as counters, toilet seats, and faucets, using an EPA-registered disinfectant (such as List Q) after using a shared space. This may include during activities like showering, using the toilet, or changing bandages that cover the rash. Consider disposable gloves used while cleaning if the rash is present on the hands.

Hand Hygiene, Source Control, and Personal Protective Equipment

  • Hand hygiene – the use of an alcohol-based hand rub or hand washing with soap and water – should be performed by people with MPOX and household contacts after touching rash material, clothing, linens, or environmental surfaces that may have had contact with rash material.
  • Cover all skin rashes to the extent possible by wearing long sleeves or long pants. Gloves can be considered for covering rash on the hands when not in isolation such as when receiving medical care.
  • People with MPOX should use well-fitting source control (e.g., medical mask), if close contact with others cannot be avoided, such as when receiving medical care.
  • Other household members should wear a respirator or a well-fitting mask when in close contact (e.g., within 6 feet) with the person with MPOX for more than a brief encounter.
  • When possible, the person with MPOX should change their own bandages and handle contaminated linens while wearing disposable gloves, followed by immediate handwashing after removing gloves.
    • As a last resort, if assistance is needed with these activities, a household member should avoid extensive contact and wear, at a minimum, disposable medical gloves, and a well-fitting mask or respirator. Any clothing that contacts the rash during dressing changes should be immediately laundered. Gloves should be disposed of after use, followed by handwashing.

Contain and dispose of contaminated waste, such as dressings, bandages, or disposable gloves. See Disinfecting Home and Other Non-Healthcare Settings.

Vaccines & Treatment

Most MPOX infections are mild and will heal without any treatment. However, antiviral drugs, such as tecovirimat (TPOXX), may be used as treatment. This drug may be recommended for people who are more likely to get severely ill or for people who are experiencing a severe disease. It may also be recommended for people who have rash or sores in areas that may be at higher risk for severe complications, such as the eyes or the genital area.

People who may be at risk for more severe illness include those with a weakened immune system, young children (<8 years of age), those who are pregnant or breastfeeding, and those with a history of certain skin diseases like eczema.

For more information on treatment, please visit the CDC Patient’s Guide for Tecovirimat and the CDPH Mpox Tecovirimat Treatment Information for Providers guidance.

Vaccines will now be administered intradermally. This strategy involves injecting a smaller dose of vaccine intradermally, or in the upper layer of the skin. The strategy, called dose sparing, could turn a one-dose vial of the vaccine into up to five separate doses. Individuals are considered fully vaccinated 2 weeks after receiving their second dose of the JYNNEOS vaccine.

The JYNNEOS vaccine is approved by the U.S. Food and Drug Administration (FDA) to prevent both MPOX and smallpox. Vaccination helps protect against MPOX when given before or shortly after an exposure.

Where can I find more information?

    • CDPH Monkeypox Health Alert
    • CDPH Monkeypox homepage
    • World Health Organization (WHO)- Monkeypox
    • Joint Letter Calling on CDC to Expand Monkeypox Virus Testing and Vaccine
    • White House Statement on Monkeypox Strategy (June 28, 2022)
    • CDC – Get the Facts about Monkeypox
    • CDC – Social Gatherings, Safer Sex and Monkeypox
    • Considerations for Monkeypox Vaccination
    • California Vaccine Distribution
    • Sacramento County Vaccine Information
    • Intradermal Vaccine Strategy
    • LA County Vaccine Portal

LA COUNTY: Consent for Minors:

  • Currently, a consent form is required for all minors aged 6 months through 17 at each visit.
  • Youth 16 and 17 years of age should be accompanied by their parent. or legal guardian if possible. If this is not possible, they must bring a consent form signed by their parent or legal guardian.
  • Children ages 6 months through 15 years must be accompanied by their parent, legal guardian, or a responsible adult. If the child is accompanied by a responsible adult, the consent form must name the responsible person and be signed by the parent or legal guardian.
  • Click HERE to visit the LA County Vaccine portal.

The information provided on this website is intended for your general knowledge only and is not a substitute for professional medical advice or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your health.

Any person who MAY be at risk for MPOX infection or persons who request vaccination may receive the vaccination without having to report specific risk factors.

However, some individuals are at higher risk for MPOX infection and/or complications of mpox infection. They should be considered a priority and are strongly encouraged to receive the vaccination to decrease infection spread, minimize serious illness, and prevent fatalities. This includes any of the following:

  • Anyone living with human immunodeficiency virus (HIV). It is recommended that additional efforts be made to reach those with a CD4 count <350/mm3, an unsuppressed HIV viral load, or an opportunistic infection, due to increased risk for complications of mpox
  • Any man or trans person who has sex with men or trans persons
  • People who use or who are eligible for HIV pre-exposure prophylaxis (PrEP)
  • Sex workers
  • Sexual partners of the above groups
  • People who have had direct skin-to-skin contact with one or more people AND who know others in their community that have had mpox infection
  • People who have been diagnosed with a bacterial sexually transmitted disease (STD) (e.g., chlamydia, gonorrhea, syphilis) in the past 3 months
  • People who anticipate experiencing the above risks

Known close contacts of people who have mpox should be vaccinated as soon as possible. This is called post-exposure prophylaxis (PEP).

People in specific occupational groups should be offered vaccination. These include:

  • Occupational groups recommended for vaccination by Advisory Committee on Immunization Practices (ACIP).
  • Healthcare workers (HCWs) who are likely to collect laboratory specimens from patients with mpox (e.g., persons working in sexual health clinics or clinical settings that serve at-risk populations).

Please see CDPH Considerations for Mpox Vaccination in California for further details and guidance.

Please contact your healthcare provider or occupational health department if you are eligible for the MPOX vaccine. If you do not have a healthcare provider, please contact 2-1-1 or monkeypox@acgov.org

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