Mpox is in the same family as smallpox, but much milder. With this outbreak, people are often noticing the rash or rectal discomfort first before any other symptoms. The rash can occur all over the body and will go through stages, starting as a flat rash or red bump becoming a blister or pimple filled with pus and then the center of the lesion will fall inward with the boarders remaining raised like a belly button. Finally, the lesions will scab over. As part of this outbreak these rashes are occurring in sensitive areas including the genitals, penis, rectum, and mouth. The rash can be associated with significant swelling and pain as it progresses and people with rectal symptoms are sometimes experiencing bleeding. The illness can include swollen lymph nodes, particularly in the groin if the rash is in the genital area, exhaustion, muscle aches, and fever or chills. However, many patients may only have the rash. The rash typically takes 2-4 weeks to heal. Once the skin underneath is healed the scabs will fall off and at this point the person is no longer infectious.
Suspicion for mpox should be heightened if a rash occurs in a person who:
Mpox can spread to anyone through prolonged close, personal, often skin-to-skin contact including:
This contact can happen during intimate sexual contact including:
We know the virus can be spread in fluid or pus from mpox sores, and are trying to better understand how often the virus is present in semen or vaginal fluids. Testing has demonstrated the virus in seminal fluid.
Antiviral medication is available and may shorten the course and severity of illness. We are recommending and providing treatment for anyone who is more likely to get severely ill as well as anyone with lesions of their genitals, rectum, mouth, or near their eyes where progression of those lesions can be painful and potentially debilitating Otherwise, mpox will resolve on its own in most cases. The antiviral tecovirimat (TPOXX), is available through expanded access from the CDC as part of an investigational protocol. Whitman-Walker Health can evaluate patients and if it is determined that treatment is needed oversee this treatment with signed informed consent
Current FDA approved vaccinations against smallpox are also effective for monkeypox and are gradually becoming more widely available! Jynneos is an attenuated live virus vaccine which has been approved by the U.S. Food and Drug Administration for the prevention of monkeypox. DC Health is making limited appointments available on their website.
Before exposure or unknown if exposed: (Pre-exposure, also being called PEP++)
After known exposure: (Post-exposure, PEP)
Older adults who were vaccinated against smallpox as children are still recommended to receive the Jynneos vaccine if they fall into either of the above categories.
Per CDC, close contacts of someone who has monkeypox can get vaccinated to prevent or lessen the severity of disease. Getting vaccinated as soon as possible after exposure to someone with mpox (if exposed less than 14 days ago, ideally within 4 days of exposure) provides the best chance to prevent the disease or make it less severe.
If you need help deciding whether you should get vaccinated, talk to a healthcare provider or Schedule Mpox vaccines at Whitman-Walker by texting 202-978-6123, calling us at 202-745-7000, or emailing firstname.lastname@example.org.
Yes. There is a vaccine called the Jynneos vaccine. This vaccine is a weakened (attenuated) live virus vaccine that is FDA approved for protection against smallpox and mpox. The Jynneos vaccine is recommended for those at risk of mpox with this current outbreak. The vaccine is effective at protecting people against monkeypox illness.
Weakened live virus vaccines are made of live virus that is unable to replicate itself. Other weakened live virus vaccines that you may be familiar with are the measles, mumps, rubella (MMR) vaccine, the influenza (flu) vaccine, the varicella (chicken pox) vaccine and the yellow fever vaccine.
The vaccine is very well tolerated, and the most common side effect is soreness, redness, swelling, and itching at the injection site. Other side effects include fatigue, muscle pain, headache, and nausea. Allergic reactions to the vaccine are extremely rare.
The safety of the vaccine has been studied in those who are living with HIV. And people with well controlled HIV respond well to the vaccine. Immunocompromised persons, including those receiving immunosuppressive therapy, may have a diminished immune response to the vaccine. This means that they may not be fully protected from mpox even after receiving the vaccine.
JYNNEOS is a 2-dose vaccine developed to protect against mpox and smallpox infections. People need to get both doses of the vaccine for the best protection against mpox. The second dose should be given 4 weeks after the first dose.
Experts do believe the vaccine can be used for PEP. The vaccine can reduce the risk of infection if given within four days after exposure and should reduce the risk of serious illness if given within 14 days after exposure. The sooner you get the vaccine after exposure the more likely it is to work.
You had known or suspected exposure to someone with mpox
You had a sex partner in the past 2 weeks who was diagnosed with mpox
You are a gay, bisexual, or other man who has sex with men or a transgender, nonbinary, or gender-diverse person who in the past 6 months has had any of the following: