Mpox

Background

Human Mpox is a rare but serious illness caused by infection with the Mpox virus, which can infect humans and other animals, such as monkeys and rodents. The human Mpox virus belongs to the genus Orthopoxvirus. The Orthopoxvirus genus also includes variola virus (which causes smallpox), vaccinia virus (used in the smallpox vaccine), and cowpox virus.

In May 2022, several clusters of Mpox cases were reported in countries that don't normally report human Mpox, including the United States. People with Mpox in the current outbreak generally report having close, sustained physical contact with other people who have monkeypox. Anyone who has been in close contact with someone who has Mpox is at risk, regardless of gender or sexual orientation. Early data suggest that gay, bisexual, and other men who have sex with men make up a high number of cases. 

CDC is urging healthcare providers in the United States to be alert for patients who have rash illnesses  consistent with Mpox, regardless of whether they have travel or specific risk factors for Mpox and regardless of gender or sexual orientation.

CDC is working with state and local health officials to identify people who may have been in contact with individuals who have tested positive for Mpox, so they can monitor their health.

On June 16, 2022, MDH reported a presumed human Mpox virus infection in a Maryland resident.

The Maryland Department of Health (MDH) is reporting demographics and human Mpox case counts and vaccination numbers on their data dashboard.

The data dashboard will be updated weekly on Fridays and display:

• Total confirmed cases in the state
• Confirmed cases by jurisdiction 
• Confirmed cases by age, sex, race, and ethnicity  
• Number of people vaccinated statewide    

County case counts below 10 will not be shown to protect patient privacy. If those counts meet or exceed 10 cases, the numbers will be updated.

Symptoms of Mpox can include:

• Fever
• Headache
• Muscle aches and backache
• A rash that can look like pimples or blisters that appears on the face, inside the mouth, and on other parts of the body, like the hands, feet, chest, genitals, or anus.
• Swollen lymph nodes
• Chills
• Exhaustion

The rash goes through different stages before healing completely. The illness typically lasts 2-4 weeks. Sometimes, people get a rash first, followed by other symptoms. Others only experience a rash.

For more information, check out CDC's website. 

Mpox spreads in different ways. The virus can spread from person-to-person through:

• direct contact with the 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 items (such as clothing or linens) that previously touched the infectious rash or body fluids
• pregnant people can spread the virus to their fetus through the placenta

It’s also possible for people to get Mpox from infected animals, either by being scratched or bitten by the animal or by preparing or eating meat or using products from an infected animal.

Mpox can spread from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. The illness typically lasts 2-4 weeks. People who do not have Mpox symptoms cannot spread the virus to others. At this time, it is not known if Mpox can spread through semen or vaginal fluids.

Take the following steps to prevent getting Mpox:

• Avoid close, skin-to-skin contact with people who have a rash that looks like Mpox.
• Do not touch the rash or scabs of a person with Mpox.
• Do not kiss, hug, cuddle or have sex with someone with Mpox.
• Do not share eating utensils or cups with a person with Mpox.
• Do not handle or touch the bedding, towels, or clothing of a person with Mpox.
• Wash your hands often with soap and water or use an alcohol-based hand sanitizer.
• In Central and West Africa, avoid contact with animals that can spread Mpox virus, usually rodents and primates. Also, avoid sick or dead animals, as well as bedding or other materials they have touched.
• Healthcare providers treating potentially-infected patients should ensure that the patient is properly isolated and that the appropriate personal protective equipment (PPE) is used.

If you are sick with Mpox, follow CDC guidance on how to isolate and disinfect at home to avoid exposing others.

Testing

If you think you have been exposed to Mpox or have symptoms, talk with your healthcare provider. Healthcare providers who suspect human Mpox in a patient can now order testing directly through some commercial laboratories.  Providers seeking Mpox virus testing at the MDH laboratory must get health department approval prior to submitting specimens and follow the  MDH Laboratories Administration specimen submission guidance. Healthcare providers should educate patients on  home isolation while results are pending.

Treatment

There are no treatments specifically for Mpox virus infections. However, Mpox and smallpox viruses are genetically similar, which means that antiviral drugs and vaccines developed to protect against smallpox may be used to prevent and treat Mpox virus infections.

Antivirals, such as tecovirimat (TPOXX), may be recommended for people who are more likely to get severely ill, like patients with weakened immune systems.

• CDC guidance for treatment of Mpox
• CDC guidance on obtaining Tecovirimat (TPOXX)  
  
  

Vaccine

There are two vaccines licensed for preventing Mpox infection: ACAM 2000 and JYNNEOS. Mpox vaccines are effective at protecting people against Mpox when given before exposure to Mpox. Experts also believe that vaccination after a Mpox exposure may help prevent the disease or make it less severe. 

The sooner an exposed person gets the vaccine, the better. CDC recommends that the vaccine be given within 4 days from the date of exposure in order to prevent onset of the disease. If given between 4–14 days after the date of exposure, vaccination may reduce the symptoms of disease, but may not prevent the disease.

Resources:

• Maryland Department of Health Mpox Information
• CDC Mpox
• Current cases of Mpox can be found on the CDC website.
• Fact Sheet: Social Gatherings, Safer Sex, and Monkeypox
• Fact Sheet: The Facts About Human Monkeypox  [Spanish Language Version]