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Division of Communicable Disease Control

Mpox

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Questions and Answers

What are the basics? 

What is mpox? 

Mpox is an illness caused by infection with the mpox virus, which is related to the smallpox virus. While less severe and much less contagious than smallpox, mpox can be a serious illness. It can spread from infected humans, animals, and materials contaminated with the virus, but primarily spreads through close, personal, skin-to-skin contact with people who have mpox symptoms, such as rashes and sores.

Is mpox a new disease? 

No, mpox is not a new disease. Mpox was first discovered in 1958. The first human case of mpox was recorded in 1970 in the Democratic Republic of Congo. Mpox is endemic (regularly found) in west and central African countries.

Should I be worried about mpox? 

As of 2022, mpox has spread to areas in which it was previously not commonly seen, like Europe and the United States, including California. While anyone who is exposed can acquire mpox, the infection is mostly affecting populations that identify as gay, bisexual, transgender, and other men who have sex with men. 

Mpox is thought to be most contagious when symptoms like flu-like illness, rash and sores are present, making it easier for infected individuals to know when to stay away from others to prevent further spread. However, studies have shown that mpox can spread up to four days prior to symptom onset. See CDC | How it Spreads for more information.

Is mpox related to COVID-19? 

No, mpox is a completely different disease, unrelated to COVID-19. Mpox spread takes place through prolonged direct close contact, and people are generally contagious when they have a rash or other symptoms. This is different from COVID-19, which spreads easily through the air.

Does the mpox virus have variants? 

There are two known families or “clades” of mpox virus. The clade recently identified in Europe and in the United States is the West African clade (clade IIb), which tends to cause less severe disease.

All viruses change and evolve over time. However, the mpox virus is a DNA virus which mutates more slowly than coronaviruses (like the one that causes COVID-19), which are RNA viruses. Because DNA viruses mutate much more slowly, it is unlikely that new variants of mpox will emerge.

What about Clade I mpox virus?

Infections from Clade I have historically caused more severe illness. Clade I associated mpox infections have not been previously identified outside of certain endemic regions in Africa. 

In December 2023, CDC released an advisory to health departments about an outbreak of Clade I associated mpox infections in the Democratic Republic of the Congo (DRC). If you have symptoms of mpox, let your provider know if you or any close contacts—such as sexual partners or persons in your household—recently traveled to the DRC as additional testing may be indicated.

Who can get mpox? 

Anyone can get mpox after having close physical contact with someone who has the infection, especially if coming into direct contact with rashes and sores, bodily fluids, or materials contaminated from rashes, sores, or bodily fluids.The current risk to the general public is low. Though not exclusively, most recent cases include gay, bisexual, transgender, and other men who have sex with men, as well as household contacts.

How serious is mpox? 

Mpox is usually a mild disease with symptoms lasting from 2 to 4 weeks. Certain groups of people may be at higher risk for severe disease. These groups include people with weakened immune systems, infants under 1 year old, people with a history of eczema, and people who are pregnant or breastfeeding.

Infections with the strain (clade IIb) of mpox virus identified in this outbreak are rarely fatal. Over 99% of people who get this form of the infection are likely to survive. Despite this, symptoms can be extremely painful, and people might have permanent scarring resulting from rashes and sores. ​​

How does mpox spread? 

How is mpox transmitted? 

Mpox is mainly spread by people with symptoms but can also spread from people with very mild illness who don’t know they’re infected, or people without visible symptoms yet. 

Mpox can be spread through close, personal, often skin-to-skin contact, including:

  • ​​Direct contact with body fluids of people with mpox, such as drainage from skin sores, saliva, snot, mucus, and areas around the anus, rectum, or vagina. This direct contact can happen during intimate contact, including:
    • ​Oral, anal, or vaginal sex, or touching the genitals (penis, testicles, labia, and vagina) or anus (butt) of a person with mpox
    • Hugging, massage, and kissing
    • Prolonged face-to-face contact, such as can occur during kissing or cuddling.

Touching items (such as bedding towels, clothing, cups, and utensils) that previously touched the sores or body fluids of people with mpox is considered lower risk. However, precautions should be taken when directly caring for a person with mpox, including wearing appropriate Personal Protective Equipment (PPE)

To date, there has been no evidence that mpox is spread by: 

  • ​Attending an outdoor event with fully clothed people
  • Trying on clothes or shoes at the store
  • Traveling in an airport, on a plane or on other public transit
  • Swimming in a pool or body of water
  • Going to a public setting (grocery store, restaurant, workplace, restroom)

See CDC | How Mpox Spreads for more information. 

If you believe you may have exposed someone to mpox while you were infectious, you can let them know anonymously (consider using tellyourpartner.org​), so they can self-monitor for 21-days, get vaccinated to reduce the risk of serious infection, and be tested as soon as possible if symptoms develop. Testing is strongly encouraged to help identify and prevent infection.

​If you have symptoms, getting tested for mpox and sexually transmitted infections is strongly encouraged to help identify infections and prevent infections in others. Visit GetTested | CDC​ to find a testing location near you.

If you have been exposed to mpox, monitoring for symptoms and avoiding sexual contact with others for 21 days is highly recommended. For people who haven't already been vaccinated, mpox vaccination is most effective when obtained as soon as possible after exposure and is strongly encouraged for at-risk patients to prevent severe illness. 

Is mpox a sexually transmitted infection (STI)? 

Sex is just one of the ways that the mpox virus can spread. Mpox primarily spreads from skin-to-skin contact, especially close or intimate physical contact such as sex or touching rashes. Mpox can also spread through contact with contaminated materials like utensils, cups, bedding, towels, clothing, or sex toys. 

While mpox has been isolated in semen, scientists are still investigating whether the virus could be spread by exposure to semen or vaginal fluids. 

Mpox may look like other STIs that cause a rash on the genitals and anus, including herpes, syphilis, molluscum contagiosum, and chancroid. Mpox may also cause inflammation of the rectum (proctitis), which can result in rectal pain – something that may also be seen with other STIs. It’s always important to talk to a health care provider as soon as you notice unusual rashes or sores or have rectal pain. For more information, see the CDPH fact sheet on safer sex and mpox (PDF). 

When is mpox contagious? 

Mpox symptoms usually start from 3 days to 3 weeks after exposure to the virus. People are thought to be contagious until all sores have fully healed and a fresh layer of skin has formed, which can take several (~2-4) weeks. There is a growing body of scientific evidence that shows some people can spread mpox virus to others from 1 to 4 days prior to symptoms appearing (CDC | How it Spreads).

Researchers are still trying to understand if the virus can spread from someone who never develops any symptoms. Although the specific infectivity of asymptomatic cases has not yet been determined, the potential prevalence of undetected asymptomatic mpox cases could contribute to the current global pandemic (CDC). 

Should parents be concerned about the spread of mpox in classrooms? 

We continue to see very low transmission of the virus in the general population, including children. Of the handful of probable or confirmed mpox cases in children, spread has usually been through household contacts.

Could my pet get mpox? 

The CDC and CDPH do not currently believe that mpox poses a high risk to pets. However, infected animals (mammals) can spread mpox to people, and people who are infected can spread mpox to animals through close contact, including petting, cuddling, hugging, kissing, licking, sharing sleeping areas, and sharing food.

People with mpox should avoid contact with animals, including pets, domestic animals, and wildlife to prevent spreading the virus. People with mpox should ask another household member or outside friend/family member to care for pets until the person with mpox is fully recovered. For pets in the home, visit CDC | Pets & Mpox.​ ​​

What are the signs and symptoms? 

What are the signs and symptoms of mpox? 

Mpox often starts with symptoms like those of the flu, with fever, low energy, swollen lymph nodes, and general body aches followed by a rash or sores. However, people have developed a rash or sore without systemic symptoms. The sores can go through several stages, including scabs, before healing. They can look like many different illnesses, including herpes, molluscum contagiosum, cold sores, pimples, or blisters; they may be painful or itchy. 

The rash or sores may be located on or near the genitals (penis, testicles, labia, and vagina) or anus (butt) but could also be on other areas like the hands, feet, chest, and face. They may also be limited to one part of the body. 

People with mpox may experience all or only a few of these symptoms with most people developing rashes or sores. Sometimes the sores can be in places that are difficult for someone to see. Some people have reported developing the rash or sores before (or without) the flu-like symptoms. 

What should I do if I have symptoms of mpox? 

Contact a health care provider or your local health department as soon as possible and let them know you have symptoms so they can test for mpox and provide treatment as needed. 

People who have mpox symptoms should ideally isolate away from others until their symptoms have gone away completely and until all sores have healed and a fresh layer of skin has formed. If needing to be around others, people with mpox should completely cover sores and wear a well-fitting mask. 

Standard laundry detergents are appropriate for washing clothes or linens (e.g., bedding and towels) used by someone with mpox. Please refer to the CDC | Mpox | If You Are Sick for more information. 

How is mpox prevented? 

How is mpox prevented? 

There are number of ways to prevent the spread of mpox, including: 

  • Getting vaccinated (two-doses) for mpox. Find a vaccine near you My Turn - Manage your appointments (ca.gov)​: Mpox Vaccine Locator
  • Continuing to reduce or avoid behaviors that increase risk for mpox exposure until 14 days after your second dose. 
  • Talking to your sexual partner/s about any recent illness and being aware of new or unexplained sores or rashes on your body or your partner's body, including on the genitals and anus 
  • Avoiding close contact, including hugging, kissing, cuddling and sexual activity with people with symptoms like sores or rashes. 
  • Washing your hands often with soap and water or using an alcohol-based hand sanitizer 
  • Using appropriate PPE (like a mask, gown and gloves) when caring for people with mpox. 

If you choose to remain sexually active, see the CDPH fact sheet on safer sex and mpox (PDF) and visit CDC’s Safer Sex, Social Gatherings, and Mpox webpage

For more information, see the CDC’s Mpox Prevention webpage​

What should I do if I’ve been exposed to mpox? 

Contact a health care provider or your local health department as soon as possible and let them know you have been exposed to mpox. Monitor for any new signs or symptoms of mpox and avoid sexual contact with others for 21 days after your last exposure to mpox. Health care providers and local health departments can recommend a vaccine to help prevent infection or decrease the seriousness of the illness. To find a vaccine location, use the MyTurn​ site for more information.

How do I clean clothing, bedding, and other materials if I have mpox? 

The mpox virus can survive in linens, clothing and on surfaces, particularly when in dark, cool, and low humidity environments. Porous materials (bedding, clothing, etc.) may harbor live virus for longer periods of time than non-porous (plastic, glass, metal) surfaces. 

Orthopoxviruses, like mpox, are very sensitive to UV light and to many disinfectants. Disinfection is recommended for all areas (such as home and vehicle) where a person with mpox has spent time, as well as any items that may be contaminated. 

Visit CDC's webpage on Disinfecting Home and Other Non-Healthcare Settings​ for more information, including details on which type of disinfectants to use.​

What is the mpox vaccine? 

What is the mpox vaccine? 

The Centers for Disease Control and Prevention (CDC) and the California Department of Public Health (CDPH) recommend vaccination for people who have been exposed to mpox and people who may be at risk for mpox. 

The JYNNEOS vaccine is approved by the U.S. Food and Drug Administration (FDA) to prevent both mpox and smallpox. Vaccination helps protect against mpox when given before or shortly after an exposure. This vaccine is currently available in the United States from the federal Strategic National Stockpile. 

For more information on mpox vaccines for Providers and Local Heath Departments, please see the Mpox Vaccine Provider and Local Health Department Q&A​

Who is currently recommended to receive the vaccine? 

Any person who MAY be at risk for mpox infection or persons who request vaccination may receive vaccination without having to report specific risk factors. 

CDC recommends vaccination against mpox if: 

  • 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: 
    • ​​A new diagnosis of one or more sexually transmitted infections (e.g., chlamydia, gonorrhea, or syphilis) 
    • ​More than one sex partner 
  • You have had any of the following in the past 6 months: 
    • ​Sex at a commercial sex venue (like a sex club or bathhouse) 
    • Sex related to a large commercial event or in a geographic area (city or county for example) where mpox virus transmission is occurring 
    • ​​Sex in exchange for money or other items 
  • You have a sex partner with any of the above risks. 
  • You anticipate experiencing any of the above scenarios. 
  • You have HIV or other causes of immune suppression and have had recent or anticipate future risk of mpox exposure from any of the above scenarios. 
  • You work in settings where you may be exposed to mpox: 
    • ​​​​You work with orthopoxviruses in a laboratory 

When should the vaccine be given after an exposure? 

The JYNNEOS vaccine should be given within 4 days from the date of exposure, if possible, to help prevent disease. If given 4–14 days after the date of exposure, vaccination may reduce the symptoms of the illness, but may not prevent infection. 

How can I get the vaccine? 

Contact your health care provider to see if they have the JYNNEOS vaccine. If your health care provider does not have the vaccine or you do not have a healthcare provider, use the Mpox Vaccine Locator or MyTurn to find a location. If you have trouble obtaining the vaccine, please contact your local health department for further guidance.

How is the vaccine given?

The JYNNEOS vaccine is given through a shot (injection). The JYNNEOS vaccine can be given in two methods: 

  1. The standard method is a subcutaneous injection which is a shot given beneath the skin in the upper arm. This method has been approved for people 18 years or older and is also authorized under an Emergency Use Authorization (EUA) for people under 18 years of age. 
  2. ​Under newer guidelines from the FDA and CDC, the vaccine can also be given through intradermal injection, in the skin layer underneath the epidermis (which is the upper skin layer) for people 18 years or older. Intradermal injection is typically given in the forearm and requires a smaller amount of vaccine than the subcutaneous injection to create a similar immune response. Intradermal injection can also be given in the upper arm or on the back below the shoulder blade. 

Public health jurisdictions and healthcare providers have the flexibility to offer the intradermal or subcutaneous regimen, balancing optimal vaccine use and acceptance, feasibility of administration, and available vaccine supply. People of any age with a history of developing keloid scars, and individuals younger than 18 years of age, should receive the vaccine via the subcutaneous route. CDC recommends people get two JYNNEOS doses four weeks apart. 

How protected am I after getting the vaccine? 

Mpox vaccines are thought to be effective at protecting people against mpox or making symptoms less severe when given before or soon after exposure to mpox. Initial studies have shown some protection even from a single dose of the JYNNEOS vaccine, however a person is not considered fully vaccinated until they have received 2 doses of JYNNEOS vaccine. 

Because they may not be completely protected, even after receiving 2 doses of the JYNNEOS vaccine, vaccinated individuals are still recommended to take additional measures to protect themselves against catching or spreading mpox, and to isolate at home when they have a rash or other symptoms until they have confirmed whether they have mpox. 

CDPH will continue to monitor the effectiveness of the JYNNEOS vaccine during the current outbreak. 

What is CDPH's policy on second doses? 

CDPH strongly recommends that all eligible individuals complete their JYNNEOS vaccine series by receiving their second dose at least 28 days after their first dose. 

A person who is diagnosed with mpox after their first dose of JYNNEOS should not receive a second dose at this time (unless they are immunocompromised).​

When am I considered fully vaccinated? 

Individuals are considered fully vaccinated 2 weeks after receiving their second dose of the JYNNEOS vaccine. 

Who should NOT receive the vaccine? 

People who have had a serious allergic reaction to a previous dose of the JYNNEOS vaccine or a component in the vaccine should talk to their health care provider to see if it is safe to receive the vaccine. 

While you may still be able to be vaccinated with JYNNEOS if you have the following conditions, please tell your vaccination provider if you: 

  • Have any severe, life-threatening allergies 
  • Are pregnant or think you may be pregnant 
  • Are breastfeeding 
  • ​Have a weakened immune system 

The JYNNEOS vaccine is not recommended for someone with symptoms or who has tested positive for mpox. 

What are the side effects? 

Most people who get the JYNNEOS vaccine have minor reactions. These may include pain, redness, swelling, firmness, or itching where the shot was given, especially for intradermal injection (between layers of the skin). There may also be muscle pain, headaches, nausea, chills, or feeling tired. There is a small chance of fever. As with any medicine, there is a very small chance of a vaccine causing a severe allergic reaction. 

What if I have a severe allergic reaction? 

If you have signs of a severe allergic reaction (such as hives, swelling of the face or throat, difficulty breathing, a fast heartbeat, or dizziness), call 911 immediately or go to the nearest hospital. For other concerns, contact a health care provider. 

Adverse events that occur in a recipient following mpox vaccination should be reported to V-safe. Reporting is encouraged for any clinically significant adverse event, even if it is uncertain whether the vaccine caused the event. Information on how to submit a report is available at the V-safe website or by calling 1- 800-232-4636. 

Can I get the vaccine if I am pregnant or might be pregnant? 

Pregnant individuals should discuss risks and benefits of the JYNNEOS vaccine with their health care providers. While data on the risks of JYNNEOS vaccination during pregnancy are limited, mpox infection during pregnancy is associated with complications, including severe congenital infection, pregnancy loss, and maternal mortality. 

Can I get the vaccine if I am breastfeeding? 

Yes, individuals who are breastfeeding may receive the JYNNEOS vaccine if they are at risk. It is unknown whether JYNNEOS is passed through human breast milk or if there are any effects on either the breastfed infant or milk production. However, because JYNNEOS vaccine does not contain a virus that replicates, babies cannot get mpox infection from the vaccine if it is transmitted through breast milk. Individuals should discuss risks and benefits of vaccination with their health care providers. 

How can I lock my vaccine record so that it is only visible to my health care provider and public health authorities? 

Patients have the right to 'lock' their record in the California Immunization Registry (CAIR) so that immunization information is only visible to the patient's health care provider and public health authorities. Patients have the right to review their vaccine record and can decline to share their vaccine record with other CAIR users. To request to lock your My CAIR Record, complete the Request to Lock My CAIR Record form​ and follow the directions to electronically submit the form. If you experience issues when attempting to submit the request, please contact the CAIR Help Desk at CAIRHelpDesk@cdph.ca.gov

What if I want to reverse the “lock” on my vaccine record? 

If a patient changes their mind about limiting access, they can request the vaccine record be ‘unlocked’ at any time by completing the Request to Unlock My CAIR Record form and following the directions to electronically submit the form. 

What to Expect If You Are Diagnosed with Mpox​​ 

A public health worker from the health department may contact you about your positive test result to discuss mpox, help notify any potential contacts confidentially, explain home isolation and how to prevent spread to others, and make sure you have important health information. 

Your clinical provider can advise about treatment for mpox: Types of treatment may include skin care to help rashes heal, medicines to help manage symptoms like pain or itching, and/or if you’re eligible for antiviral medicine. More information about mpox treatment is available here​

What about taking time off from work? 

Similar to other medical conditions, your clinical provider may be able to provide a doctor’s note if you need to take time off and/or if your infection is impacting your ability to work. Your employer’s human resources (HR)can provide information about what benefits may be available for illness such as paid sick leave, FMLA (Family and Medical Leave Act), or short-term disability insurance. 

Workers who are employed or actively looking for work and who are unable to do their regular work may qualify for financial support from California’s State Disability Insurance. Persons must be under the care of a clinical provider who can complete the medical certification part of the application, so talk with your provider if you are applying. 

Your local public health department or 2-1-1 may be able to share information on accessing additional local support or resources. 

Do I have to tell my employer I have mpox? 

The health department will determine if/when employers should be notified due to potential public health risk (e.g., potential exposures to coworkers or clients). Confidential otifications may be routinely required as part of infection control plans in certain settings, such as healthcare or congregate settings. 

Unless otherwise advised by the health department, generally the decision to disclose mpox to an employer may be like any other employee medical condition or illness not related to COVID-19. Similar to other medical conditions, your clinical provider may be able to provide a doctor’s note if you need to take time off, are requesting accommodations, and/or if your infection is impacting your ability to work. ​​

What are the treatment options for mpox?

What treatments are available for mpox? 

Most mpox infections are mild and heal without any treatment. However, antiviral drugs, such as tecovirimat (TPOXX), may be used to treat mpox. It is important to talk to your health care provider if you have symptoms of mpox and are experiencing pain or irritation due to the rash or sores. Your provider may be able to offer treatments that are not specific to mpox, but can help reduce your symptoms and discomfort, like prescribed mouth rinses, stool softeners, or topical gels or creams. For more information, see CDPH Supportive Care Suggestions

TPOXX, an antiviral medication being used for the treatment of mpox infection, is available orally through a clinical trial called Study of Tecovirimat for Human Monkeypox Virus (STOMP) and an expanded access Investigational New Drug (EA-IND) protocol. 

For more information on treatment, please visit the CDC Patient's Guide for Tecovirimat and the CDPH Mpox Tecovirimat Treatment Information for Providers​

For more information on obtaining TPOXX through the STOMP trial, visit www.stomptpoxx.org or the California Prevention Training Center information guides at STOMP: Study of Tecovirimat for Mpox - Patient Handouts

Additional information for treatment of severe manifestations of mpox can be found at CDC's Interim Clinical Treatment Considerations for Severe Manifestations of Mpox. ​

Infection Control in Workplaces and Healthcare Settings

General considerations for employee health and safety

Some workplaces are subject to the Cal/OSHA Aerosol Transmissible Diseases (ATD) Standard​ (PDF), and Bloodborne Pathogens (CA State 5193)​ (PDF), and employers should consult those regulations for additional applicable requirements. Settings not covered by these standards still must protect their employees under other laws and regulations. See Cal/OSHA Protecting Workers from Mpox for Employers and Workers Covered by the Aerosol Transmissible Diseases Standard (PDF). 

Employers concerned about a potential workplace exposure should consult their local health department​ for further guidance. Similar to the management of other communicable diseases, llocal health departments will typically lead the response efforts for potential exposures and provide advise of recommendations on a case-by-case basis as needed. Employers should also be mindful of confidentiality and ensure affected employees are aware of paid leave and other available support options. Certain workplaces may have additional setting-specific guidance as well as licensing or other reporting requirements. Information for healthcare settings is detailed below.

Introduction: What are the infection control practices of mpox in healthcare settings?

The California Department of Public Health (CDPH) recommends California healthcare facilities follow the CDC’s Infection Control in Healthcare Settings guidance for mpox. This Q&A provides some California-specific considerations for implementing CDC's guidance​ and additional recommendations to facilitate identification and management of mpox-infected healthcare personnel (HCP) to prevent exposures to patients and other HCP. CDPH recommends providing information about mpox to all HCP and that all healthcare facilities incorporate this information into their Aerosol Transmissible Diseases (ATD) exposure control plans (PDF). 

In which healthcare settings should the guidance in this Q&A be applied? 

These recommendations apply to any setting in which healthcare is delivered, including but not limited to acute care hospitals (ACH), long-term care acute care hospitals (LTACH), skilled nursing facilities (SNF), ambulatory clinics, dental offices, home healthcare, medical clinics that are located within other types of facilities, such as medical clinics located within correctional or detention facilities. 
These practices are not intended for other congregate living settings, such as assisted living, independent living, shelters, although some principles may apply. See CDC recommendations for reducing mpox transmission in congregate living settings​

Are Airborne Infection Isolation Rooms (AIIRs) required for the care of patients with suspected or confirmed mpox? 

CDC does not routinely recommend special air handling for patients with suspected or confirmed mpox, except during intubation, extubation, or any other procedure likely to aerosolize oral secretions, which should be performed in airborne infection isolation rooms (AIIRs). Thus, mpox patients do not need to be transferred to a facility with an AIIR for the purposes of isolation only. When possible, a patient with suspected or confirmed mpox should be put in a single-person room with dedicated bathroom, and the door should be kept closed if safe to do so. Transport of the patient should be limited to medically essential purposes. However, these recommendations are not always possible in real-world settings. When space and resources are scarce or limited, see the California Prevention Training Center's "Preventing Occupational Mpox Transmission in Outpatient Clinics" for real-world strategies allows clinics to care for patients with mpox as safely and effectively as possible. The healthcare team should also avoid activities that resuspend infectious particles from lesions (e.g., fanning, dusting, sweeping, etc.). Please see the Cal/OSHA mpox guidance for further information: Cal/OSHA Guidance on MPOX Virus for Employers Covered by Section 5199​ (PDF). 

What are additional preventative measures a HCP should consider when providing care for a patient with confirmed or suspected case of mpox? 

Follow protocols for worker health and safety in accordance with the Cal/OSHA Guidance on Mpox Virus for Employers Covered by Section 5199 (PDF). Ensure access to appropriate face coverings for all patients. Patients should continue to follow CDPH Masking Guidance​
  1. Respirators (e.g., N95s, KN95s, KF94s) are recommended. The Cal/OSHA Aerosol Transmissible Diseases (ATD) Standard (PDF) contains additional requirements for respirator use for staff in contact with patients with suspected or confirmed mpox. 
  2. Staff who must enter isolation areas must wear a gown, gloves, eye protection (goggles or face shield), and a NIOSH-approved particulate respirator equipped with N95 filters or higher. Refer to CDC Personal Protective Equipment (PDF) sequence. 
  3. ​In some workplaces, employers are subject to the Cal/OSHA Bloodborne Pathogen Standards and the Cal/OSHA Aerosol Transmissible Diseases (ATD) Standard​ (PDF) and should consult those regulations for additional applicable requirements. Additional workplace safety questions can be directed to: Cal/OSHA Safety and Health Training and Instruction Requirements for Employers​ lists the topics, suggested educational materials, the types of workers needing training, and the required frequency of that training. Cal/OSHA Consultation Services: Toll-free assistance number 1(800) 963-9424 or email InfoCons@dir.ca.gov
Health care professionals can find additional guidance on infection control and prevention in CDPH Information for Health Care Providers and the CDC Infection Control: Healthcare Settings

What information should be given to all HCP to prevent mpox transmission from an infected HCP to patients and other HCP? 

  • ​Provide information (e.g., fact sheets) to HCP on risk factors for mpox, characteristic symptoms suggestive of mpox, and available preventive and treatment measures. 
  • Develop and share a management plan for HCP who have had occupational and non-occupational mpox exposures, including timely access to post-exposure prophylaxis (PEP) with vaccine consultation with the local health department (LHD). See the CDC's Recommendation’s for PEP to get more information. 
  • Instruct HCP not to come to work and to seek prompt medical evaluation (including testing and treatment, as appropriate) if having any symptoms characteristic of mpox, including systemic symptoms (e.g., fever, sore throat, swollen glands) in the absence of lesions, as well as presence of characteristic skin lesions. 
  • Provide guidance to isolate at home​ if mpox is suspected or confirmed. Include instructions to avoid touching lesions and then touching clothing, towels or other materials that are touched by others, with special attention to antiseptic technique when changing bandages on skin lesions. 
  • Make available information about occupational health or public health resources (PDF) available to HCP who do not have a healthcare provider. 
  • Share sick leave policies as well as information about short-term disability and other financial support options. 

Do HCP who have been exposed to mpox, either at work or outside of work, need to be restricted from work? 

No. HCP who have been exposed should consult with a provider or LHD to determine if they qualify for PEP with JYNNEOS™ vaccine. They do not need to be excluded from the workplace but should be instructed to self-monitor for onset of symptoms throughout the 21-day incubation period following last exposure. If they experience symptoms of mpox, they should not come to work and should follow the guidance provided above. If they were exposed to mpox at work, employers should consult the ATD (PDF) standard and the Cal/OSHA Guidance on mpox Virus for Employers Covered by Section 5199​ (PDF). Reference the CDC’s Infection Control in Health Settings​ for additional guidance on risk-stratification and PEP recommendations. Additional guidance on risk-stratification and PEP recommendations. 

How should healthcare facilities determine the level of risk to patients and other HCP who might have been exposed to a mpox-infected HCP during the infectious period?

Although the CDC framework for mpox exposure evaluation is intended for HCP caring for patients with mpox, many of the same principles can be applied when assessing exposure risk to patients and other HCP potentially exposed to a mpox-infected HCP. Exposures warranting patient or co-worker notification, monitoring, and consideration of PEP include: 
  • ​​Unprotected contact between an exposed individual's skin or mucous membranes and the skin lesions or bodily fluids from the mpox-infected HCP or soiled materials (e.g., linens, clothing); or 
  • ​​Being within 6 feet for a total of 3 hours or more (cumulative) of an unmasked mpox-infected HCP without wearing a NIOSH approved particulate respirator with N95 filters or higher and eye protection. 
For contact tracing to identify exposed patients or co-workers, the exposure period begins 4 days prior to symptom onset and ends when all lesions are healed, scabs have fallen off, and fresh skin is present at the site of all lesions. When assessing potential exposures to patients and other HCP, healthcare facilities should consider the extent, locations of the mpox-infected HCP's lesions, and whether these were always covered by clothing, bandages, or gloves while at work. In general, no patients or co-workers would be considered exposed if the mpox-infected HCP lesions were always covered and the case wore a surgical mask or respirator for COVID-19 always source control

When can an HCP with mpox return to work in a healthcare setting? 

HCP with mpox should not return to work until their systemic symptoms have resolved, there are no new lesions appearing, all lesions have crusted, all scabs have fallen off, and there is fresh skin at the lesion sites. Repeat testing is not required. However, the decision about when to return to work should be made with the HCP's occupational health program, and potentially with input from public health authorities as recommended by CDC​. Since it could take as long as 4 weeks for complete healing to occur, it is reasonable to consider re-assigning the HCP to remote work, or to a position with minimal contact with other HCP and patients (e.g., administrative work in a private office).

What is the guidance for mpox medical waste management? 

See CDPH Mpox Disease Medical Waste Management – Interim Guidelines​. Note: Clade I MPXV is a Category A infectious substance, whereas Clade II has been determined to be Category B.

Where can I find more information?

CDPH closely monitors mpox transmission in the U.S. and California to ensure rapid identification of cases. CDPH works with local health officials and CDC to ensure appropriate care and response, including outreach and communications, laboratory testing, contact tracing, obtaining vaccine to support local vaccination efforts for people who may have been exposed, and making antiviral treatment more widely available in California. 
Additionally, CDPH is promoting awareness amongst health care providers and the public about appropriate testing and infection control when patients with suspected mpox disease are cared for in healthcare settings. CDPH is working to help health care providers and the public become familiar with the symptoms and appearance of mpox. 
Visit the CDC’s About Mpox webpage and our Community Resources page​ for more information.​

How Can We Help You?

Connect with CDPH for additional mpox resources.

Contact CDPH STD Control Branch Mpox Team

If you need further clarification or have questions, comments, and concerns regarding CDPH Mpox, submit an inquiry​.

Contact Your Local Public Health Department

Reach out to your local health department with any questions.​

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