Mpox

A: Mpox is a rare disease caused by infection with the mpox virus, which belongs to the family of viruses that includes variola virus (which causes smallpox), vaccinia virus (used in the smallpox vaccine), and cowpox virus, but it is not related to chickenpox. Mpox does not spread easily between people without close contact. The threat of mpox to the general U.S. population remains LOW at this time.

As we have since the beginning of the outbreak, the Indian Health Service is taking a proactive approach focusing on public health education in tribal communities, contact tracing, access to testing, and access to available medical countermeasures, including vaccines and treatment.

A: People with mpox often get a rash. The rash can be in multiple places on the body, or it may be in a more concentrated in one area of the body. The rash may be located on or near the genitals (penis, testicles, labia, and vagina) or anus (butthole) and could be on other areas like the hands, feet, chest, face, or mouth.

• The rash will go through several stages, including scabs, before healing.
• The rash can initially look like pimples or blisters and that are typically painful and sometimes itchy.

Other symptoms of mpox can include:

• Fever
• Chills
• Swollen lymph nodes
• Exhaustion
• Muscle aches and backache
• Headache
• Respiratory symptoms, such as sore throat, nasal congestion, or cough

You may experience all or only a few symptoms:

• Sometimes, people have flu-like symptoms before the rash.
• Some people get a rash first, followed by other symptoms.
• Others only experience a rash, which may be in multiple places on the body, or in a concentrated area.

A: Mpox symptoms usually start within 3 weeks of exposure to the virus. If someone has flu-like symptoms, they will usually develop a rash 1-4 days later. Mpox can be spread from the time symptoms start until the rash has healed, all scabs have fallen off, and a fresh layer of skin has formed. The illness typically lasts 2-4 weeks.

If you have a new or unexplained rash or other symptoms:

• Avoid close contact, including sex or being intimate with anyone, until you have been checked out by a health care provider.
• Contact your health care provider or your local IHS, tribal, or urban Indian organization facility
• When you see a health care provider, wear a mask, and remind them that this virus is circulating in the area.

A:

• Direct contact with an infectious rash, scabs, or body fluids
• Respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact, such as kissing, cuddling, or sex
• Touching objects, fabrics (such as clothing or linens) that previously touched the rash or body fluids of someone with mpox
• Being scratched or bitten by an infected animal

• Mpox can be acquired by all people, regardless of gender identity or sexual orientation
• Mpox can spread from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. This can take several weeks.

A:

• If you are awaiting mpox test results, remain in isolation until the diagnosis is confirmed or you are told that you do not have mpox.


• 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. Ideally, people with mpox would remain isolated at home or at another location Exit Disclaimer: You Are Leaving www.ihs.gov  for the duration of illness, which typically lasts two to four weeks. However, if a person with mpox is unable to remain fully isolated throughout the illness, they should do the following:

• While symptomatic with a fever or any respiratory symptoms, including sore throat, nasal congestion, or cough, remain isolated in the home and away from others unless it is necessary to see a healthcare provider or for an emergency.
  • This includes avoiding close or physical contact with other people Exit Disclaimer: You Are Leaving www.ihs.gov and animals Exit Disclaimer: You Are Leaving www.ihs.gov .
  • Cover the lesions, wear a well-fitting mask (more information below), and avoid public transportation when leaving the home as required for medical care or an emergency.
  • Reduce or avoid behaviors that increase risk of mpox exposure:

• While a rash persists but in the absence of a fever or respiratory symptoms:
  • Cover all parts of the rash with clothing, gloves, and/or bandages.
  • Wear a well-fitting mask to prevent the wearer from spreading oral and respiratory secretions when interacting with others until the rash and all other symptoms have resolved.
  • 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.

• Reduce or avoid behaviors that increase risk of mpox exposure:
  • Limit your number of sex partners to reduce your likelihood of exposure.
  • Get vaccinated Exit Disclaimer: You Are Leaving www.ihs.gov  CDC recommends vaccination for people who have been exposed to mpox and people who may be more likely to get mpox.
  • Visit mpox and Safer Sex (cdc.gov) [PDF]Exit Disclaimer: You Are Leaving www.ihs.gov 

• If you are awaiting mpox test results, remain in isolation until the diagnosis is confirmed or you are told that you do not have mpox.

• Until all signs and symptoms of mpox illness have fully resolved:
  • Do not share items that have been worn or handled with other people or animals. Launder or disinfect Exit Disclaimer: You Are Leaving www.ihs.gov  items that have been worn or handled and surfaces Exit Disclaimer: You Are Leaving www.ihs.gov  that have been touched by a lesion.
  • 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 use by others.
  • Avoid crowds and congregate settings Exit Disclaimer: You Are Leaving www.ihs.gov .
  • Wash hands often with soap and water or use an alcohol-based hand sanitizer, especially after direct contact with the rash.

A: The CDC recommends vaccination for people who have been exposed to mpox. Contact your health care provider or your local IHS, tribal, or urban Indian organization facility today to see if you should get vaccinated against mpox.

People more likely to get mpox include:

• People who have been identified by public health officials as a contact of someone with mpox
• People who are aware that one of their sexual partners in the past 2 weeks has been diagnosed with mpox
• People who had multiple sexual partners in the past 2 weeks in an area with known mpox

• People whose jobs may expose them to orthopoxviruses Exit Disclaimer: You Are Leaving www.ihs.gov , such as:
• Laboratory workers who perform testing for orthopoxviruses (Note: No IHS laboratory workers are using the diagnostic testing equipment specified by the CDC.)
• Laboratory workers who handle cultures or animals with orthopoxviruses
• Some designated healthcare or public health workers

The preferred vaccine to protect against mpox is JYNNEOS, which is a two-dose vaccine. It takes 14 days after getting the second dose of JYNNEOS for its immune protection to reach its maximum.

A: Mpox testing is available both through public health laboratories (CDC and state health departments) as well as many commercial reference labs. IHS patients should consult with their health care provider or public health staff about testing options if they have symptoms of mpox or may have been exposed to mpox.