The Doc on Monkeypox in Kansas City
If you believe you have been exposed or may have 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 more severe cases by clicking here...
News Flash 7.28.2022
MPX Vaccines are available, but in our region- exposure must be verified. (Currently small numbers of exposures and the limited number of vaccines are going to higher prevalence areas like NY City.)
Please call 816-513-6152- the Kansas City Missouri Health Department.Missouri’s allotment of JYNNEOS vaccine is only available for use in Missouri to individuals with exposures in the intermediate to high categories (who meet the following criteria):
1- Post-Exposure Prophylaxis (PEP): Individuals who are contacts to laboratory confirmed cases of orthopox/monkeypox virus with the degree of exposures meeting the intermediate or high category.
OR
2- Post-Exposure Prophylaxis (PEP) ++: Individuals who are aware that one of their sexual partners has been diagnosed with monkeypox, but they may not know or be able to provide the individuals name. In addition, individuals who have had multiple sexual partners or other high-risk exposures in areas or locations (ex. clubs, events, etc.) with known monkeypox virus transmission;
ALSO- Date of Last Exposure: The vaccine can be administered within the 14 days past last date of exposure. In addition, the individual has not developed symptoms of monkeypox.
2- Post-Exposure Prophylaxis (PEP) ++: Individuals who are aware that one of their sexual partners has been diagnosed with monkeypox, but they may not know or be able to provide the individuals name. In addition, individuals who have had multiple sexual partners or other high-risk exposures in areas or locations (ex. clubs, events, etc.) with known monkeypox virus transmission;
ALSO- Date of Last Exposure: The vaccine can be administered within the 14 days past last date of exposure. In addition, the individual has not developed symptoms of monkeypox.
Monkeypox is spreading 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.
In New York, with hundreds of cases, "nearly all have been among men who have sex with men, and it appears the virus is mostly transmitting through close, intimate contact. The risk is particularly high if they have multiple sexual partners or are hooking up via apps or at raves."
New York Times
To lower the risk, men who have sex with men can talk to their sex partners about monkeypox and watch for sores. Using a condom will reduce the chances of getting the sores in sensitive areas. Consideration should be to temporarily reduce the number of sexual partners or avoid riskier activities, such as anonymous sex and sex parties. Practicing good hygiene including handwashing helps.
Monkeypox in Kansas City-
One case was reported on June 18, 2022 in KC, MO. Another was reported in JOCO, KS on July 9. There are undoubtedly other unreported cases.
Click above to view the CDC map of reported cases by state.
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 will soon be available to exposed individuals in Kansas and Missouri. Currently most of the vaccines are being sent to New York, San Franscisco and other higher prevalence areas.
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.
If you believe you had exposure to someone with a confirmed or probable case of MPX, please call the KC Health Department at 816-513-6152 or the DocShop at 913-362-0220.
Vaccines
JYNNEOSTM vaccine is administered as a live virus that is non-replicating. It is administered as two subcutaneous injections four weeks apart. There is no visible “take” 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.
Call the DocShop 913-362-0220 or your local Health Department.
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.