Human Monkeypox

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• Who should get vaccinated?

  The Centers for Disease Control and Prevention (CDC) recommends vaccination for people who have been exposed to monkeypox and people who may be more likely to get monkeypox, including:

  • People who may have been identified by public health officials as a contact of someone with monkeypox; or
  • People who know one of their sexual partners in the past 2 weeks has been diagnosed with monkeypox; or
  • People who had multiple sexual partners in the past 2 weeks in an area with known monkeypox. 

  Based on CDC and the California Department of Public Health (CDPH) guidance, the County of San Diego is currently prioritizing vaccination for:

  • People who have been identified by known cases as intimate or otherwise close contacts of a person diagnosed with monkeypox.
  • Those who have been intimate or otherwise had skin-to-skin contact with a person who has a monkeypox-like rash.
• Where can I get vaccinated?

  The vaccine is in limited supply.  Please continue to monitor this webpage for upcoming vaccination opportunities.

   

• How can I schedule my second dose of monkeypox vaccine?

  The federal supply of monkeypox vaccine remains limited. The public health priority is to administer a first dose of vaccine to eligible individuals who are at risk for monkeypox exposure. When the vaccine supply improves, the County of San Diego will make second doses available.

  Please continue to check our website, at www.sandiegocounty.gov/monkeypoxsd, for updated information about vaccine availability.

• How are vaccine doses allocated to local health jurisdictions (LHJ) in California?

  The CDPH allocates a certain number of doses per LHJ. Various formulas are used to allocate the limited number of monkeypox vaccines to LHJs. To determine populations at highest risk of monkeypox transmission, the formulas include the number of early syphilis cases among men as a proxy. The County of San Diego does not determine this formula.

  Given the continued limited supply of the Jynneos vaccine, the County of San Diego will provide first doses to offer protection to more at-risk San Diegans. This is the best strategy until an adequate vaccine supply is received. Additionally, this single dose strategy is consistent with the monkeypox vaccine distribution strategy taken in the California Department of Public Health, New York, United Kingdom (UK), and Canada.

• I have been exposed to monkeypox. What should I do?
  • Monitor for symptoms. 
  • Let partner(s) know you have been exposed.
  • Limit close physical contacts during this time.
  • Call your healthcare provider, or 2-1-1, if you do not have a healthcare provider. If you develop symptoms, see a healthcare provider as soon as possible. 
  • Seek out a vaccine if you are told by your partner that they have monkeypox, or someone contacts you to tell you that you were exposed. 
    • We know there are many more people in the LGBTQ+ community who need protection from the vaccine and should get it. Because we have such limited vaccines, we are temporarily asking everyone to prioritize those who have a direct exposure. 
    • Getting a vaccine soon after exposure – ideally within 4 days but up to 14 days after – can help prevent you from becoming infected with the monkeypox virus.
• How do you test for monkeypox?
  • You must have a rash with fluid-filled lesions similar to blisters to get a monkeypox test.
  • The monkeypox test is done on your skin with a swab at a clinic by a health care provider. The swab is rubbed against lesions on your skin, or parts of your rash, and then sent to a specialized lab for monkeypox testing. 
  • A preliminary lab test result should be available in a few days. While you are waiting, be sure to take steps to care for yourself and others: 
    • Stay home and away from others. 
    • Put off travel on public transportation and domestic and international travel.
    • Contact your sex partner(s) and people you have had close contact with since the start of your symptoms.
    • Protect any pets.
• Is there treatment for monkeypox?
  • Most people get well from monkeypox without needing any medicines or other treatment. 
  • Vaccination is not a treatment for monkeypox. If you test positive, you are not a candidate for vaccination, but there are other treatment options. 
  • The U.S. Food and Drug Administration (FDA) has approved Tecovirimat (TPOXX or ST-246) as a treatment for Monkeypox and it is available from healthcare providers. 
  • There are other options to help control outbreaks of monkeypox. To learn more about the other treatment options, visit the CDC Monkeypox | Treatment webpage.
  • Always consult your healthcare provider before seeking or using any medical treatment.
• How can I reduce my chances of getting monkeypox from somebody else?
  • Ask your partners about recent illnesses or rashes. Delay or defer close or intimate contact if they have a rash or have been recently sick. 
  • If you are in one of the high-risk populations listed above, consider getting vaccinated.
  • Condoms can help reduce your chance of STIs, but they are not known to reduce the spread of monkeypox. You may be exposed to the virus through bedding, clothing or other physical contact that is not necessarily sexual.
• How can I prevent the spread of monkeypox?

  To prevent the spread of monkeypox:

  • If you have a rash or feel ill, stay home and contact your healthcare provider, if necessary, especially if you may have been previously exposed to monkeypox. 
  • Practice good hand hygiene after contact with potentially infected animals or humans. Wash your hands with soap and water or use an alcohol-based sanitizer. 
  • Avoid contact with materials (e.g., bedding or laundry) that have been in contact with a sick person or animal. 
  • If you take care of patients, use appropriate personal protective equipment (PPE), which includes a gown, gloves, respirator, and eye protection. 
  • Rapid identification and reporting of possible cases or suspected exposure.

  If you have symptoms of monkeypox, contact your healthcare provider. If you do not have a healthcare provider, call 2-1-1 San Diego for information about getting access to a healthcare provider near you.

  Read Frequently Asked Questions for more information.

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• Should I be concerned?

  The Centers for Disease Control and Prevention (CDC) states that based on the limited information available, the risk appears to be small. If you have symptoms of monkeypox, contact your healthcare provider right away. 
  

  The CDC is working with state and local health officials to identify people who have been in contact with monkeypox. This is to help prevent the spread of disease and to monitor the health of individuals who tested positive for monkeypox. It is important to address disease outbreaks while the risk is small to prevent larger outbreaks.

• What are the symptoms?

  Visual Examples of Monkeypox Rash

  

  Photo Credit: NHS England High Consequence Infectious Disease Network

  In humans, the symptoms of monkeypox are similar to, but milder than, the signs and symptoms of smallpox.

  Monkeypox symptoms begin with: 

  • Fever 
  • Headache 
  • Muscle aches
  • Backache
  • Swollen lymph nodes
  • Chills 
  • Exhaustion

  Within 1 to 3 days (sometimes longer) after the appearance of fever, a rash develops, often beginning on the face and then spreading to other parts of the body (like the extremities and genital areas).

  The incubation period (time from infection to symptoms) for monkeypox is usually 7-14 days but can range from 5-21 days. The illness typically lasts for 2-4 weeks. 

  Anyone who has symptoms of monkeypox, such as unusual rashes or lesions, should contact a healthcare provider right away. 

  Painful lesions progress through the following stages before falling off:

  • Macules (flat, discolored areas of skin)
  • Papules (solid or cystic raised spot on the skin that is less than 1 centimeter wide).  
  • Vesicles (small fluid-filled blisters on the skin)
  • Pustules (small, inflamed, pus-filled, blister-like sores on the skin)
  • Scabs
• Will wearing a condom prevent people from getting monkeypox?
  • Condoms during sex are an important way to protect yourself and others from HIV and other STIs like gonorrhea, chlamydia, and syphilis. 
  • We do not know yet whether condoms reduce the risk of getting or giving someone else monkeypox during sex. 
  • While we learn more about how the monkeypox virus is spread, we want everyone to know that monkeypox can be spread during any close physical contact, including sex; face-to-face coughing or sneezing, kissing, or licking, skin-to-skin rubbing, or sharing sex toys, bedding, towels, clothing, or utensils, among other ways.
• If I had the smallpox vaccine, am I protected from monkeypox?
  • Monkeypox and smallpox are in the same family of viruses. 
  • According to the CDC, since monkeypox is closely related to the virus that causes smallpox, the smallpox vaccine can protect you from getting monkeypox.

  However, if you have been exposed to monkeypox and it has been three years or more since your smallpox vaccine, you should think about getting a monkeypox vaccine.

• How long is an infected person contagious?

  • You are able to spread monkeypox to other people from the start of your symptoms (like feeling like you have the flu) or the start of a rash, until all scabs have fallen off and new skin covers all the monkeypox spots.
  • This can take 2 to 4 weeks.

• Where can I get more information?

  County of San Diego

  • 2-1-1 San Diego
  • County News Center
    • County Working with LGBTQ Leaders to Prevent Spread of Monkeypox, Vaccinate People at Higher Risk (July 25, 2022) 
    • Men Who Have Sex with Men Encouraged to Protect Themselves from Monkeypox (July 12, 2022)
    • County Identifies Third Probable Case of hMPXV (June 17, 2022).
    • Two Probable Cases of Monkeypox Identified in San Diego County (June 15, 2022).

  CDPH

  • Monkeypox—Transmission

  CDC

  • Monkeypox 2022 Cases
  • About Monkeypox
  • Monkeypox Treatment
  • Signs and Symptoms
  • Clinical Recognition
  • Travelers’ Health-Smallpox and Other Orthopoxvirus-Associated Infections
    • Monkeypox in Multiple Countries—Level 2, Practice Enhanced Precautions
  • Social Gatherings, Safe Sex, and Monkeypox
  • Health Equity Guiding Principles for Inclusive Information.
  • Reducing Stigma in Monkeypox Communication and Community Engagement.
  • Summer 2022 Health Tips for Gay and Bisexual Men.
  • Preventing Monkeypox Spread in Congregate Settings

  FDA

  • FDA Approves the First Drug with an Indication for Treatment of Smallpox.

  World Health Organization (WHO)

  • Monkeypox

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• Actions Requested

  1. Consider a diagnosis of monkeypox in people who present with an unusual or characteristic rash and who in the month preceding illness:

  • Reports having contact with a person or people with a similar appearing rash or who received a diagnosis of confirmed or probable monkeypox or
  • Had close or intimate in-person contact with individuals in a social network experiencing monkeypox activity, this includes men who have sex with men (MSM) who meet partners through an online website, digital application (“app”), or social event (e.g., a bar or party) or
  • Traveled outside the US to a country with confirmed cases of monkeypox or where monkeypox virus is endemic or
  • Had contact with a dead or live wild animal or exotic pet that is an African endemic species or used a product derived from such animals (e.g., game meat, creams, lotions, powders, etc.)

  2. Report suspected cases of monkeypox to County Epidemiology Unit within one working day using a Confidential Morbidity Report faxed to 858-715-6458 or sent by secure email to epi-cdreporting.hhsa@sdcounty.ca.gov.   

  • 8 am to 5 pm, Monday through Friday: 619-692-8499. 
  • Monkeypox virus-specific testing is available through commercial laboratories or through the Public Health Laboratory.
  • Testing through the Public Health Laboratory requires approval but sample collection and refrigeration before approval is acceptable. 
  • For more information: Health Advisory Update #3: Human Monkeypox, Testing at Commercial Laboratories.

  3. Instruct suspected cases to isolate until testing is resulted.

  4. To request monkeypox testing by the PHL, collect swabs (detailed instructions) and then call 619- 692-8499 (8 am to 5 pm, Monday through Friday). Swabs for PHL testing should be transported in dry sterile containers without viral media.

• Resources for Healthcare Professionals

  County of San Diego

  • CAHAN San Diego Alerts
    • Human Monkeypox, Testing at Commercial Laboratories (July 15, 2022)
    • Meningococcal Infections and Monkeypox in Men who Have Sex with Men (June 10, 2022).
    • Human Monkeypox (May 23, 2022).

  • County News Center
    • County Working with LGBTQ Leaders to Prevent Spread of Monkeypox, Vaccinate People at Higher Risk (July 25, 2022).
    • Men Who Have Sex with Men Encouraged to Protect Themselves from Monkeypox (July 12, 2022)
    • County Identifies Third Probable Case of hMPXV (June 17, 2022).
    • Two Probable Cases of Monkeypox Identified in San Diego County (June 15, 2022).

  CDPH

  • Monkeypox—Transmission

  CDC

  • Monkeypox 2022 Cases
  • Sign and Symptoms
  • Clinical Recognition
  • Specimen Collection
  • Treatment
  • Infection Control: Healthcare Settings
  • Information for Laboratory Personnel
  • Information for Veterinarians
  • Travelers’ Health-Smallpox and Other Orthopoxvirus-Associated Infections
  • Information for Healthcare Professionals
  • Monkeypox and Smallpox Vaccine Guidance
  • Monitoring People Who Have Been Exposed
  • Preventing Monkeypox Spread in Congregate Settings

  FDA

  • FDA Approves the First Drug with an Indication for Treatment of Smallpox.

  World Health Organization (WHO)

  • Monkeypox