Mpox update: Symptoms, transmission and treatment

MPOX is a virus in the same family of viruses as smallpox and cowpox. MPOX infections are rare. Anyone can get MPOX. It is not an STI. If you have recently experienced an unexplained rash, please get assessed by your primary care physician.

For the latest information about MPOX, visit the CDC website.

Symptoms

The key symptom of MPOX is a rash that can look like pimples or blisters. This rash can appear on any part of the body, including:

• Face, including inside the mouth
• Hands and Feet
• Chest
• Genitals

The rash can include small or large lesions. The lesions are often filled with pus and scab over as they start to heal. These lesions are often painful.

Other symptoms of MPOX include:

• Fever
• Headache
• Muscle aches and backache
• Chills
• Exhaustion
• Swollen lymph nodes
• Cough or sore throat

Symptoms usually appear 5-21 days after exposure. The illness typically lasts 2-4 weeks. MPOX rarely results in death or hospitalization, though hospitalization may be used for pain management. People who are immunocompromised may be more likely to get seriously ill.

Transmission

MPOX can spread in different ways. The most common is direct contact with an infectious rash. MPOX can also spread through body fluids and respiratory droplets and secretions, typically through prolonged close contact, such as kissing, cuddling, or sex with an infected person. It can also spread through touching items such as bedding, towels, or clothing that have come in contact with the infectious rash or body fluids. Although rare in the US, it is also possible to get MPOX from infected animals.

Risk

While MPOX is rare and the current threat is low, there are some things you can do to lower your risk:

• Avoid close contact with people who have MPOX symptoms, including face-to-face contact, touching, and sex.
• Practice good handwashing.
• Avoid contact with animals or materials like bedding, towels, and clothing that may have been exposed to MPOX.
• Limiting your number of sexual partners and avoiding anonymous sex can lower your risk.

I think I have MPOX, what should I do?

Contact your primary care provider right away to get tested. If you don’t have a primary care provider or are having trouble getting testing call our disease intervention specialists at 406-258-3896 to be connected to services.

If you test positive:

If you test positive for MPOX, Missoula Public Health (MPH) will reach out to you with specific isolation guidance. Isolate from your ENTIRE household, including pets, until MPH reaches out to you. CDC data suggest people can spread MPOX from the time symptoms start until all symptoms have resolved, including full healing of the rash with formation of a fresh layer of skin. The CDC says, ideally, people with MPOX would remain in isolation for the duration of illness, which typically lasts two to four weeks.

MPOX usually lasts 2 to 4 weeks and resolves without treatment. An antiviral such as tecovirimat (TPOXX) may be recommended depending on the severity of the illness. Please contact your primary care provider if you are interested in TPOXX.

If you’ve been exposed to MPOX:

Missoula Public Health will reach out to you with specific guidance. In the meantime, close contacts of MPOX cases should monitor their health for 21 days after their last exposure. This includes taking their temperature at morning and night and checking for other symptoms of MPOX. If symptoms develop, individuals will need to isolate themselves from others.

Vaccine availability

The Advisory Committee on Immunization Practices (ACIP) recommends the 2-dose JYNNEOS series to several populations and for different indications. Please call 406-258-3363 or stop by the Missoula Immunization Clinic at 301 W. Alder to discuss your questions with a nurse.

• For pre-exposure vaccination of people at risk for occupational exposure to orthopoxviruses (as an alternative to ACAM2000)
• For people aged 18 years and older at risk of mpox during an mpox outbreak:
  • CDC has determined that ongoing human-to-human transmission of clade I MPXV in Central and East Africa meets the criteria to be considered an outbreak and is issuing recommendations for vaccine use among travelers at increased risk of mpox exposure who are planning to travel to those specific countries.
  • Travelers to affected countries who anticipate the following activities should be offered vaccination with the 2-dose JYNNEOS series: sex with a new partner; sex at a commercial sex venue (e.g., sex club or bathhouse); sex in exchange for money, good, drugs, or other trade; or sex in association with a large public event (e.g., rave, party, or festival).
• For people aged 18 years and older with the following risks:
  • Gay, bisexual, and other men who have sex with men, transgender or nonbinary people who in the past 6 months have had one of the following: a new diagnosis of ≥1 sexually transmitted disease; more than one sex partner; sex at a commercial sex venue; or sex in association with a large public event in a geographic area where mpox transmission is occurring
  • Sexual partners of people with the risks described above
  • People who anticipate experiencing any of the above

Currently, CDC does not recommend routine immunization against mpox for the general public. JYNNEOS is not recommended as a routine vaccination for healthcare personnel unless sexual risk factors are present.