Mpox

​Monkeypox is not a sexually transmitted disease and does not spread easily between people. However, anyone who has extremely close personal contact — mostly skin-to-skin — including direct contact with monkeypox rash, scabs, or body fluid from a person with monkeypox, can get it and should take steps to protect themselves.  

Take the following steps to prevent getting monkeypox: 

• Avoid close, skin-to-skin contact with people who have a rash that looks like pimples or blisters. 
• Do not touch the rash or scabs of a person with monkeypox. 
• Do not kiss, hug, cuddle or have sex with someone with monkeypox. 
• Do not handle or touch the unwashed bedding, towels, or clothing of a person with monkeypox. 
• Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially before eating or touching your face and after you use the bathroom. 
• Do not share eating utensils or cups with a person with monkeypox. 
• If you have symptoms or test positive, isolate yourself until the rash heals to avoid transmitting monkeypox to others.
  

​According to the CDC, symptoms of monkeypox can include: 

• Fever 
• Headache 
• Muscle aches and backache 
• Swollen lymph nodes 
• Chills 
• Exhaustion 
• Respiratory symptoms (e.g. sore throat, nasal congestion, or cough) 
• A rash that may be located on or near the genitals (penis, testicles, labia, and vagina) or anus (butthole) but could also be on other areas like the hands, feet, chest, face, or mouth. 
• The rash will go through several stages, including scabs, before healing in 2 to 4 weeks. 
• The rash can look like pimples or blisters and may be painful or itchy. 
• You may experience all or only a few symptoms

On May 15, 2023, the CDC released a HAN Health Advisory about the potential for a resurgence of Mpox (formerly called monkeypox) infections in the summer of 2023. The Pennsylvania Department of Health (PA DOH) has responded to this announcement by issuing PA HAN 694.

With new Mpox cases occurring in some people who are vaccinated, it is important that clinicians quickly identify cases to limit a possible Mpox resurgence in the United States. Persons at high risk for Mpox exposure should be vaccinated with the recommended 2-dose JYNNEOS series. The second dose should be given 28 days (4 weeks) after the first dose. At this time, data suggest that gay, bisexual, and other men who have sex with men make up the majority of cases in the current mpox outbreak. However, anyone, regardless of sexual orientation or gender identity, who has been in close, personal contact with someone who has mpox is at risk.

Currently, the CDC does not recommend routine immunization against mpox for the general public. However, extensive risk assessment should not be conducted on people who request vaccination to avoid the barriers created by the stigma experienced by many who could benefit from vaccination. For people in the community at risk (e.g., gay, bisexual, or other MSM; transgender or nonbinary people), asking for vaccination is adequate attestation for individual risk of mpox exposure. 

Mpox vaccination should be offered to the following people with a high potential for exposure to mpox: 

• People who had known or suspected exposure to someone with mpox.
• People who had a sex partner in the past 2 weeks who was diagnosed with mpox.
• Gay, bisexual, and other MSM, and transgender or nonbinary people (including adolescents who fall into any of these categories) who, in the past 6 months, have had:
  • A new diagnosis of one or more sexually transmitted diseases (e.g., chlamydia, gonorrhea, syphilis).
  • More than one sex partner.
  • People who have had any of the following in the past 6 months.
  • Sex at a commercial sex venue.
  • Sex in association with a large public event in a geographic area where mpox transmission is occurring.
    
  • Sex in exchange for money or other items.
• People who are sex partners of people with the above risks.
• People who anticipate experiencing any of the above scenarios.
• People with HIV infection or other causes of immunosuppression who have had recent or anticipate potential mpox exposure.
• People who work in settings where they may be exposed to mpox.
  • People who work with orthopox viruses in a laboratory.

JYNNEOS vaccine may be administered via the standard regimen that involves a subcutaneous injection volume of 0.5mL. JYNNEOS may be administered via an alternative regimen which involves an intradermal injection volume of 0.1mL. The alternative regimen, when feasible, is preferred because this could increase the number of available JYNNEOS vaccine doses by up to five-fold. Results from a clinical study showed that the lower intradermal dose was immunologically non-inferior to the standard subcutaneous dose. However, providers are recommended to have a conversation with each patient regarding their comfort level with each method of administration. People of any age who have a history of developing keloid scars are recommended to receive the standard regimen of JYNNEOS. Please see the CDC's Vaccine Considerations for more information.

The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, is sponsoring a Phase 3 clinical trial evaluating the antiviral tecovirimat, also known as TPOXX, for the treatment of human Mpox infection. The NIAID-funded AIDS Clinical Trials Group (ACTG) is leading the study, now enrolling adults and children with Mpox infection in the United States.

Per the Emergency Use Authorization (JYNNEOS) and the HHS Mpox Vaccination Program Provider Agreement, Mpox vaccine providers are responsible for mandatory reporting of all serious adverse events following JYNNEOS vaccination to the Vaccine Adverse Reporting System (VAERS). Providers are also encouraged to report to VAERS any additional clinically significant adverse events following vaccination, even if they are unsure if vaccination caused the event.

For information on how to submit a report to VAERS, visit VAERS—Report an Adverse Event (hhs.gov) or call 1-800-822-7967.

If you are a provider seeking treatment for confirmed or suspected mpox patients, please complete the PA DOH Mpox Medication Request form, Mpox Medication Request Form. A team member will be in contact shortly after reviewing the request.