Monkeypox (MPV)
The Latest News: HHS Prepares to End Mpox Public Health Emergency
With the low number of cases today, HHS does not expect to renew the emergency declaration when it ends on January 31, 2023. But it response operations will still be run from the White House in 2023.
WHO Renames Monkeypox as "mpox"
On Nov. 29, 2022, the WHO announced that "mpox" is now the preferred name for monkeypox, based on reports of racist and stigmatizing language used online with the disease's original name. Both names will continue to be used for one year as "monkeypox" is gradually phased out. In response, the CDC announced that it is updating its webpages with the term "mpox" throughout.
The WHO also announced that mpox will be included in the online ICD-10 disease classification system beginning in December. It will become a part of the official 2023 release of ICD-11, while "monkeypox" will remain a searchable term to match up with historical information.
About the 2022 Outbreak
The Centers for Disease Control (CDC) has been tracking the spread of mpox in the U.S. As of Dec. 2, there have been 29,603 confirmed mpox cases, but spread has decreased.
The Department of Health and Human Services declared the 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 mpox, regardless of travel or specific risk factors for mpox and regardless of gender or sexual orientation. View CDC FAQs for specific questions.
What Is mpox?
The CDC describes mpox 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 mpox infection for the general population is 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. Mpox can be transmitted during intimate contact and by sustained personal contact and shared bedding/clothing.
How to Recognize Potential mpox Infections
Patients with mpox may present differently and features of the newest monkeypox cases could be confused with sexually transmitted infections (STI). The CDC offers clinical recognition guidance for distinguishing monkeypox from other rash illnesses, or other infections. It also includes information on identifying mpox rash characteristics, incubation period, isolation procedures and treatment.
Given the latest data on the spread of mpox and new evidence about risk of severe illness in people with HIV, CDC is encouraging clinicians to test for co-infection with STI’s in patients who meet one or more of the epidemiologic criteria. It is also encouraged that clinicians include monkeypox on their differential diagnosis for patients presenting with an STI-associated or STI-like rash.
This presentation is designed to address concerns and provide members with guidance and a status update on the U.S. outbreak.
AAFP Senior Vice President of Education, Inclusiveness and Physician Well-Being Margot Savoy, MD, MPH, FAAFP, discusses diagnosis, treatment options, infection prevention strategies and more.
Watch this free 15-minute video and earn .25 CME credits.
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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 mpox virus infections. However, mpox 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 mpox virus infections.
Tecovirimat is a smallpox treatment being used as a first-line medication to treat mpox. 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 mpox remains low, and there are ways to reduce risk even more. The CDC offers guidance on social gatherings and safer sex practices. They also offer tips on infection prevention in healthcare settings.
Two vaccines licensed by the FDA may be used for the prevention of mpox disease – JYNNEOS and ACAM2000. Widespread vaccination is not recommended at this time. The CDC’s interim considerations for mpox vaccine recommends that vaccination be considered for people at high risk for infection to prevent mpox disease.
The FDA has also issued an 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 mpox 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 mpox infection.
View a video on how to administer a JYNNEOS vaccine intradermally.
Clinical Considerations: Children and Adolescents
The CDC has released considerations for the clinical management of mpox 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 mpox, suspected mpox, or confirmed mpox.
- Mpox 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 mpox.
- Treatment should be considered on a case-by-case basis for children and adolescents with suspected or confirmed mpox who are at risk of severe disease or who develop complications of mpox.
Additional Mpox Tools
Updated! What Healthcare Professionals Should Know
CDC/AAMC Clinicians’ Checklist: Clinical Assessment of Patient with Suspected Mpox
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 mpox?” and “How does mpox spread?”
World Health Organization: Mpox
With its origin in Africa, and as cases are increasing in multiple countries, mpox is considered a global outbreak. WHO has additional resources you can reference.
Latest Monkeypox News
- White House Announces New Actions to Combat Monkeypox Outbreak
- FDA Authorizes Emergency Use of JYNNEOS Vaccine to Increase Supply: Healthcare providers can use the vaccine by intradermal injection for individuals 18 years of age and older determined to be at high risk.
- HHS Declares Public Health Emergency in Response to Monkeypox
- Special Session on Monkeypox Now Available for AAFP Members
- President Biden Announces Team to Lead Monkeypox Response
- New codes launch for Monkeypox lab testing, vaccination
- Latest CDC Monkeypox Health Alert Network (HAN) Update
- Public Health Expert Fields Monkeypox Questions
- HHS Expands Availability of Monkeypox Vaccine
- CDC requests providers report vaccine adverse events
- WHO Declares Monkeypox Outbreak Represents a Public Health Emergency of International Concern