• Monkeypox (MPV)

    The Latest News: FDA Authorizes Emergency Use of JYNNEOS Vaccine to Increase Vaccine Supply

    The vaccine EUA issued on Aug. 9 allows healthcare providers to use the vaccine by intradermal injection for individuals 18 years of age and older who are determined to be at high risk for monkeypox infection. This will increase the total number of doses available. The AAFP is reviewing the EUA for Jynneos. Read more in AAFP Reviewing Federal Action on Monkeypox Vaccine Supply.

    About the 2022 Outbreak

    The Centers for Disease Control (CDC) has been tracking the spread of monkeypox (MPV) in the U.S. As of August 12, there were more than 10,700 confirmed monkeypox cases in 49 states, Washington, D.C., and Puerto Rico, and continuing to increase.

    The Department of Health and Human Services declared the monkeypox outbreak a Public Health Emergency. After experiencing the COVID-19 pandemic, people are concerned and want to know what it means to their families. 

    Clinicians should be alert for patients who have rash illnesses consistent with monkeypox, regardless of travel or specific risk factors for monkeypox and regardless of gender or sexual orientation. View CDC FAQs for specific questions

    Hear the most recent information in the CDC's July 26 Updates on the Epidemiology, Testing, Treatment, and Vaccination call. 

    What Is Monkeypox? 

    The CDC describes monkeypox as a rare, infectious disease that is most often mild. Monkeypox virus is part of the same family of viruses as smallpox, and is endemic in certain African countries. It's not as easily transmittable as viruses like COVID-19. 

    The risk of monkeypox infection for the general population is still fairly low. Early data from the outbreak suggested that men who have sex with men made up a high proportion of total cases; however, anyone who has been in close contact with someone who has monkeypox is at risk. Monkeypox is not considered a sexually transmitted infection, but it can be transmitted during sexual and intimate contact, and with sustained personal contact and shared bedding/clothing

    How to Recognize Potential MPV Infections 

    Patients may present differently. The CDC offers clinical recognition guidance for distinguishing monkeypox from other rash illnesses, or other infections. It also includes information on identifying monkeypox rash characteristics, incubation period, isolation procedures and treatment. The AAFP continues to review information from CDC and other health care partners to share with our members.

    Emerging Infections Update: Monkeypox Virus

    Family physicians are likely to be among the first health care professionals in the country to care for patients with monkeypox.

    The following presentation is designed to address concerns and provide members with guidance and a status update on the outbreak in the United States.

    AAFP Senior Vice President of Education, Inclusiveness and Physician Well-Being Margot Savoy, MD, MPH, FAAFP, discusses a variety of topics including diagnosis, treatment options, infection prevention strategies and more.

    Watch this free 15-minute video and earn .25 CME credits.

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    Emerging Infections Update Title Slide

    Signs & Symptoms

    Most infected people have mild cases, but there is risk for serious disease. 

    • Fever
    • Headache
    • Muscle aches and backache
    • Swollen lymph nodes
    • Chills
    • Exhaustion
    • A rash that can look like pimples or blisters that appears on the face, inside the mouth, and on other parts of the body, like the hands, feet, chest, genitals, or anus.

    Sometimes, people get a rash first, followed by other symptoms. Others only experience a rash. 

    Treatment Guidance

    There are no treatments specifically for monkeypox virus infections. However, monkeypox and smallpox viruses are genetically similar, which means that antiviral drugs and vaccines developed to protect against smallpox may be used to prevent and treat monkeypox virus infections.

    Tecovirimat is a smallpox treatment being used as a first-line medication to treat monkeypox. Tecovirimat has been made available under the expanded access investigational new drug (EA-IND) from the Strategic National Stockpile.

    For more information, see CDC’s website for Interim Clinical Guidance for the Treatment of Monkeypox and Obtaining and Using TPOXX (Tecovirimat).

     


    Prevention & Vaccines

    The risk to most people from monkeypox remains low, and there are many things you can do to reduce your risk even more. The CDC offers guidance on social gatherings and safer sex practices

    Two vaccines licensed by the FDA may be used for the prevention of monkeypox disease – JYNNEOS and ACAM2000. However, widespread vaccination is not recommended at this time. The CDC’s interim considerations for monkeypox vaccine recommends that vaccination can be considered for people determined to be at high risk for infection to prevent monkeypox disease.

    The FDA has also issued an Emergency Use Authorization (EUA) for the emergency use of JYNNEOS for:

    • Active immunization by intradermal injection for prevention of monkeypox disease in individuals 18 years of age and older determined to be at high risk for monkeypox infection.
    • Active immunization by subcutaneous injection for prevention of monkeypox disease in individuals less than 18 years of age determined to be at high risk for monkeypox infection.


    Clinical Considerations: Children and Adolescents

    The CDC has released considerations for the clinical management of monkeypox in children and adolescents younger than 18 years old. These are intended to help U.S. clinicians and health systems develop a plan for managing children and adolescents with exposure to monkeypox, suspected monkeypox, or confirmed monkeypox.

    • Monkeypox should be considered when children or adolescents present with a rash that could be consistent with the disease, especially if epidemiologic criteria are present.
    • Young children, children with eczema and other skin conditions, and children with immunocompromising conditions may be at increased risk of severe disease when they contract monkeypox.
    • Treatment should be considered on a case-by-case basis for children and adolescents with suspected or confirmed monkeypox who are at risk of severe disease or who develop complications of monkeypox.


    Additional Monkeypox Tools 

    CDC/AAMC Clinicians’ Checklist: Clinical Assessment of Patient with Suspected Monkeypox

    This clinician checklist includes information on:

    • Preparing for Possible Cases
    • Guidelines for Rash or Lesion Specimen Collecting
    • How to Manage a Suspected Case
    • Instructions for Patients While Test Results are Pending
    • Treatment Protocol

    Public Health Collaborative: Answers to Tough Questions

    Public Health Collaborative has updated Answers to Tough Questions with new messaging to help you answer questions like “What is monkeypox?” and “How does monkeypox spread?” 

    World Health Organization: Monkeypox

    With its origin in Africa, and as cases are increasing in multiple countries, MPV is considered a global outbreak. WHO has additional resources you can reference.