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Monkeypox

OHA Introduces Monkeypox Website

The Oregon Health Authority recently launched a new website dedicated to helping people in Oregon learn more about the ongoing monkeypox outbreak. The website includes information for the public, clinicians, public health, and community organizations; the website is also available in Spanish.

Anyone can get monkeypox. However, during the current outbreak, most cases have been detected among gay or bisexual men or men who report having sex with other men. Monkeypox is spread primarily through close, skin-to-skin contact, which may include sex, cuddling, massage, and kissing.

To protect yourself and others, be aware of your health. Monkeypox may start with fever, achiness, or sore throat, but may also start with just a rash or sores. If you're feeling sick and notice any new rashes – especially on the genitals or around the anus – avoid close, skin-to-skin contact and talk to a healthcare provider (or call 211 if you don't have one).

Let your provider know, before the appointment, that you think you might have monkeypox and cover any lesions you have. Ask your provider about monkeypox testing. Even if you are not in a high-risk category, but you think that your symptoms or rash are concerning for monkeypox, talk to your provider. Testing may be recommended for you.

The new monkeypox website includes a weekly summary of case data and will be updated on Wednesdays.


What are the symptoms?
Initial symptoms of hMPXV often include fever, headache and muscle aches. These symptoms are followed in one to three days by a rash, often on the face, spreading to the limbs. The rash starts with flat patches that then form large, firm bumps, which then fill with fluid or pus. These then scab and fall off, usually over two to four weeks. Symptoms usually start within seven to 14 days after exposure, with a range of five to 21 days.

When can a person ill with hMPXV spread it to others?
Ill people can potentially transmit the infection from when symptoms start until the rash has resolved. However, this is not an easy infection to catch. hMPXV typically requires prolonged, close contact. People at increased risk include sexual partners of an ill person, or family members and healthcare workers caring for someone ill with hMPXV.

Are there vaccines for hMPXV?
There is a vaccine specifically for hMPXV and smallpox called Jynneos. It could be used to protect people with high-risk exposure to someone ill with hMPXV. There is another vaccine, ACAM2000, that is approved to prevent smallpox. It could be used under special arrangements with CDC, but it is more likely to cause adverse effects.

Vaccines would be used to protect people who have known exposure to someone ill with hMPXV infection. It works to prevent or decrease disease even after someone was exposed. Members of the public who haven't been exposed don't need this vaccine.

How is OHA responding to the outbreak?
Currently, there are 84 cases across 18 states, no deaths and one case in Oregon.

OHA is working with community partners to share information about hMPXV, the outbreak and infection prevention strategies with people who might be at increased risk of infection. OHA is sharing information with clinicians about the outbreak, how to recognize and test for hMPXV illness and how to prevent spread.

For more information on hMPXV, visit this FAQ page.


The Centers for Disease Control and Prevention (CDC) has been working closely with international and state health partners to respond to global outbreaks of monkeypox. 

Currently, the West African variant of monkeypox has been found in the U.S. According to the CDC and Association of American Medical Colleges (AAMC), physicians and other health care providers should know the following for a clinical assessment of a patient suspected of having monkeypox:

  • Symptoms: Historically, people with monkeypox report flu-like symptoms (such as a fever, body aches, and swollen lymph nodes) before a characteristic rash appears on the body, often on the face, arms, and hands. During the current outbreak, some patients have developed a rash around the genitals or anus before any other symptoms, and some have not developed flu-like symptoms at all. The rash may resemble a rash found with herpes simplex, varicella/shingles, or syphilis. More details are available here.
  • Diagnosis: The orthopox PCR test is the accurate diagnostic tool performed within a laboratory in order to accurately detect the virus. Currently, labs that are part of the national Laboratory Response Network are performing an orthopoxvirus PCR test that was cleared by the Food and Drug Administration (FDA). CDC labs can further characterize the strain of monkeypox with a specific viral test and genome sequencing. An orthopox positive test alone is sufficient for full public health action.
  • Specimen Collection: Use sterile dry polyester, nylon, or Dacron swabs. Do not use cotton swabs. Swab or brush lesion vigorously with two separate sterile dry swabs. If possible, swab two different lesions. If the specimen is not sent to a lab within your immediate proximity, the sample should be frozen. More details are available here.
  • Isolation: Isolate patients suspected of having monkeypox. Keep patients' doors closed. Make sure personnel wear appropriate PPE.
  • Positive Test Results: If a test is positive, work with your public health department. A positive orthopoxvirus test is enough to take the actions necessary to care for the patient and help prevent additional spread – the same actions they would take for a positive monkeypox test result.
    • Health authorities can isolate the patient, start treatment if needed, begin contact tracing, and offer post-exposure vaccination to contacts while confirmatory tests for monkeypox are under way.
  • Treatment Protocol: Consult the CDC interim treatment guidance for monkeypox for clinical guidance and available medical countermeasures. Although there is not a specific treatment for monkeypox at this time, outbreaks can be mitigated.

Resources

The following resources will help you stay up to date.

CDC:


AAMC and Member Institutions:


Other:

Information for Patients:

Johns Hopkins University Bloomberg School of Public Health, an AAMC member institution, has published What You Need To Know About Monkeypoxwhich may be shared with patients.


Updated June 16, 2022