Mpox

What is mpox?

The mpox or MPV spreads through close intimate contact, including contact with body fluids, sores, items like clothing or bedding that have been contaminated with fluids or sores, or through prolonged face-to-face contact in which respiratory droplets from a case enter the mouth or eyes of another person.

People typically recover in two to four weeks, and most cases do not require hospitalization. However, the disease can be serious, particularly for those who are immunocompromised, children, people with a history of eczema, or people who are pregnant or breastfeeding.

2022 Outbreak

There was a multi-country outbreak of mpox in 2022, including cases in Washington State. Cases associated with this outbreak have been confirmed in Snohomish County. 

To date the majority of people diagnosed with mpox in the United States have been men (includes people assigned male at birth) who reported intimate contact with other men, sometimes with anonymous or multiple partners. However, it is important to remember that anyone who has been in close contact with someone who has mpox is at risk. Snohomish County has reported at leat one case that is outside of the higher risk demographic.

In this outbreak, the risk of children getting infected with mpox virus is low. 

For updates, please visit the Washington State Department of Health mpox page.

Symptoms

Symptoms of mpox include a rash that can appear anywhere on the body, as well as flu-like symptoms and swollen lymph nodes. The current outbreak has included many cases with lesions in the genital or anal area.

Prevention

Precautions to reduce the spread of mpox include: 

• avoiding or limiting intimate skin-to-skin contact with people who have sores, rashes or bumps on their skin
• clear communication with individuals you have intimate contact with as well as with any new or unknown partners about whether you or they are experiencing symptoms
• and avoiding close physical contact as well as not sharing clothing or towels with anyone who has symptoms, particularly open wounds, sores, or rashes 

If you believe you may have been exposed and you develop symptoms such as a new rash with sores, bumps or fluid-filled bumps as well as flu-like symptoms and swollen lymph nodes, please contact your healthcare provider.

Vaccination

Vaccination against mpox is not currently recommended for the general public. A limited supply of the JYNNEOS vaccine has arrived in Washington State, and the supply remains limited nationwide. Vaccination appointments are not available at the Snohomish County Health Department.

The vaccine can be administered to high-risk contacts of cases. When individuals are identified who were exposed to mpox via a known case, public health staff contact them directly. The Health Department will refer confirmed high-risk contacts to a healthcare provider that can administer the vaccine.  

Vaccination is also prioritized for people who meet any of the following criteria as part of a strategy known as Pre-Exposure Vaccination (previously PEP++): 

• Gay, bisexual, or other men or transgender people who have sex with men and who have had multiple or anonymous gay, male bisexual, or transgender sex partners in the last 6 months
• Methamphetamine use in the last 6 months
• People who have exchanged sex for money, drugs, or other purposes in the past 6 months
• People who have been sexually assaulted, regardless of gender or sexual orientation.
•  People who have had sexual contact or prolonged skin-to-skin exposure with people who were exposed to MPV. 
• A new diagnosis in the last 12 months of one or more nationally reportable sexually 

  transmitted diseases (i.e., acute HIV, chancroid, chlamydia, gonorrhea, or syphilis).

• The following minority populations (among those who meet the above criteria) should be prioritized for outreach and for vaccination: 

  • Black, Hispanic/Latinx, Native Hawaiian and other Pacific Islanders, Asian, Indigenous, or American Indian/Alaska Native who are GBMSM.
  • Individuals who have attended a bathhouse or public sex venue, or participated in group sex (sex including >3 people at the same time) in the last 6 months.
  • Individuals who have experienced homelessness/unstable housing (including living in a shelter, car, or congregate setting; living with friends or relatives; couch surfing; agricultural workers and seafood workers) in the last 6 months. 
  • Individuals who are currently or in the past 6 months have been incarcerated.
  • Individuals who are currently taking PrEP to prevent HIV infection. 
• If there is a surplus of vaccine, the following populations should be included: 
  • All individuals who have had multiple or anonymous sex partners in the last 6 months. 
  •  Healthcare and public health workers who provide direct care to individuals with syphilis or other STIs.

These criteria may change as vaccine availability changes or as we learn more about populations at risk of infection.

Treatment

The Health Department is working with multiple community partner clinics to increase the accessibility of the TPOXX treatment for Snohomish County residents who need it. TPOXX is FDA-approved for the treatment of human smallpox disease caused by Variola virus in adults and children. It is currently being used to treat mpox under an Investigational New Drug protocol by CDC. 

For Healthcare Providers

Snohomish County healthcare providers who are interested in becoming TPOXX providers can complete the short online survey here and someone will be in touch with more information. 

Providers in the county should receive health alerts by email. The alerts are also posted online:

• Health alerts for medical providers

Health care providers can request to be added to our distribution list by emailing kbray@snohd.org. Please send with the subject “Request to be added to Health Advisories” and include your name, job title, affiliation and the best email address to receive advisories.