Mpox (Monkeypox)

To see updated mpox numbers for Utah, visit the CDC website.

Mpox vaccine continues to be provided to those people who would benefit from its protection, but data on this is no longer being updated on this website.

Symptoms

• The most common symptom of mpox is a new rash. People can also get a fever, joint pain, swollen lymph nodes, and a headache. Read about the signs and symptoms of mpox and see pictures of the rash on the CDC website.
• If you have symptoms of mpox, contact your healthcare provider or visit a clinic near you.

How it spreads

• Skin-to-skin contact is the most common way mpox is spread. Condoms will not prevent the spread of mpox. Mpox is not spread through casual encounters that don’t involve physical touch, such as walking past someone who has mpox or having a casual conversation with someone who has mpox. Read more about how mpox spreads on the CDC website.

Prevention

• Skin-to-skin contact is the most common way mpox is spread. Condoms will not prevent the spread of mpox. Mpox is not spread through casual encounters that don’t involve physical touch, such as walking past someone who has mpox or having a casual conversation with someone who has mpox. Read more about how mpox spreads on the CDC website.

• It is best to stay home, except to get medical care, until a healthcare provider says all sores have fully healed and you are no longer able to spread mpox to others. This can take 2-4 weeks. During this time:
  • Separate yourself and personal items from other people in your home.
    • Wear a well-fitting mask if you need to be in close contact with others in your home.
  • Do not share items that you have worn or touched. Wash or disinfect items that have been worn or touched and any surfaces that may have touched your rash.
  • Avoid close physical contact, including sexual and/or close intimate contact, with other people.
  • Avoid sharing utensils or cups. Items should be cleaned and disinfected before others use them.
  • Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially after direct contact with the rash.
  • Avoid contact with animals, including pets.

• If you are not able to stay home until your sores are fully healed, you may leave your home if you no longer have a fever, sore throat, or congestion (stuffy nose). If you do leave your home before your sores have healed, you should:
  • Cover all parts of the rash with clothing, gloves, and/or bandages.
  • Avoid crowds or congregate settings.
  • Wear a well-fitting mask when interacting with others until the rash and all other symptoms have gone away.
    • Masks should fit closely on the face without any gaps along the edges or around the nose and be comfortable when worn properly over the nose and mouth.
• If you had close, intimate, or physical contact with anyone after your symptoms started, let them know about your diagnosis. Tell them to watch for symptoms like a fever of more than 100.4*F, chills, swollen lymph nodes, and/or a new skin rash for 21 days after the last time they had skin-to-skin or close, intimate contact with you.

• Provide the names and contact information of your close contacts to your local health department to ensure your contacts can receive the appropriate care, if necessary.

For more information on isolation and infection control at home, visit the CDC website.

• Watch for symptoms such as a fever over 100.4°F, chills, swollen lymph nodes, and/or a new skin rash until it has been 21 days since the last time you had skin-to-skin or close, intimate contact with the person who has mpox.
• You can continue with your normal daily activities if you do not have symptoms. However, you should not donate blood, cells (plasma), tissue, breast milk, semen, or organs during the 21 days while you watch for symptoms.
• If you begin having symptoms, immediately contact your healthcare provider or visit a public health clinic near you.
• Anyone who has had close physical contact with someone who has mpox can get a post-exposure vaccine to prevent illness. The sooner you can get the vaccine after exposure, the better. Call your local health department to schedule a vaccine:
  • Bear River Health Department
    • 435-792-6427
  • Central Utah Public Health Department
    • 435-896-5451
  • Davis County Health Department
    • 801-525-5200
  • Salt Lake County Health Department
    • 385-468-SHOT (7468)
  • San Juan Public Health Department
    • 435-587-3838
  • Southeast Utah Health Department
    • 435-636-1166
  • Southwest Utah Public Health Department
    • 435-668-0342, or
    • 435-359-8407
  • Summit County Health Department
    • 435-333-1500
  • Tooele County Health Department
    • 435-277-2310, or
    • 435-277-2311
  • Tooele County Health Department
    • 435-277-2310, or
    • 435-277-2311
  • TriCounty Health Department
    • 435-247-1197
  • Utah County Health Department
    • 801-851-2961
  • Wasatch County
    • 435-657-3232
  • Weber-Morgan Health Department
    • 801-399-7252

• Information for the public
• Information for healthcare providers

Mpox testing is now available at multiple clinical labs. Clinicians should contact their testing laboratory to understand what testing options are available. At this time, ARUP, LabCorp, Quest, Aegis, Mayo Clinic, and Sonic are providing this testing. If your clinic is not able to test for monkeypox through a commercial laboratory, UPHL is able to perform a limited number of tests.

For any patient you suspect may have mpox, we encourage you to:

1) Wear gloves, gown, eye protection and respiratory mask (N95 or PAPR) while you interact with the patient.

2) Obtain information from the patient regarding:

• a) Any contact with individuals known to have monkeypox
• b) Recent travel
  • i) Participation in raves, sex parties, or bathhouses
• c) Any recent sexual contact. Specifically inquire about:
  • i) Men who have sex with men (MSM)
  • ii) Females of MSM partners
  • iii) Sexual contact during travel
  • iv) Anonymous sex through dating and hookup apps
  • See the sexual behaviors interview guide from the Hawai’i Department of Health for guidance
• d) Symptom onset dates and progression

3) Document symptom characteristics:

• a) Fever, muscle aches, lymphadenopathy
• b) Rash
  • i) Distribution
  • ii) Characteristics—(umbilication, fluid filled, etc.)
  • iii) With patient permission, take photos of the rash to review with public health. Try to avoid areas that would identify the person unless needed.

4) If you suspect mpox, it is best to collect samples at the time of visit rather than asking the patient to return later.

• a) Identify the “juiciest” looking lesion.
• b) Vigorously swab or brush the lesion with two separate sterile dry polyester or Dacron swabs. One swab will be tested locally and the other swab will be sent to the CDC for confirmation testing. It is not necessary to unroof the lesion. These lesions can be tender or painful, please keep this in mind when swabbing.
• c) Only one set of swabs (used to test the same lesions) is necessary; however if there are lesions on different locations on the body or lesions in different stages it is appropriate to send additional sets of swabs. Be sure to label what swabs are duplicates of each other.
• d) Place each swab in a dry sterile tube and seal (one tube for each swab). DO NOT ADD ANY TRANSPORT MEDIA or BUFFER SOLUTION.
• e) Store tube with swab in a refrigerator or -20 degree freezer. Collected specimens are stable for 7 days refrigerated and 60 days frozen. They should be transported to the Utah Public Health Laboratory (UPHL) refrigerated or frozen within the stability timeframe mentioned above.
• f) Submit specimens to UPHL with individual completed UPHL Infectious Disease test Request Forms. Mark “other” and write in ‘Mpox’.

5) Call your local health department to report the suspect case and get approval for testing at UPHL. Weekend and after-hour reports can be directed to the 24-hour phone disease reporting line (1-888-EPI-UTAH).

• a) If applicable, the local health department and DHHS will begin contact tracing and assessing contacts for post-exposure prophylactic (PEP) treatments, such as a vaccine. Severely ill cases of MPX may be considered for antiviral medication.

6) ANY patient with high suspicion for mpox should be told to isolate at home away from other people and animals. They should isolate until monkeypox is ruled out or until new skin forms over all the lesions (typically around 2 to 4 weeks).

7) For patients who report engaging in unprotected sex, HIV and STD testing (e.g., syphilis, gonorrhea, chlamydia) are highly encouraged in the areas of exposure. Extragenital testing (oral, anal) can be conducted in exposed sites via a swab. If additional HIV or STD testing is being done, the clinician should inform the testing laboratory that the patient is being evaluated for monkeypox so the laboratory staff can handle the samples safely.

8) People who handle any linens used by the suspect patient should use PPE to protect themselves from exposure.

9) Additional general information can be found on the CDC website:
https://www.cdc.gov/poxvirus/mpox/clinicians/index.html

• Disease plan

• Salt Lake County Health Department
• Centers for Disease Control and Prevention (CDC)
• MedLine Plus
• The Center for Food Security and Public Health
• World Health Organization (WHO)