MONKEYPOX
A previous subtype of Clade II caused a global epidemic in 2022, mostly among men with a history of having sex with men. That version affected about 100,000 people and about 200 died before the epidemic burned out. It continues to circulate in the U.S. and flares intermittently.
The more recent virus of concern is a Clade Ib subtype is causing disease in the Democratic Republic of Congo, as well as in Burundi, Central African Republic, Republic of Congo, Rwanda and Uganda. More than 57,000 cases with a higher death rate (nearly 1,200) are associated with this outbreak. Clade Ib previously was known to spread mainly through consumption of contaminated meat or close contact with infected animals and people. Now this virus is spreading sexually.
Mpox is transmitted through close personal contact. The incubation period is three to 17 days, and the illness usually manifests as a painful rash on the hands, feet, chest, face, anus or genitals.
There have been cases in the U.S. in people who have traveled from Africa. The C.D.C. recommends that all people at risk, including sexually active gay and bisexual men and women who have transactional sex, receive two doses of the Jynneos vaccine.
The more recent virus of concern is a Clade Ib subtype is causing disease in the Democratic Republic of Congo, as well as in Burundi, Central African Republic, Republic of Congo, Rwanda and Uganda. More than 57,000 cases with a higher death rate (nearly 1,200) are associated with this outbreak. Clade Ib previously was known to spread mainly through consumption of contaminated meat or close contact with infected animals and people. Now this virus is spreading sexually.
Mpox is transmitted through close personal contact. The incubation period is three to 17 days, and the illness usually manifests as a painful rash on the hands, feet, chest, face, anus or genitals.
There have been cases in the U.S. in people who have traveled from Africa. The C.D.C. recommends that all people at risk, including sexually active gay and bisexual men and women who have transactional sex, receive two doses of the Jynneos vaccine.
Updated Vaccine (JYNNEOS TM) is now available at your local Health Department.
If you believe you have been exposed or may have Monkeypox, OR if you wish to be vaccinated to prevent Monkeypox- please call the Doc Shop at 913-362-0220 or your local Health Department.
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The sores start as red spots, then become blisters and are most often very painful, as with herpes blisters. After healing they may scar.
The pictures we chose to put up front show minimal rash. You may see photos of more severe cases by clicking here...
- MPX Vaccines are available NOW. Call your local health department or the Doc Shop (913-362-0220). Who should be vaccinated to reduce the chance of infection or severe disease with Monkeypox? People who may be at higher risk of serious illness and/or who have an identified risk of exposure. Higher risk-
- * People with immunocompromise
- HIV
- Leukemia
- Lymphoma
- Rheumatoid arthritis, ulcerative colitis or other auto-immune disease
- Post-transplant
- Undergoing radiation or chemotherapy or on anti-rejection or immune suppressive medicines
- * People with a history or presence of skin conditions
- eczema
- burns
- impetigo
- varicella zoster virus infection
- herpes simplex virus infection
- severe acne
- psoriasis
- * Pregnant or breastfeeding women
- Exposure risks-
- * People who have a history of multiple sex partners.
- * People who have had a sexually transmitted disease (Syphilis, Gonorrhea, Chlamydia) within the past year. or Known exposure- * People who are contacts to known cases of Monkeypox. (The vaccine can be administered within the 14 days past last date of exposure if there are no symptoms of disease.)
Monkeypox in the United States.
What is it?Monkeypox is a disease caused by an orthopox virus. Monkeypox virus is part of the same family of viruses as Variola virus, the virus that causes Smallpox. (Recall that Smallpox was eradicated through vaccinations and natural infections have not been seen since 1977 in Somalia.)
What are the signs?Monkeypox symptoms are similar to smallpox symptoms, but usually milder, and monkeypox is not as likely to be fatal. Monkeypox is not related to chickenpox, but the rash looks similar.• During the first 5 days a fever, headache, muscle aches, tiredness and swollen lymph nodes may be present. • Usually within 3 days of the fever, the rash begins to appear. The blisters are usually more concentrated on the face and extremities and may be seen on the palms of the hands and soles of the feet.• After-effects may include chronic tiredness, scarring, loss of vision, fogginess, etc.
More severe symptoms may develop in people with risks including HIV or other immune compromise (undergoing radiation, chemotherapy, organ transplant, etc.)
Who is at risk?Monkeypox is transmitted through large droplets and through close skin-to-skin contact.
Cases have been clustered in men who have sex with men in New York, San Franscisco and elsewhere.
How is it prevented?• Avoid skin-to-skin contact with anyone who has a new rash.• Avoid exposure by using masks, handwashing, etc.• Use condoms during sex.• Do not share eating utensils or cups with others. info from CDC and WHO.
What are the signs?Monkeypox symptoms are similar to smallpox symptoms, but usually milder, and monkeypox is not as likely to be fatal. Monkeypox is not related to chickenpox, but the rash looks similar.• During the first 5 days a fever, headache, muscle aches, tiredness and swollen lymph nodes may be present. • Usually within 3 days of the fever, the rash begins to appear. The blisters are usually more concentrated on the face and extremities and may be seen on the palms of the hands and soles of the feet.• After-effects may include chronic tiredness, scarring, loss of vision, fogginess, etc.
More severe symptoms may develop in people with risks including HIV or other immune compromise (undergoing radiation, chemotherapy, organ transplant, etc.)
Who is at risk?Monkeypox is transmitted through large droplets and through close skin-to-skin contact.
Cases have been clustered in men who have sex with men in New York, San Franscisco and elsewhere.
How is it prevented?• Avoid skin-to-skin contact with anyone who has a new rash.• Avoid exposure by using masks, handwashing, etc.• Use condoms during sex.• Do not share eating utensils or cups with others. info from CDC and WHO.
Vaccines
JYNNEOSTM vaccine is administered as a live virus that is non-replicating (not able to cause disease). It is administered as two subcutaneous injections four weeks apart. There is no visible “take”(unlike the previous smallpox vaccinations of the 1950's) and as a result, no risk for spread to other parts of the body or other people. People who receive JYNNEOS TM are not considered vaccinated until 2 weeks after they receive the second dose of the vaccine.
This vaccine may also be used in treating Monkeypox
CDC recommends that the vaccine be given within 4 days from the date of exposure in order to prevent onset of the disease. If given between 4–14 days after the date of exposure, vaccination may reduce the symptoms of disease, but may not prevent the disease.
On November 18, 2024, the CDC reported MPox infection was identified in the U.S. (California) in a person who had traveled from Africa.
The previous Clade II MPXV that caused a global outbreak in 2022 is continuing to circulate in the U.S. with low levels of infection mostly among men who have sex with men. Due to the potential for an outbreak of one or both of these viruses, the CDC recommends getting vaccinated if you were exposed to monkeypox or are at higher risk of being exposed to monkeypox can help protect you and your community. (Higher risk is defined in part by sexual activity and includes gay and bisexual men and transwomen as well as people who participate in transactional sex (prostitution). 11/2024 SLee
The previous Clade II MPXV that caused a global outbreak in 2022 is continuing to circulate in the U.S. with low levels of infection mostly among men who have sex with men. Due to the potential for an outbreak of one or both of these viruses, the CDC recommends getting vaccinated if you were exposed to monkeypox or are at higher risk of being exposed to monkeypox can help protect you and your community. (Higher risk is defined in part by sexual activity and includes gay and bisexual men and transwomen as well as people who participate in transactional sex (prostitution). 11/2024 SLee
Yes, condoms reduce the chances of getting the sores in sensitive areas. Consider temporarily reducing the number of sexual partners or avoid anonymous sex and sex parties.
Monkeypox in Kansas City-
A few cases were reported in the 2022 outbreak. None since.
There are treatments available if you believe you have been exposed to or have developed Monkeypox.
People at high risk are encouraged to consider vaccination.
Vaccines are now available to exposed individuals in Kansas and Missouri (call your local Health Department).
CDC definition of High Risk Exposures:
Unprotected contact between a person’s skin or mucous membranes and the skin, lesions, or bodily fluids from a MPX patient known to have confirmed or probable monkeypox infection. (Health care contact without gloves. Sexual contact, including kissing - patient saliva to the eyes or oral cavity of a person), or contaminated materials (e.g., linens, clothing)
-OR-Being within 6 feet of a MPX patient during any procedures that may create aerosols from oral secretions, skin lesions, or resuspension of dried exudates (e.g., shaking of soiled linens), without wearing an N95 or equivalent respirator (or higher) and eye protection.
CDC definition of Intermediate Risk Exposures:
Being within 6 feet for 3 hours or more of an unmasked known MPX patient without wearing, at a minimum, a surgical mask
-OR-Health care or other activities resulting in contact between sleeves and other parts of an individual’s clothing and the known MPX patient’s skin lesions or bodily fluids, or their soiled linens or dressings (e.g., turning, bathing, or assisting with transfer) while wearing gloves but not wearing a gown.
Please call the DocShop 913-362-0220 or your local Health Department.
Call if you believe you had exposure to someone with a confirmed or probable case of MPX.
The CDC recommends vaccination for people who have been exposed to monkeypox and people who are at higher risk of being exposed to monkeypox.
TREATMENT
Currently there is no treatment approved specifically for monkeypox virus infections. However, antivirals developed for use in patients with smallpox may prove beneficial against monkeypox. The following medical countermeasures are currently available from the Strategic National Stockpile (SNS) as options for the treatment of monkeypox:
• Tecovirimat (also known as TPOXX, ST-246) is an antiviral medication approved by the FDA for the treatment of smallpox in adults and children. Studies in a variety of animal species have shown that tecovirimat is effective in treating disease caused by orthopoxviruses. Clinical trials in people showed the drug was safe and had only minor side effects. CDC allows for the use of stockpiled tecovirimat to treat monkeypox during an outbreak. Tecovirimat is available as a pill or an injection.
• Vaccinia Immune Globulin Intravenous (VIGIV)VIGIV is licensed by FDA for the treatment of complications due to vaccinia vaccination. It is unknown whether a person with severe monkeypox infection will benefit from treatment with VIG. However, healthcare providers may consider its use in severe cases.
VIG can be considered for prophylactic use in an exposed person with severe immunodeficiency in T-cell function for which smallpox vaccination following exposure to monkeypox virus is contraindicated.
• Cidofovir (also known as Vistide) is an antiviral medication approved by the FDA for the treatment of cytomegalovirus (CMV) retinitis in patients with Acquired Immunodeficiency Syndrome (AIDS). It has been effective against orthopoxviruses in in vitro and animal studies. Renal toxicity may be an issue.
• Brincidofovir (also known as Tembexa) is an antiviral medication approved by the FDA in 2021 for the treatment of human smallpox disease in adult and pediatric patients, including neonates. It has shown to be effective against orthopoxviruses in in vitro and animal studies. Brincidofovir is not currently available from the SNS.
• Vaccinia Immune Globulin Intravenous (VIGIV)VIGIV is licensed by FDA for the treatment of complications due to vaccinia vaccination. It is unknown whether a person with severe monkeypox infection will benefit from treatment with VIG. However, healthcare providers may consider its use in severe cases.
VIG can be considered for prophylactic use in an exposed person with severe immunodeficiency in T-cell function for which smallpox vaccination following exposure to monkeypox virus is contraindicated.
• Cidofovir (also known as Vistide) is an antiviral medication approved by the FDA for the treatment of cytomegalovirus (CMV) retinitis in patients with Acquired Immunodeficiency Syndrome (AIDS). It has been effective against orthopoxviruses in in vitro and animal studies. Renal toxicity may be an issue.
• Brincidofovir (also known as Tembexa) is an antiviral medication approved by the FDA in 2021 for the treatment of human smallpox disease in adult and pediatric patients, including neonates. It has shown to be effective against orthopoxviruses in in vitro and animal studies. Brincidofovir is not currently available from the SNS.