Mpox (Formerly Monkeypox)

What is mpox?

Mpox is a rare disease caused by infection with the mpox virus. It remains a public health concern because the illness is similar to smallpox and can spread through close contact with infected humans, animals, or contaminated materials. While mpox is generally less transmissible and less severe than smallpox, it can still cause serious illness. First identified in 1958, the virus was historically endemic primarily to Central and West Africa. Outside these regions, outbreaks were previously tied to international travel or imported animals. However, since the 2022 global outbreak, cases have been reported worldwide through sustained human-to-human community transmission, including ongoing concerns regarding distinct viral clades (Clade I and Clade II) spreading regionally and internationally.

A recent CDC study suggests that mpox may be becoming endemic in the U.S., with persistent low-level transmission continuing since the 2022 outbreak. Data also indicates that unvaccinated individuals are nearly 10 times more likely to be hospitalized, underscoring the importance of vaccination.

How does mpox spread?

It spreads through close prolonged contact with an infected person. This may include coming into contact with skin lesions or body fluids, sharing clothes or other materials, such as bed linens or towels that have been used by an infected person, or inhaling respiratory droplets during prolonged face-to-face contact.

Mpox can be spread through:

• Direct skin-to-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 (mainly happens when living with or caring for someone who has mpox)

Mpox is NOT spread through:

• Casual conversations
• Walking by someone with mpox, like in a grocery store
• Touching items like doorknobs

Symptoms

Mpox may start with symptoms like the flu, such as a fever, low energy, swollen lymph nodes and general body aches. Typically, mpox symptoms start within 21 days of exposure to the virus. If an individual has flu-like symptoms, they will likely develop a rash 1–4 days later. Sores will go through several stages, including scabs, before healing. They can look like pimples or blisters and may be painful and itchy.

Other symptoms may include:

• Fever
• Chills
• Body aches
• Headaches
• Sores/Rash

Please call your medical provider if you think you may have been exposed to mpox and are showing signs and symptoms.

Testing

If you've been exposed to or have an illness you believe could be mpox, contact your health care provider. They can test and send it to a commercial lab, just like they do for a wide range of other tests. Urgent care centers can also test for mpox, but call ahead to make sure they're ready for you.

If you don't have health insurance, you can contact the Department of Health at 410-222-6633.

Treatment

In most cases, mpox will resolve on its own. There are no treatments specifically for mpox virus infections. However, mpox and smallpox viruses are genetically similar, which means antiviral drugs and vaccines developed to protect against smallpox may be used to prevent and treat mpox virus infections. Antivirals, such as tecovirimat (TPOXX), may be recommended for people who are more likely to get severely ill, like patients with weakened immune systems. 

Pets

It is possible that people who are positive for mpox virus can spread it to animals through close contact, including petting, cuddling, hugging, kissing, licking, sharing sleeping areas and sharing food. Animals can also spread mpox virus to people. People with mpox should avoid contacts with any animal to prevent spreading the virus.

If your pet is exposed to mpox:

• Do not surrender, euthanize or abandon pets just because of a potential exposure or mpox virus.
• Do not wipe or bathe your pet with chemical disinfectants, alcohol, hydrogen peroxide or other products, such as hand sanitizer, counter-cleaning wipes, or other industrial or surface cleaners.
• Keep them at home and anyway from other animals and people for 21 days after the most recent contact. Infected people should not take care of exposed pets.

If you have mpox and did not have close contact with your pet, ask friends or family who live in a separate household to care for the animal until you have fully recovered. Before bringing the animal back into the home, disinfect the home following CDC recommendations.

Cleaning and Disinfection

Disinfection is recommended for all areas (e.g., home, vehicle) where a person with mpox has spent time, as well as, for items considered to be potentially contaminated. This includes linens, clothing and on environmental surfaces. It is recommended to use an EPA-registered disinfectant, in accordance with the manufacturer’s instructions. The CDC provides home cleaning and disinfection recommendations. 

Prevention

A number of ways to prevent spreading mpox:

• Talk to sexual partners about any recent illness and be aware of new or unexplained sores or rashes on you or your partner’s body.
• Limit the number of sexual partners.
• Avoid close contact, including sex of any kind (oral, anal, vaginal) and kissing or touching each others bodies, with people with symptoms like sores or rashes.
• Practice safe sex by using condoms or other barrier methods the right way and using a new condom or other barrier method every time you have sex. Order a Safe Sex Kit.
• Practice good hand hygiene.
• Isolate infected persons until symptoms, including rash, have gone away completely
• Use appropriate personal protective equipment (PPE), like a mask, gown and gloves, when caring for others with symptoms.
• Avoid contact with infected materials, such as towels, clothing, sheets, fetish gear, sex toys and toothbrushes.
• Avoid contact with infected animals.

Vaccines and Eligibility 

Vaccination is an important tool in preventing the spread of mpox. The Department of Health has expanded eligibility for the mpox vaccine, allowing vaccine distribution to anyone at high risk of infection to be vaccinated prior to exposure as supply allows.

Eligibility for the vaccine includes:

• Anyone of any sexual orientation or gender identity who has had multiple or unknown sexual partners in the past two weeks, including those considered higher risk: gay, bisexual and other men who have sex with men, and immunocompromised individuals
• Anyone of any sexual orientation or gender identity who are aware that one or more of their sexual partners from the past two weeks has been exposed to mpox
• Self-identified close contact of a person with mpox
• Impacted community member with potential mpox exposures in the prior two weeks
• Individuals whose jobs may expose them to mpox

Jynneos Vaccine

The Jynneos vaccine is a two-dose vaccine given under the skin 28 days apart that should be given within 4 to 14 days after last exposure to mpox. This vaccine can be given to any age group. You are considered fully vaccinated 14 days after the second dose of the series.