Skip Navigation LinksMonkeypox-Questions-and-Answers

Division of Communicable Disease Control

Monkeypox (MPX)

 

 

What is MPX?203What is MPX?<p>​<span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">Monkeypox (MPX) is a rare disease caused by infection with the MPX virus, which is related to the smallpox virus. While less severe and much less contagious than smallpox, MPX can be a serious illness. It spreads from infected humans, animals, and materials contaminated with the virus bu</span><span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">t primarily through close, personal, skin-to-skin contact with people who have MPX symptoms, such as rash and sores.</span><br></p>
Is MPX a new disease?204Is MPX a new disease?<p><br></p><span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">No, MPX is not a new disease. MPX was first discovered in 1958 in monkeys, hence the name 'MPX'. The first human case of MPX was recorded in 1970 in the Democratic Republic of Congo. MPX is endemic (regularly found) in west and central African countries.</span>
Should I be worried about MPX?205Should I be worried about MPX?<p>​<span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;">There is a rec</span><span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;">ent increase in reported cases where MPX is not commonly seen, like Europe and the United States, including California. While it's good to stay alert about any emerging public health outbreaks, </span><span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;box-sizing:border-box;font-weight:700;">transmission rates are low in the general public.</span><span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;"> </span></p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">MPX is a known illness that spreads through very close contact compared to other infectious diseases like COVID-19 that are primarily spread though very small particles in the air. MPX is also 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.<br></p>
Is MPX related to COVID-19?206Is MPX related to COVID-19?<p>​<span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">No, MPX is a completely different disease, is not related to COVID-19, and spreads differently. People are generally contagious when they have a rash or other symptoms, and MPX spread takes place through prolonged direct, close contact. This is different from COVID-19, which spreads easily through the air.</span><br></p>
Does the MPX virus have variants?207Does the MPX virus have variants?<p>​<span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">All viruses change and evolve over time. However, the MPX virus is a DNA virus which mutates slower than coronaviruses, which are RNA viruses (the virus that causes COVID-19 is a coronavirus).  There are two known families or “clades” of MPX virus. The clade recently identified in Europe and in the United States is the West African clade, which tends to cause less severe disease.</span><br></p>
Who can get MPX?208Who can get MPX?<p>​<span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">Anyone can get MPX after having close physical contact with someone who has the infection, especially if coming into direct contact with the rash and sores, bodily fluids. However, the current risk to the general public is low. Though not exclusively, most recent cases include gay, bisexual, trans, and other men who have sex with men, as well as household contacts.</span><br></p>
How serious is MPX?209How serious is MPX?<p><span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;">MPX is usually </span><span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;">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, children under 8 years of age, people with a history of eczema, and people who are pregnant or breastfeeding.</span></p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">Infections with the strain of MPX virus identified in this outbreak—the West African strain—are rarely fatal. Over 99% of people who get this form of the disease are likely to survive. Despite this, symptoms can be extremely painful, and people might have infections or permanent scarring resulting from rashes and sores.<br></p>

 

 

What are the signs and symptoms of MPX?240What are the signs and symptoms of MPX?<p>​<span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;">MPX often st</span><span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;">arts with symptoms like those of the flu, with fever, low energy, swollen lymph nodes, and general body aches. Within 1 to 3 days (sometimes longer) after the appearance of fever, the person can develop a rash or sores. The sores will go through several stages, including scabs, before healing. They can look like pimples or blisters and may be painful and itchy.</span></p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">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. <br style="box-sizing:border-box;"></p><h4 class="ms-rteElement-H4B" style="box-sizing:border-box;margin-top:10px;margin-bottom:10px;font-weight:700;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">People with MPX may experience all or only a few of these symptoms. Most people with MPX will get the rash 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.<br></h4>
What should I do if I have symptoms of MPX?241What should I do if I have symptoms of MPX?<p>​<span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;">Contact a h</span><span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;">ealth care provider or your </span><a href="/pages/localhealthservicesandoffices.aspx" style="font-family:"source sans pro", sans-serif;font-size:18px;box-sizing:border-box;color:#0071bc;background-color:transparent;outline:none;">local health department</a><span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;"> </span><span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;">as soon as possible and let them know you have symptoms so they can test for MPX and provide treatment as needed.</span></p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">People who have MPX 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 MPX should completely cover sores and wear a well-fitting mask.</p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">Standard laundry detergents are appropriate for washing clothes or linens (e.g., bedding and towels) used by someone with MPX.</p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">For more information about isolation and guidance on how to take care while presenting symptoms, please refer to the <a href="/Programs/CID/DCDC/Pages/MPX/MPX-Home-Isolation-Guidance-for-the-General-Public.aspx" style="box-sizing:border-box;color:#0071bc;background-color:transparent;outline:none;">CDPH's MPX Home Isolation Guidance for the General Public</a>.<br></p>

 

 

How is MPX transmitted?213How is MPX transmitted?<p>MPX can be spread by:</p><ul><li><p>Direct skin-to-skin contact with the sores or scabs of people with MPX</p></li><li><p>Direct contact with body fluids of people with MPX, such as drainage from skin sores or saliva that was in contact with mouth sores</p></li><li><p>Contact with the respiratory secretions of people with MPX, such as saliva, during prolonged, face-to-face contact or during intimate physical contact, such as kissing, cuddling, or sex</p></li><li><p>Touching items (such as bedding towels, clothing, cups and utensils) that previously touched the sores or body fluids of people with MPX<br></p></li></ul><p>To date, there has been no evidence that MPX is spread by:</p><ul><li><p>Attending an outdoor event with fully clothed people</p></li><li><p>Trying on clothes or shoes at the store</p></li><li><p>Traveling in an airport, on a plane or on other public transit</p></li><li><p>Swimming in a pool or body of water</p></li><li><p>Going to a public setting (grocery store, restaurant, workplace, restroom)</p></li></ul><p>If you have MPX symptoms, avoid crowded settings and close contact, including sexual or intimate contact, until you see a health care provider.</p><p>For more information about isolation recommendations, please refer to the <a href="/Programs/CID/DCDC/Pages/MPX/MPX-Home-Isolation-Guidance-for-the-General-Public.aspx">CDPH MPX Home Isolation Guidance for the General Public.</a> <br></p><h4 class="ms-rteElement-H4B">Scientists are still learning if MPX can be spread through:</h4><ul><li><p>Semen or vaginal fluids</p></li><li><p>Contact with people who have no symptoms (we think people with symptoms are most likely to spread it, but some people may have very mild illness and not know they are infected) <br></p></li></ul>
When is MPX contagious?216When is MPX contagious?<p>​<span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">MPX symptoms usually start within 2 weeks (but can be up to 17 days) 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. This can take several weeks. Researchers are still trying to understand if the virus can spread from someone who has no symptoms.</span><br></p>
Can I get MPX from attending crowded events?217Can I get MPX from attending crowded events?<p>​<span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">People can get the virus if they have close, skin-to-skin contact with someone who has MPX. Early indications are that events with activities in which people engage in close, lengthy skin-to-skin contact have resulted in cases of MPX. If you plan to attend an event, consider how much close, personal, skin-to-skin contact is likely to occur there.</span><br></p>
What Should I do if I think I might have exposed someone else to MPX?  300What Should I do if I think I might have exposed someone else to MPX?  <p>​<span data-ccp-charstyle="normaltextrun" data-ccp-charstyle-defn="{"ObjectId":"cd1e7fcd-c4b4-417f-aded-c87de6c7ba2c|24","ClassId":1073872969,"Properties":[469775450,"normaltextrun",201340122,"1",134233614,"true",469778129,"normaltextrun",469778324,"Default Paragraph Font"]}">If you think you may have exposed someone to MPX while you were infectious, it is important to let them know so that they do not infect someone else. You can let them know anonymously, please </span><span data-ccp-charstyle="normaltextrun">visit the <a href="/Programs/CID/DCDC/Pages/STD.aspx">CDPH Sexually Transmitted Disease (STD) website</a> and refer under Quick Links. Testing is strongly encouraged to help identify and prevent infection.</span><br></p>
Could my pet get MPX?218Could my pet get MPX?<p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;"><span style="box-sizing:border-box;font-size:13.5pt;line-height:19.26px;color:black;">The CDC and CDPH do not currently believe that MPX poses a high risk to pets. </span><span style="box-sizing:border-box;font-size:13.5pt;line-height:19.26px;">However, i</span><span style="box-sizing:border-box;font-size:13.5pt;line-height:19.26px;">nfected animals (mammals) can spread MPX to people, and people who are infected can spread MPX to animals through close contact, including petting, cuddling, hugging, kissing, licking, sharing sleeping areas, and sharing food.</span></p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;"><span style="box-sizing:border-box;font-size:13.5pt;line-height:19.26px;"></span><span style="box-sizing:border-box;font-weight:700;">People with MPX should avoid contact with animals,</span> including pets, <a href="https://www.cdc.gov/poxvirus/monkeypox/veterinarian/monkeypox-in-animals.html#table" style="box-sizing:border-box;color:#0071bc;background-color:transparent;outline:none;">domestic animals, and wildlife</a> to prevent spreading the virus. People with MPX should ask another household member or outside friend/family member to care for pets until the person with MPX is fully recovered.</p>
Is MPX a sexually transmitted infection (STI)?219Is MPX a sexually transmitted infection (STI)?<p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;"><span style="box-sizing:border-box;font-size:1em;">Sex is just one of the ways that the virus can spread. MPX primarily spreads from skin-to-skin contact, especially close or intimate physical contact such as sex or touching rashes. MPX can also spread contact with contaminated materials like utensils, cups, bedding, towels, clothing, or sex toys.</span></p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">Scientists are investigating whether the virus could be spread by exposure to semen or vaginal fluids, but this has not been previously known to be how the virus spreads.</p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">MPX may look like sexually transmitted infections (STIs) that cause a rash on the genitals and anus, including herpes and syphilis. MPX may also cause rectal pain, which is a symptom of proctitis (inflammation of the rectum) and can be seen in other STIs as well. It's always important to talk to a health care provider as soon as you notice unusual rashes or sores or have rectal pain.</p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">For more information, view our <a href="/Programs/CID/DCDC/CDPH%20Document%20Library/Monkeypox/safer-sex-mpx-factsheet.pdf" style="box-sizing:border-box;color:#0071bc;background-color:transparent;outline:none;">fact sheet on safer sex and MPX</a> (PDF). <br></p>
Should parents be concerned about the spread of MPX in classrooms?220Should parents be concerned about the spread of MPX in classrooms?<p>​<span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">We continue to see very low transmission of the virus in the general population, including children. Of the handful of probable or confirmed cases in children, spread has usually been through household contacts.</span><br></p>

 

 

How is MPX prevented?212How is MPX prevented?<p>​<span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;">There are</span><span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;"> number of ways to prevent the spread of MPX, including:</span></p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;"></p><ul style="box-sizing:border-box;margin-top:0px;margin-bottom:10px;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;"><li style="box-sizing:border-box;">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</li><li style="box-sizing:border-box;">Avoiding close contact, including hugging, kissing, cuddling and sexual activity with people with symptoms like sores or rashes</li><li style="box-sizing:border-box;">Not sharing materials (e.g., utensils, cups, clothing, towels, bedding) with someone who has symptoms</li><li style="box-sizing:border-box;">Washing your hands often with soap and water or using an alcohol-based hand sanitizer</li><li style="box-sizing:border-box;">Using appropriate <a href="https://www.cdc.gov/poxvirus/monkeypox/clinicians/infection-control-home.html" style="box-sizing:border-box;color:#0071bc;background-color:transparent;outline:none;">personal protective equipment (PPE)</a> (like a mask, gown and gloves) when caring for people with symptoms</li><li style="box-sizing:border-box;">Avoiding contact with infected animals <br></li></ul>
What should I do if I've been exposed to MPX?221What should I do if I've been exposed to MPX?<p>​<span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">Contact a health care provider or your </span><a href="/pages/localhealthservicesandoffices.aspx" style="box-sizing:border-box;color:#0071bc;background-color:#ffffff;outline:none;font-family:"source sans pro", sans-serif;font-size:18px;">local health department</a><span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;"> as soon as possible and let them know you have been exposed to MPX. Health care providers and local health departments may recommend a vaccine to help prevent infection or decrease the seriousness of the illness. You also may be asked to monitor for any new symptoms for 21 days after the exposure. </span><br></p>
How do I clean clothing, bedding and other materials if I have MPX?222How do I clean clothing, bedding and other materials if I have MPX?<p><span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;">The MPX vi</span><span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;">rus 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.</span></p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">Orthopoxviruses, like MPX, 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 MPX has spent time, as well as, for items considered to be potentially contaminated.</p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">Visit CDC's webpage on <a href="https://www.cdc.gov/poxvirus/monkeypox/if-sick/home-disinfection.html" style="box-sizing:border-box;color:#0071bc;background-color:transparent;outline:none;">Disinfecting Home and Other Non-Healthcare Settings</a> for more information.<br></p>

 

 

What is the MPX Vaccine?210What is the MPX Vaccine?<p>​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 MPX and people who may be at risk for MPX.</p><p>The JYNNEOS vaccine is approved by the U.S. Food and Drug Administration (FDA) to prevent both MPX and smallpox. Vaccination helps protect against MPX when given before or shortly after an exposure. This vaccine is currently available in the United States from the federal <a href="https://aspr.hhs.gov/SNS/Pages/JYNNEOS-Distribution.aspx">Strategic National Stockpile</a>.<br></p>
Who is currently recommended to receive the vaccine?226Who is currently recommended to receive the vaccine?<p>​<strong>Any person who MAY be at risk for MPX infection or</strong><strong> persons who request vaccination</strong> may receive vaccination without having to report specific risk factors.</p><p>The following groups who are at higher risk for MPX infection, and/or for complications of MPX infection, should be a priority and are <strong>strongly encouraged</strong> for vaccination to decrease infection spread, serious illness, and prevent fatalities:<br></p><ul><li>Anyone living with human immunodeficiency virus (HIV). It is recommended that additional efforts be made to reach those with a CD4 count <350/mm3, an unsuppressed HIV viral load, or an opportunistic infection, due to increased risk for complications of MPX</li><li>Any man or trans person who has sex with men or trans persons</li><li>People who use or who are eligible for HIV<strong> </strong>pre-exposure prophylaxis (PrEP) </li><li>Sex workers</li><li>Sexual partners of the above groups </li><li>People who have had direct skin-to-skin contact with one or more people AND who know others in their community that have had MPX infection</li><li>People who have been diagnosed with a bacterial sexually transmitted infection (e.g., chlamydia, gonorrhea, syphilis) in the past 3 months</li><li>People who anticipate experiencing the above risks</li></ul><p><strong>Known close contacts of people who have MPX should be vaccinated as soon as possible.</strong> This is called post-exposure prophylaxis (PEP).<br></p><p><strong>People in specific occupational groups should be offered vaccination. </strong>These include: </p><ul><li>Occupational groups recommended for vaccination by <a href="https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/smallpox.html">Advisory Committee on Immunization Practices</a> (ACIP).<br></li><li>Healthcare workers (HCWs) who are likely to collect laboratory specimens from patients with MPX (e.g., persons working in sexual health clinics or clinical settings that serve at-risk populations).<br></li></ul><p>Please see CDPH <a href="/Programs/CID/DCDC/Pages/Considerations-for-Expanded-Monkeypox-Post-Exposure-Prophylaxis.aspx">Considerations for MPX Vaccination in California</a> for further details and guidance.<br></p><br>
When should the vaccine be given after an exposure?231When should the vaccine be given after an exposure?<p>The JYNNEOS vaccine should be given within 4 days from the date of exposure, if possible, to help prevent 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. <br></p>
How can I get the vaccine?237How can I get the vaccine?<p>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,<a href="/pages/localhealthservicesandoffices.aspx"></a> use the <a href="https://mpoxvaxmap.org/">Monkeypox Vaccine Locator</a> or <a href="https://myturn.ca.gov/">MyTurn</a> to find a location. If you have trouble obtaining the vaccine, please contact your <a href="/pages/localhealthservicesandoffices.aspx#">local health department</a> for further guidance.  <br> <br> </p><p><br></p>
How is the vaccine given?227How is the vaccine given?<p>The JYNNEOS vaccine is given through a shot (injection). The JYNNEOS vaccine can be given in two methods.</p><ol><li>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.</li><li>Under new guidelines from the FDA and CDC, the vaccine can also be given through intradermal injection, or 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.<br></li></ol><div><br></div><div>During this outbreak, intradermal route is preferred, but the JYNNEOS vaccine may still be administered subcutaneously using the standard regimen. <a href="https://www.cdc.gov/poxvirus/monkeypox/interim-considerations/special-populations.html">CDC recommends </a>eligible people get two JYNNEOS doses four weeks apart. </div>
How protected am I after getting the vaccine?229How protected am I after getting the vaccine?<p>MPX vaccines are thought to be effective at protecting people against MPX or making symptoms less severe when given before or soon after exposure to MPX. Initial studies have shown some protection even from a <a href="https://www.cdc.gov/mmwr/volumes/71/wr/mm7140e3.htm?s_cid=mm7140e3_e&ACSTrackingID=USCDC_921-DM91088&ACSTrackingLabel=MMWR%20Early%20Release%20-%20Vol.%2071%2c%20September%2030%2c%202022&deliveryName=USCDC_921-DM91088#contribAff">single dose of the JYNNEOS vaccine, however a person is not considered fully vaccinated until they have received 2 doses of JYNNEOS vaccine.</a></p><p>Because they may not be completely protected, even after receiving 2 doses of JYNNEOS vaccine, vaccinated individuals are still recommended to take additional measures to <a href="https://www.cdc.gov/poxvirus/monkeypox/prevention.html">protect </a>against catching or spreading MPX and to <a href="/Programs/CID/DCDC/Pages/MPX/MPX-Home-Isolation-Guidance-for-the-General-Public.aspx" title="CDPH Isolation Guidance">isolate</a> at home when they have a rash or other symptoms until they have confirmed whether or not they have MPX.<br></p><p>CDPH will continue to monitor the effectiveness of JYNNEOS vaccine during the current outbreak. <br></p><p><br></p>
What is CDPH's policy on second doses?228What is CDPH's policy on second doses?<p>CDPH strongly recommends that all eligible individuals complete their JYNNEOS vaccine series by receiving their 2<sup>nd</sup> dose at least 28 days after their first dose.    </p><p>A person who is diagnosed with MPX after their first dose of JYNNEOS should not receive a second dose at this time (unless they are immunocompromised).  <br></p><p><br></p>
When am I considered fully vaccinated?230When am I considered fully vaccinated?<p>Individuals are considered fully vaccinated 2 weeks after receiving their second dose of the JYNNEOS vaccine.<br></p>
Who should NOT receive the vaccine?232Who should NOT receive the vaccine?<p>​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.</p><p>While you may still be able to be vaccinated with JYNNEOS if you have the following conditions, please tell your vaccination provider if you:</p><p></p><ul><li><p>Have any severe, life-threatening allergies</p></li><li><p>Are pregnant or think you may be pregnant</p></li><li><p>Are breastfeeding</p></li><li><p>Have a weakened immune system</p></li></ul><p></p><p>The JYNNEOS vaccine is not recommended for someone with symptoms or who has tested positive for MPX.</p>
What are the side effects?235What are the side effects?<p>​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). You also may have muscle pain, headaches, nausea, chills, or may feel 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.<br></p>
What if I have a severe allergic reaction?236What if I have a severe allergic reaction?<p>​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.</p><p>Adverse reactions should be reported to the Vaccine Adverse Event Reporting System (VAERS). Your health care provider will usually file this report, or you can do it yourself. Visit the <a href="https://vaers.hhs.gov/">VAERS website</a> or call 800-822-7967. VAERS is only for reporting reactions, and VAERS staff members do not give medical advice.</p><p>You can visit the <a href="https://www.fda.gov/media/131078/download">FDA website</a> (PDF) to read the package insert for this vaccine. For more information on the vaccine, visit the <a href="https://www.cdc.gov/vaccines/hcp/vis/vis-statements/smallpox-monkeypox.pdf">CDC JYNNEOS Vaccine Statement</a> (PDF) and the <a href="https://www.cdc.gov/poxvirus/monkeypox/considerations-for-monkeypox-vaccination.html">CDC's Consideration on Monkeypox Vaccine site</a>.  <br></p>
Can I get the vaccine if I am pregnant or might be pregnant?233Can I get the vaccine if I am pregnant or might be pregnant?<p>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, MPX infection during pregnancy is associated with complications, including severe congenital infection, pregnancy loss, and maternal mortality.<br></p>
Can I get the vaccine if I am breastfeeding?234Can I get the vaccine if I am breastfeeding?<p>Yes, individuals who are breastfeeding may receive the JYNNEOS vaccine if exposed to MPX. It is unknown whether JYNNEOS is passed through human breast milk. Data is not yet available on the effects of JYNNEOS in a breastfed infant or on milk production. However, because JYNNEOS vaccine does not contain a virus that replicates, babies cannot get MPX through breast milk. Individuals should discuss risks and benefits of vaccination with their health care providers.<br></p>
How can I lock my vaccine record so that it is only visible to my health care provider and public health authorities?238How can I lock my vaccine record so that it is only visible to my health care provider and public health authorities?<p>​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 <a href="https://cairforms.cairweb.org/SharingRequestForm/SharingRequestForm?SharingType=1&Language=En">Request to Lock My CAIR Record form</a> 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 <a href="mailto:CAIRHelpDesk@cdph.ca.gov">CAIRHelpDesk@cdph.ca.gov</a>.<br></p>
What if I want to reverse the “lock” on my vaccine record?239What if I want to reverse the “lock” on my vaccine record?<p>​If a patient changes their mind about limiting access, they can request the vaccine record be ‘unlocked’ at any time by completing the <a href="https://cairforms.cairweb.org/SharingRequestForm/SharingRequestForm?SharingType=2&Language=En">Request to Unlock My CAIR Record form</a> and following the directions to electronically submit the form.</p><p>For more information about MPX, visit CDPH's <a href="/Programs/CID/DCDC/Pages/monkeypox.aspx">MPX homepage</a> and <a href="/Programs/CID/DCDC/Pages/Monkeypox-Questions-and-Answers.aspx">Q&A</a>.  <br></p>

 

 

What treatments are available for MPX?214What treatments are available for MPX?<p>Most MPX infections are mild and will heal without any treatment. However, antiviral drugs developed to protect against smallpox, such as tecovirimat (TPOXX), may be used to treat MPX. This treatment may be recommended for people who are more likely to get severely ill, people who are experiencing severe disease, or those who have rash and sores in areas that are at risk for severe complications, such as eyes or genitals.</p><p>People who may be at risk for more severe illness include those with a weakened immune system, young children (< 8 years of age), those who are pregnant or breastfeeding, and those with a history of certain skin diseases like eczema.</p><p>For more information on treatment, please visit the <a href="https://www.cdc.gov/poxvirus/monkeypox/if-sick/treatment.html">CDC Patient's Guide for Tecovirimat</a>.</p><p>People who are high risk for progression to severe disease should be administered tecovirimat early in the course of illness along with <a href="/Programs/CID/DCDC/Pages/MPX/Supportive-Care-Suggestions.aspx">supportive care</a> and pain control.  </p><p>It is important to talk to your health care provider if you have symptoms of MPX and are experiencing pain or irritation due to the rash or sores. Your provider may be able to also offer treatments that are not specific to MPX, but may help to reduce your symptoms, like prescribed mouth rinses, stool softeners for those with rectal pain, or topical gels or creams.<br></p><p><br></p>

 

 

Introduction242Introduction<p>​<span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">The California Department of Public Health (CDPH) recommends California healthcare facilities follow </span><a href="http://www.cdc.gov/poxvirus/monkeypox/clinicians/infection-control-healthcare.html" target="_blank" style="box-sizing:border-box;color:#0071bc;background-color:#ffffff;outline:none;font-family:"source sans pro", sans-serif;font-size:18px;">CDC Infection Prevention and Control of MPX</a><span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;"> guidance in healthcare settings. This Q&A provides some California-specific considerations for implementing CDC's guidance and additional recommendations to facilitate identification and management of MPX-infected healthcare personnel (HCP) to prevent exposures to patients and other HCP. CDPH recommends providing information about MPX to all HCP and that all healthcare facilities incorporate this information into their Aerosol Transmissible Diseases (ATD) exposure control plans.</span><br></p>
In which healthcare settings should the guidance in this Q&A be applied?243In which healthcare settings should the guidance in this Q&A be applied?<p>​<span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;">These reco</span><span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;">mmendations 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.</span></p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">These practices are not intended for other congregate living settings, e.g., assisted living, independent living, shelters, although some principles may apply. See CDC recommendations for reducing MPX transmission in <a href="https://www.cdc.gov/poxvirus/monkeypox/specific-settings/congregate.html" target="_blank" style="box-sizing:border-box;color:#0071bc;background-color:transparent;outline:none;">congregate living settings</a>.<br></p>
Are Airborne Infection Isolation Rooms (AIIRs) required for the care of patients with suspected or confirmed MPX?244Are Airborne Infection Isolation Rooms (AIIRs) required for the care of patients with suspected or confirmed MPX?<p>​<span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">CDC does not routinely recommend special air handling for patients with suspected or confirmed MPX, except during intubation, extubation, or any other procedure likely to aerosolize oral secretions, which should be performed in airborne infection isolation rooms (AIIRs).  Thus, MPX patients do not need to be transferred to a facility with an AIIR for the purposes of isolation only. Please see the Cal/OSHA MPX Guidance for further information:  </span><a href="https://www.dir.ca.gov/dosh/documents/monkeypox-guidance.pdf" target="_blank" style="box-sizing:border-box;color:#0071bc;background-color:#ffffff;outline:none;font-family:"source sans pro", sans-serif;font-size:18px;">Cal/OSHA Guidance on MPX Virus for Employers Covered by Section 5199</a><span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;"> (PDF).</span><br></p>
What are additional preventative measures a HCP should consider when providing care for a patient with confirmed or suspected case of MPX?245What are additional preventative measures a HCP should consider when providing care for a patient with confirmed or suspected case of MPX?<p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">Follow protocols for worker health and safety in accordance with the <a href="https://www.dir.ca.gov/dosh/documents/monkeypox-guidance.pdf" style="box-sizing:border-box;color:#0071bc;background-color:transparent;outline:none;">Cal/OSHA Guidance on MPX Virus for Employers Covered by Section 5199</a> (PDF). Ensure access to appropriate face coverings for all patients. Patients should continue to follow <a href="/Programs/CID/DCDC/Pages/COVID-19/guidance-for-face-coverings.aspx" target="_blank" style="box-sizing:border-box;color:#0071bc;background-color:transparent;outline:none;">CDPH Masking Guidance</a>.  </p><blockquote style="box-sizing:border-box;padding:0px;margin:0px 0px 0px 40px;font-size:17.5px;border:none;color:#202020;font-family:"source sans pro", sans-serif;background-color:#ffffff;"><p style="box-sizing:border-box;margin-bottom:0px;">1. Respirators (e.g., N95s, KN95s, KF94s) or surgical masks with good fit are recommended. The Cal/OSHA ATD standard contains additional requirements for respirator use for staff in contact with patients with suspected or confirmed MPX.</p></blockquote><blockquote style="box-sizing:border-box;padding:0px;margin:0px 0px 0px 40px;font-size:17.5px;border:none;color:#202020;font-family:"source sans pro", sans-serif;background-color:#ffffff;"><p style="box-sizing:border-box;margin-bottom:0px;">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. Can also refer to CDC <a href="https://www.cdc.gov/hai/pdfs/ppe/PPE-Sequence.pdf" style="box-sizing:border-box;color:#0071bc;background-color:transparent;outline:none;">Personal Protective Equipment</a> (PDF) sequence.<br style="box-sizing:border-box;"></p></blockquote><blockquote style="box-sizing:border-box;padding:0px;margin:0px 0px 0px 40px;font-size:17.5px;border:none;color:#202020;font-family:"source sans pro", sans-serif;background-color:#ffffff;"><p style="box-sizing:border-box;margin-bottom:0px;">3. In some workplaces, employers are subject to the Cal/OSHA Bloodborne Pathogen Standards (PDF) 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 here:</p></blockquote><blockquote style="box-sizing:border-box;padding:0px;margin:0px 0px 0px 40px;font-size:17.5px;border:none;color:#202020;font-family:"source sans pro", sans-serif;background-color:#ffffff;"><blockquote style="box-sizing:border-box;padding:0px;margin:0px 0px 0px 40px;border:none;"><p style="box-sizing:border-box;">a. 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 <a href="mailto:InfoCons@dir.ca.gov" style="box-sizing:border-box;color:#0071bc;background-color:transparent;outline:none;">InfoCons@dir.ca.gov</a>.<br style="box-sizing:border-box;"></p><p style="box-sizing:border-box;margin-bottom:0px;"><br style="box-sizing:border-box;"></p></blockquote></blockquote><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">Health care professionals can find additional guidance on infection control and prevention in CDPH <a href="/Programs/CID/DCDC/Pages/Monkeypox-HCP-Info.aspx" target="_blank" style="box-sizing:border-box;color:#0071bc;background-color:transparent;outline:none;">Information for Health Care Providers</a> and the CDC <a href="https://www.cdc.gov/poxvirus/monkeypox/clinicians/infection-control-healthcare.html" target="_blank" style="box-sizing:border-box;color:#0071bc;background-color:transparent;outline:none;">Infection Control: Healthcare Settings | Monkeypox | Poxvirus | CDC</a>.<br></p>
What information should be given to all HCP to prevent MPX transmission from an infected HCP to patients and other HCP?246What information should be given to all HCP to prevent MPX transmission from an infected HCP to patients and other HCP?<ul style="box-sizing:border-box;margin-top:0px;margin-bottom:10px;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;"><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Provide information (e.g., fact sheets) to HCP on risk factors for MPX, characteristic symptoms suggestive of MPX, and available preventive and treatment measures.</p></li><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Develop and share the management plan for HCP who have had occupational and non-occupational MPX exposures, including timely access to post-exposure prophylaxis (PEP) with vaccine consultation with the <a href="/pages/localhealthservicesandoffices.aspx" target="_blank" style="box-sizing:border-box;color:#0071bc;background-color:transparent;outline:none;">local health department</a> (LHD).</p></li><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">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 MPX, including systemic symptoms (e.g., fever, sore throat, swollen glands) in the absence of lesions, as well as presence of characteristic skin lesions.</p></li><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Provide <a href="/Programs/CID/DCDC/Pages/MPX/MPX-Home-Isolation-Guidance-for-the-General-Public.aspx" target="_blank" style="box-sizing:border-box;color:#0071bc;background-color:transparent;outline:none;">guidance to isolate at home</a>, separate from household members, if MPX 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.<br style="box-sizing:border-box;"></p></li><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Make available information about occupational health or public health resources available to HCP who do not have a healthcare provider.</p></li><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Share sick leave policies as well as information about short-term disability and other financial support options.<br></p></li></ul>
Do HCP who have been exposed to MPX, either at work or outside of work, need to be restricted from work?247Do HCP who have been exposed to MPX, either at work or outside of work, need to be restricted from work?<p>​<span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">No. HCP who have been exposed should consult with a provider or </span><a href="/pages/localhealthservicesandoffices.aspx" target="_blank" style="box-sizing:border-box;color:#0071bc;background-color:#ffffff;outline:none;font-family:"source sans pro", sans-serif;font-size:18px;">LHD</a><span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;"> to determine if they qualify for PEP with </span><a href="/Programs/CID/DCDC/Pages/Monkeypox-Vaccines.aspx" target="_blank" style="box-sizing:border-box;color:#0071bc;background-color:#ffffff;outline:none;font-family:"source sans pro", sans-serif;font-size:18px;">JYNNEOS™ vaccine</a><span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">. 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 MPX, they should not come to work and should follow the guidance provided above. If they were exposed to MPX at work, employers should consult the </span><a href="https://www.dir.ca.gov/dosh/dosh_publications/ATD-Guide.pdf" style="box-sizing:border-box;color:#0071bc;background-color:#ffffff;outline:none;font-family:"source sans pro", sans-serif;font-size:18px;">ATD</a><span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;"> (PDF) standard and the </span><a href="https://www.dir.ca.gov/dosh/documents/monkeypox-guidance.pdf" style="box-sizing:border-box;color:#0071bc;background-color:#ffffff;outline:none;font-family:"source sans pro", sans-serif;font-size:18px;">Cal/OSHA Guidance on MPX Virus for Employers Covered by Section 5199</a><span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;"> (PDF) to determine applicable requirements.</span><br></p>
How should healthcare facilities determine the level of risk to patients and other HCP who might have been exposed to a MPX-infected HCP during their infectious period?248How should healthcare facilities determine the level of risk to patients and other HCP who might have been exposed to a MPX-infected HCP during their infectious period?<p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">Although the <a href="https://www.cdc.gov/poxvirus/monkeypox/clinicians/infection-control-healthcare.html" style="box-sizing:border-box;color:#0071bc;background-color:transparent;outline:none;">CDC framework for MPX exposure evaluation</a> is intended for HCP caring for patients with MPX, many of the same principles can be applied when assessing exposure risk to patients and other HCP potentially exposed to a MPX-infected HCP. Exposures warranting patient or co-worker notification, monitoring, and consideration of PEP include:</p><ul style="box-sizing:border-box;margin-top:0px;margin-bottom:10px;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;"><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Unprotected contact between an exposed individual's skin or mucous membranes and the skin lesions or bodily fluids from the MPX-infected HCP or soiled materials (e.g., linens, clothing); or</p></li><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Being within 6 feet for a total of 3 hours or more (cumulative) of an unmasked MPX-infected HCP without wearing a surgical mask or respirator.</p></li></ul><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">For contact tracing to identify exposed patients or co-workers, the exposure period begins at 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 MPX-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 MPX-infected HCP lesions were always covered and <span style="box-sizing:border-box;font-weight:700;">they wore a surgical mask or respirator for COVID-19 source control at all times</span>.<br></p>
When can an HCP with MPX return to work in a healthcare setting?249When can an HCP with MPX return to work in a healthcare setting?<p>​<span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">HCP with MPX should generally 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. 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 </span><a href="https://www.cdc.gov/poxvirus/monkeypox/clinicians/infection-control-healthcare.html" style="box-sizing:border-box;color:#0071bc;background-color:#ffffff;outline:none;font-family:"source sans pro", sans-serif;font-size:18px;">CDC</a><span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">. 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). </span><br></p>

 

 

What is CDPH doing about MPX?211What is CDPH doing about MPX?<p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">C<span style="box-sizing:border-box;font-size:1em;">DPH has activated our public health response coordination center and is closely monitoring MPX transmission in the U.S. and California to ensure rapid identification of cases. CDPH is working 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.</span></p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">Additionally, CDPH is promoting awareness amongst health care providers and the public about appropriate testing and infection control when patients with suspected MPX 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 MPX. <br></p>
Where can I find more information?225Where can I find more information?<p>​<span style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:13.5pt;background-color:#ffffff;line-height:19.26px;">Visit the </span><span style="box-sizing:border-box;color:#202020;background-color:#ffffff;font-size:11pt;line-height:15.6933px;font-family:calibri, sans-serif;"><a href="https://www.cdc.gov/poxvirus/monkeypox/about/index.html" style="box-sizing:border-box;color:#0071bc;background-color:transparent;outline:none;"><span style="box-sizing:border-box;font-size:13.5pt;line-height:19.26px;font-family:"source sans pro", sans-serif;">CDC’s About Monkeypox webpage</span></a></span><span style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:13.5pt;background-color:#ffffff;line-height:19.26px;"> and our </span><span style="box-sizing:border-box;color:#202020;background-color:#ffffff;font-size:11pt;line-height:15.6933px;font-family:calibri, sans-serif;"><a href="/Programs/CID/DCDC/Pages/Monkeypox-Community.aspx" style="box-sizing:border-box;color:#0071bc;background-color:transparent;outline:none;"><span style="box-sizing:border-box;font-size:13.5pt;line-height:19.26px;font-family:"source sans pro", sans-serif;">Community Resources</span></a></span><span style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:13.5pt;background-color:#ffffff;line-height:19.26px;"> page for more information.</span><br></p>

Page Last Updated :