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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 (formerly known as monkeypox) 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.​

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. Most cases in the United States have occurred in gay, bisexual, transgender, and other men who have sex with men, with some cases found to be infected through household contact to people infected with mpox.

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 in the current global outbreak, including California, 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. ​​

Go to Q&A: Mpox Symptoms

Does mpox have variants? 

There are two types of mpox: clade I and clade II. The clade identified in Europe and in the United States outbreaks is the West African clade (clade II), 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 can cause more severe illness. Clade I associated mpox infections have not been identified outside of 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. The mpox vaccine is believed to be effective against both clade II and clade I mpox.

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

To date, there is very low transmission of mpox in the general population, including in children. Of the handful of probable or confirmed mpox cases in children, spread has usually been through shared household contact to someone infected with mpox.

Can animals or pets get mpox? 

The primary route of transmission in the current global outbreak has been human to human contact, but other mammals have been known to carry mpox. Mpox transmission from infected animals in West and Central Africa has been documented (e.g., getting scratched, bitten, or while handling animal bodies or fluids such as during hunting and trapping) and a 2003 mpox outbreak in the U.S.​ was associated with imported pet prairie dogs.

While CDC and CDPH do not believe that mpox currently poses a high risk to pets, persons with mpox should avoid contact with animals and ask another household member or outside friend/family member to care for pets until they are fully recovered. Transmission of mpox between people and animals can potentially occur through close contact, including petting, cuddling, and sharing sleeping areas or food. For pets in the home, visit  CDC | Pets & Mpox.​​

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)
  • Transmission from a pregnant person with mpox to the fetus during pregnancy or the newborn during delivery

To date, there has been no evidence that mpox is spread by casual contact with other people such as attending an outdoor event with fully clothed people, trying on clothes or shoes at the store, traveling on a plane or other public transit, swimming in a pool or body of water, or going to other public settings (grocery store, restaurants, workplaces, restrooms). See CDC | How Mpox Spreads for more information. 

Go to Q&A: Mpox Symptoms | If You Have Been Exposed​ | Mpox Prevention

When is mpox contagious? 

Mpox symptoms can start anywhere from 3 days to 3 weeks after exposure to the virus. A person with mpox can spread it to others from before symptoms start until all sores have healed, scabs have fallen off, and a fresh layer of skin has formed underneath, which can take several weeks (CDC | How it Spreads).

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 contact with contaminated materials like utensils, cups, bedding, towels, clothing, or sex toys. 

While helpful, condoms alone cannot adequately protect against mpox since the rash can occur on different parts of the body. Mpox has been found in semen, but scientists are still investigating whether the virus could be spread by exposure to semen or vaginal fluids. For more information on how to protect yourself, see CDPH Factsheet: Safer Sex and Mpox  (PDF). 

Does all STI testing include a mpox test?

Not usually - only persons who have mpox symptoms can be tested for mpox, which is done with a swab of the rash or sore(s). 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 is recommended that people being evaluated for mpox also get tested for HIV and STIs, as 35-40% of those reported to have mpox infections have also had HIV or a STI.

It's always important to talk to a health care provider as soon as you notice unusual rashes or sores or have rectal pain. Visit CDC GetTested to find STI testing near you.

What are the signs and symptoms? 

Mpox can often start with symptoms like the flu, with fever, low energy, swollen lymph nodes, and general body aches. Most persons with mpox will then go on to develop a rash or sores, usually within several days. However, some people have reported developing the rash or sores before or without other symptoms. 

The 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.  The rash or sores can look like pimples or blisters and can go through several stages, including scabs, before healing. They may be painful or itchy. Sometimes the sores can be in places that are difficult for someone to see, and they can look similar to other illnesses like herpes or cold sores. ​

What should I do if I have symptoms of mpox?

If you have symptoms, getting tested for mpox and sexually transmitted infections is strong​​ly encouraged to help identify infections, get treatment, and prevent infections in others. 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. See CDC | GetTested to find a clinic near you.

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. See CDC | What to Do If You Are Sick and CDC | Isolation and Infection Control at Home for more information on isolation and preventing spread to others.​

How is mpox prevented? 

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

  • Getting vaccinated if you may be at risk for mpox. For the most protection, make sure you get both vaccine doses—find a vaccinating provider near you. 
  • 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 with people who have symptoms. If someone has a rash or sores that look like mpox, avoid skin-to-skin contact such as hugging, kissing, cuddling and sexual activity.
  • Not sharing materials (e.g., towels, fetish gear, sex toys, and toothbrushes) with someone who has mpox.
  • Washing your hands often with soap and water or using an alcohol-based hand sanitizer.
  • Protecting yourself when caring for someone with mpox by using appropriate PPE (like a mask, gown and gloves).
  • If you have mpox, preventing spread to others: Prevent spread to others by isolating away from others until the rash is healed, cleaning and disinfecting shared areas in the home, and notifying close contacts who may have been exposed. See CDC | If You Are Sick for more information.
  • If you have been exposed to mpox, taking precautions: It is recommended to monitor yourself for symptoms and avoid close, personal or intimate contact with others for 21 days after exposure; getting vaccinated right after exposure may also prevent infection. If you notice any rash or sores, get tested. See CDC | If You’re a Close Contact for more information.

See CDPH Safer Sex & Mpox​ (PDF) and CDC | Safer Sex, Social Gatherings, and Mpox for information on how to lower your chances of getting mpox from sexual or intimate activities. For more information, see CDC | Mpox Prevention​​.

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

If you have been exposed to mpox, it is highly recommended to monitor for symptoms and avoid close, personal or intimate contact—including sex—with others for 21 days after the exposure. It can take anywhere from 3 days to 3 weeks after exposure for symptoms to develop.​

The mpox vaccine can be given to an unvaccinated person right after an mpox exposure as post-exposure prophylaxis (PEP) to prevent mpox infection. If given within 4 days from the exposure, the vaccine may prevent mpox infection; if given 5-14 days after the exposure, the vaccine may not prevent infection but may still prevent severe symptoms. See the CDPH Mpox Vaccine page to find a vaccinating provider near you or call your local health department for assistance getting the vaccine after exposure.

See CDC | If You’re a Close Contact for more information. For post-exposure monitoring recommendations, see CDC Mpox Monitoring and Risk Assessment for Persons Exposed in the Community​.​

What is the mpox vaccine? 

What is the mpox vaccine? 

JYNNEOS vaccine is approved by the U.S. Food and Drug Administration (FDA) to prevent both mpox and smallpox. CDC and CDPH recommend vaccination to people who may be at risk for mpox and for certain people who have been exposed to mpox (e.g., recent partners, household members, and certain healthcare workers).​​

Vaccination is an important tool in preventing mpox and also provides protection against severe illness from mpox. See CDPH Mpox Vaccination​ to find a vaccinating provider near you. ​​

Who is currently recommended to receive the vaccine? 

Any person who MAY be at risk for mpox infection​ or who requests the vaccine may receive vaccination without having to report specific risk factors.

To prevent mpox after exposure: CDC recommends the mpox vaccine as post-exposure prophylaxis (PEP) for unvaccinated persons promptly after certain types of exposure to mpox. The vaccine may prevent mpox infection if given within 4 days of exposure; if given 4-14 days after the exposure, the vaccine may prevent severe symptoms but may not prevent infection. See the CDPH Vaccine page to find a vaccinating provider near you or call your local health department for assistance getting the vaccine after an exposure.

Routine prevention before possible exposure: CDC also recommends preventive vaccination against mpox for individuals who may be at risk given their personal or partner(s) health history:

  • Gay, bisexual, or other men who have sex with men and transgender, nonbinary, or gender-diverse persons who:
    • Have more than one sex partner or anticipating having more than one sex partner or
    • Have a recent diagnosis of chlamydia, gonorrhea, or syphilis in the past 6 months
  • Persons who, in the past 6 months, had or anticipate having sex at a commercial sex venue (like a sex club or bathhouse) or sex related to a large commercial event where mpox transmission may occur
  • Persons who have a sex partner with any of the above risks or who anticipate experiencing any of the above scenarios
  • Persons who are at risk for occupational exposure to orthopoxviruses (e.g., certain people who work in a laboratory or a healthcare facility)
Note​: Persons who have HIV, are immunosuppressed, or who have significant skin conditions (e.g., eczema) are at risk for more severe mpox illness. Vaccination may be particularly important for these persons if they experience or anticipate any of the above scenarios.

How can I get the vaccine?

See the CDPH Mpox Vaccination page to find a vaccinating provider near you.

Healthcare providers and public health jurisdictions should refer to the CDPH Immunization Branch EZIZ Mpox Vaccination Resources​ for up-to-date information about JYNNEOS vaccine ordering, administration, and other resources.

How protected am I after getting the vaccine? 

Mpox vaccination provides protection against severe illness resulting from mpox and most reported mpox infections have occurred in persons who are unvaccinated.

Reported infections are rare in fully vaccinated persons. Studies show that a single vaccine dose can lower your risk of getting mpox by 75% and that two doses can lower your risk up to 86% (CDC | JYNNEOS Vaccine Effectiveness​). Studies have also shown that if infections do occur, infections in vaccinated persons are less severe than infections in unvaccinated persons.

People are considered fully vaccinated 2 weeks after their second dose. Vaccinated individuals are still recommended to consider additional measures to protect themselves from mpox, and to seek care for mpox testing if they have a rash or other symptoms. CDPH will continue to monitor the effectiveness of the JYNNEOS vaccine during the current outbreak.

What if I still need my second dose?

The second dose of JYNNEOS should be given at least 28 days after the first dose.  If it has been more than 28 days since your first dose, you may still get the second dose to complete the vaccine series. However, 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?

Persons for whom mpox vaccine is not recommended:

  • People who have had a serious allergic reaction to a previous dose of the JYNNEOS vaccine or a component in the vaccine 
  • ​People with mpox symptoms or persons who have tested positive for mpox

Talk with your provider if you have questions about getting the vaccine, are currently feeling ill/sick, are pregnant or breastfeeding, or have a history of allergic reaction to the gentamicin, ciprofloxacin, chicken, or egg protein. See CDC Mpox Vaccine Recommendations​ for more information.

Can I get the vaccine if I have a weakened immune system?

Yes. JYNNEOS vaccine is non-replicating so persons who are immunocompromised, including persons with HIV or AIDS, may receive the vaccine. People who are immunosuppressed are more at risk for severe disease and complications if they get infected with 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. ​​​​

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. 

Go to Q&A: Mpox Treatment

How do I prevent spreading mpox to others?

Because mpox is contagious until all scabs fall off and heal over, CDC recommends that people with mpox remain isolated at home away from others (including pets) for the duration of illness.

The public health worker will discuss isolation with you as it depends on several different factors. For general information about how to prevent household mpox transmission including cleaning, see CDC | Isolation and Infection Control At Home​.

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 for any items that may be contaminated.

Visit CDC | Mpox Cleaning and Disinfecting​ for more information, including details on which type of disinfectants to use.

How can I tell my partner(s) or others that they were exposed?

If you believe you may have exposed someone to mpox while you were infectious, you can let them know anonymously (consider using tellyourpartner.org​​). The health department may also assist you in notifying persons who may have been exposed.

Notifying exposed persons is important so they can monitor for any symptoms, get vaccinated, and know to get tested if they currently have or develop symptoms. See CDC | If You’re a Close Contact​ for more information or talk with the public health worker if you have questions.

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 notifications 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?

Supportive care and pain management: Most mpox infections are mild and heal without any treatment. If you are experiencing pain or irritation due to the mpox rash or sores, talk to your health care provider. They may be able to offer over-the-counter or prescription 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.

Skin care and self-care are also important to promote healing—see CDC What to Do If You Are Sick – Taking Care of Yourself​ for more information.

Antiviral medication: Antiviral drugs, such as tecovirimat (TPOXX), may also be used to treat mpox. TPOXX is thought to reduce the amount of mpox virus in the body and is prescribed most often for people with severe mpox infection or who are likely to get severely ill. Data about TPOXX for treatment of mpox in people is still limited, so the medication is only available through a clinical trial or for certain patients through a special prescription protocol (experimental compassionate use):

  • Oral TPOXX (pills) is primarily available through a clinical trial called Study of Tecovirimat for Human Monkeypox Virus (STOMP)​. The study is open to individuals with suspected or confirmed mpox, regardless of mpox disease severity. Individuals are given either placebo (sugar pill) or treatment (TPOXX) medication. Individuals are monitored closely while in the study and if they develop worsening of symptoms, they will be given TPOXX. Providers may refer patients to the study or individuals can self-enroll in the study.
  • ​Less commonly, providers may prescribe oral or IV TPOXX to certain patients who meet specific clinical criteria for severe disease or risk of severe disease.

TPOXX information for patients with mpox:

Talk with your provider if you have questions about treatment for mpox.

Where can healthcare providers find more information about mpox treatment?

Many patients with mpox have a mild, self-limited disease and recover without medical intervention. Supportive Care should be initiated for all patients who have mpox symptoms. This may include topical or systemic medications or other clinical interventions to control pain, itching, nausea and vomiting. Patients should be monitored closely to ensure resolution of illness without complications that would require further intervention.

Antiviral treatment, such as Tecovirimat (TPOXX), may be used to treat mpox. While there is currently no treatment approved specifically for mpox, antivirals developed for use in smallpox are available and may be beneficial against mpox. Treatment should be considered for patients with severe disease or at risk for severe disease; enrollment in the clinical trial is open to individuals regardless of disease severity. See the CDC Emergency Authorization Investigational New Drug (EA-IND) Protocol for ongoing updates, including eligibility criteria.

  • At this time, oral TPOXX is available primarily through referral to the NIAD-funded clinical trial STOMP (Study of Tecovirimat for Human Monkeypox Virus). Patients with suspected or confirmed mpox should be informed about STOMP. Providers may refer patients to the study or patients may self-enroll in the study. See STOMP Informational Handout for Providers (PDF) and STOMP Informational Handouts for Patients from CAPTC.
  • ​For patients who meet specified clinical eligibility criteria and are either not eligible for STOMP or who decline to participate, oral and IV TPOXX may be prescribed through CDC EA-IND protocol. TPOXX prescribed through this protocol is fulfilled through pre-positioned or stockpiled supplies in consultation with your local health jurisdiction. See CDPH Mpox Tecovirimat Treatment Information for Providers​ for more information on how to obtain TPOXX.

Treatment resources for providers:

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 Disease Standard (Title 8 Section 5199) (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, local health departments will typically lead the response efforts for potential exposures and advise 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 Infection Control in Healthcare Settings guidance for mpox. This Q&A provides some California-specific considerations for implementing CDC's guidance.
Mpox is considered an aerosol transmissible disease covered by the Cal/OSHA Aerosol Transmissible Diseases (ATD) Standard (PDF) and applicable settings should consult those regulations for additional requirements—see Cal/OSHA: Protecting Workers from Mpox for Employers and Workers Covered by the Aerosol Transmissible Disease Standard (Title 8 Section 5199)​ (PDF). CDPH recommends providing information about mpox to all HCP and that all healthcare facilities incorporate this information into their ATD exposure control plans. 

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, and 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, or shelters, although some principles may apply. See CDPH Mpox Guidance for Congregate Living Settings and CDC | Considerations for Reducing Mpox Transmission in Congregate Settings​.​

What preventative measures should healthcare staff consider when providing care for a patient with confirmed or suspected mpox?

Facilities should have written infection control plans or procedures in accordance with applicable regulations such as Cal/OSHA: Protecting Workers from Mpox for Employers and Workers Covered by the Aerosol Transmissible Disease Standard (Title 8 Section 5199) (PDF) and Cal/OSHA Bloodborne Pathogen Standards​.
Recommendations for preventing mpox transmission include:
  1. Ensure procedures to identify and respond to suspected mpox cases as per the Cal/OSHA ATD Standard
    • ​Outpatient cases generally do not need to be transferred to a facility for the purposes of airborne isolation only, unless otherwise directed by the local health officer. Transport of patients should be limited to medically essential purposes.​
    • Generally, if AIIR is not available: a patient with suspected or confirmed mpox should be roomed quickly to a single-person room (with dedicated bathroom if possible) and the door should be kept closed if safe to do so.
    • Airborne isolation rooms should be used when possible and available for facilities as outlined in the ATD Standard.​​
  2. Ensure that patients with suspected or confirmed mpox wear face coverings and use other source control (e.g., clothing or bandage to cover lesions).
  3. ​Ensure health care providers (HCP) caring for patients with suspected or confirmed mpox use appropriate PPE.
  4. Ensure environmental infection control procedures are in place.
    • Staff involved in cleaning/disinfecting of the room are wearing appropriate PPE (including gown, gloves, eyewear, and fit-tested N95 or higher).
    • Establish procedures for handling contaminated laundry and cleaning, so that activities which may resuspend infectious particles from lesions (e.g., fanning, dusting, sweeping) are avoided.
    • See CDC Environmental Infection Control​ for more information.
​See the California Prevention Training Center's Preventing Occupational Mpox Transmission in Outpatient Clinics for real-world strategies for clinics to care for patients with mpox as safely and effectively as possible when space or resources are limited. 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.
See​ Cal/OSHA Safety and Health Training and Instruction Requirements for Employers​​ for suggested educational materials, the types of workers needing training, and the required frequency of that training. Additional workplace safety questions can be directed to Cal/OSHA Consultation Services: Toll-free assistance number 1(800) 963-9424 or email infoCons@dir.ca.gov.

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 for aerosol-generating procedures such as intubation or extubation, which should be performed in airborne infection isolation rooms. Mpox is considered an aerosol transmissible disease covered by the Cal/OSHA ATD Standard​ (PDF) and ATD-covered settings should therefore reference Cal/OSHA for employer-specific requirements and infection control procedures for aerosol transmissible diseases in their setting—see Cal/OSHA Protecting Workers from Mpox for Employers and Workers Covered by the Aerosol Transmissible Disease Standard (Title 8 Section 5199) (PDF).

What information should be given to all HCP to prevent mpox transmission after an on-site exposure? 

  • ​Provide information (e.g., fact sheets) 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. Consult the local health department (LHD)​ and see the CDC's Recommendations for PEP for 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 information about occupational health or public health resources (PDF) available to staff who do not have a healthcare provider.
  • Share sick leave policies as well as information about short-term disability and other financial support options.
  • ATD-covered settings should reference Cal/OSHA: Protecting Workers from Mpox for Employers and Workers Covered by the Aerosol Transmissible Disease Standard (Title 8 Section 5199) (PDF).

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

No. HCP who have been exposed should consult with a provider or  LHD  to determine if post-exposure prophylaxis (PEP) with the JYNNEOS vaccine is recommended​. 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.
Employers subject to the Cal/OSHA Bloodborne Pathogen Standards and the Cal/OSHA Aerosol Transmissible Diseases (ATD) Standard​ (PDF) should consult those regulations for additional applicable requirements. See Cal/OSHA: Protecting Workers from Mpox for Employers and Workers Covered by the Aerosol Transmissible Disease Standard (Title 8 Section 5199) ​(PDF) for more information and reference CDC Infection Control in Health Settings​​ for 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 HCP with mpox infection?

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 HCP with mpox infection.
​For contact tracing, the infectious window for mpox begins 4 days prior to symptom onset and ends when all lesions are healed (i.e., 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 of the 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 HCP with mpox was maintaining adequate source control (with lesions always covered and by wearing a surgical mask or respirator).

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

Ideally, 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 CDC Infection Prevention and Control of Mpox in Healthcare Settings​ and  CDPH Mpox Disease Medical Waste Management – Interim Guidelines​. Note: As of March 2024, clade I mpox virus (MPXV) specimens are now classified as a Category B infectious substance similar to clade II MPXV (except for clade I MPXV viral cultures, which remain Category A). See Safety Advisory Notice: Classification of MPXV Diagnostic Samples and Waste​.

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, communications, laboratory testing, contact tracing, obtaining vaccine to support local vaccination efforts, 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. Talk with a healthcare provider if you have questions about your health.
For more information: See CDC About Mpox and CDPH Community Mpox Guidance.
For providers, laboratories, and local health departments: See CDPH Mpox Guidance​.

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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