MPX is a historically rare viral infection, that is caused by infection with the monkeypox virus that is similar to smallpox, but milder. MPX is endemic to Central and West Africa, but as of May 2022 cases of monkeypox have been detected in various European countries and the United States, including California. MPX can affect all people in every community, regardless of gender identity or sexual orientation. It is a public health concern for all.
MPX symptoms are similar to smallpox but less severe. Once exposed to MPX, symptoms usually develop in 7-14 days, but can range from 5-21 days. Symptoms of MPX can include:
- Muscle aches
- Swollen lymph nodes
- Respiratory symptoms such as a sore throat, nasal congestion or cough.
Within 1 to 3 days after fever, a rash develops which may last 2 to 4 weeks. Most people will recover on their own, but those who are immunocompromised may have severe disease and additional complications such as sepsis, pneumonia, encephalitis, and loss of vision.
MPX can look like other diseases, such as syphilis. For more information on sexual health services available in the city, please visit the Sexual Health (STD) Clinic website.
MPX can be spread from person to person through direct contact with body fluids or lesions, or contaminated materials such as clothing or linens, and through respiratory droplets through prolonged face-to-face contact. Medical countermeasures to prevent and/or treat monkeypox are available in the form of vaccines and antivirals (additional information below).
The risk of MPX in the general population remains very low based on the information available. Long Beach Health is continuing to investigate and conduct contact tracing. For any close contact, Long Beach Health will monitor and coordinate post-exposure prevention, as needed.
To learn more about MPX, read our FAQ: English | Spanish | Khmer | Tagalog
THE CITY HAS BEGUN ADMINISTERING THE JYNNEOS VACCINE TO THOSE 18+ THROUGH INTRADERMAL INJECTION.
On August 9, the Food and Drug Administration (FDA) authorized the emergency use of the Jynneos vaccine to allow healthcare providers to use the vaccine by intradermal injection for those who are determined to be at high risk for MPX nfection.
|The JYNNEOS vaccine remains limited in the United States.
As of September 12, vaccine is only available for the following groups in Long Beach:
The Health Department is working to ensure access to MPX vaccines to our unhoused community who meet these criteria. Long Beach Health Department will expand eligibility as additional vaccine is available. The federal government anticipates distributing additional doses later this month.
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Consent for Minors:
- Currently, a consent form is required for all minors aged 6 months through 17 at each visit.
- Youth 16 and 17 years of age should be accompanied by their parent or legal guardian if possible. If this is not possible, they must bring a consent form signed by their parent or legal guardian.
- Children ages 6 months through 15 years must be accompanied by their parent, legal guardian, or a responsible adult. If the child is accompanied by a responsible adult, the consent form must name the responsible person and be signed by the parent or legal guardian.
Healthcare providers should be alert and consider MPX in patients who present with an unexplained rash or lesions consistent with monkeypox:
- Instruct patient to isolate and avoid contact with other people while waiting for test results
- Submit specimens for monkeypox testing through commercial laboratories if possible. Testing is now available through commercial laboratories including:
- TPOXX Protocol for Providers
Specimen Collection: Vigorously swab or brush the base of the lesion with a sterile dry polyester, rayon, or Dacron swab. Collect a second swab from the same lesion. Insert both swabs into the sterile plastic aliquot tube or sleeve and break off the end of the swabs, if required, to tightly close the sample. More than one lesion should be sampled, preferably from different body sites. Store specimens in 4° C.
A combination of standard, contact, and droplet precautions should be applied in all healthcare settings when a patient presents with fever and vesicular/pustular rash. The patient should be placed in an isolation room (negative air-pressure if available). PPE should be donned before entering the patient’s room and disposed of prior to leaving the isolation room. PPE measures include: disposable gown and gloves, N95 (or comparable) filtering disposable respirator, and eye protection. For more information visit: Infection Control: Hospital | Monkeypox | Poxvirus | CDC.
What should I do if I think I have Monkeypox (MPX)?
If you have symptoms and think you may have MPX, please call your healthcare provider who will determine the need for testing. If you do not have a healthcare provider and are experiencing symptoms, please contact the City of Long Beach’s public health information line at 562.570.7907 for assistance with finding healthcare services.
If you have a rash that might be due to MPX, your healthcare provider will evaluate you and, based on their evaluation, may swab your rash for testing. The swabs are sent to a commercial lab, and the test result should be available in a few days. There are no self-tests or home-tests for MPX at this time.
For patients who test positive for MPX, your healthcare provider will determine the course of action for treatment.
What does the rash look like?
Photo Credit: NHS England High Consequence Infectious Disease Network and UK Health Security Agency
What should I do if I was diagnosed with MPX?
Stay home unless it is necessary to see a healthcare provider. Do not resume activities outside of the home and do not return to work until all lesions are fully healed and a fresh layer of skin has formed at lesion sites and other symptoms have improved.
Refer to the CDPH MPX Home Isolation Guidance for the General Public for additional information.
When can I return to work if I have MPX?
Workers may return to work when:
- Fever or respiratory symptoms have resolved for at least 48 hours; AND
- No new lesions have appeared for at least 48 hours; AND
- Any lesions that cannot be covered, such as those on the face, are fully healed; AND
- Employment doesn’t involve direct physical care or contact with others, (i.e. massage therapy, estheticians, sex worker); AND
- Employment is not in a setting of concern (i.e. homeless shelter, healthcare setting, senior care facilities, correctional facilities/detention centers, childcare or preschool, K-12 schools); AND
- Virtual work is not possible
Persons with MPX who work in a setting of concern should not return to the workplace until all skin lesions have healed (i.e., scabs have fallen off and a fresh layer of skin has formed at the lesion sites) and any other symptoms have been resolved for at least 48 hours. Before returning to a setting of concern, consultation in a healthcare provider is advised.
Can I get vaccinated if I have been exposed to someone with MPX?
If given before exposure or within 4 days of exposure, JYNNEOS may reduce the chance of infection. If given between 5 and 14 days of exposure, it may lower the severity of symptoms.
Do I still qualify for JYNNEOS if I have been vaccinated against small pox?
Individuals who were previously vaccinated with ACAM2000 can be vaccinated with Jynneos without precaution.
When am I considered fully vaccinated?
You will not be fully vaccinated and getting the most benefit from this vaccine until 2 weeks after your second dose of JYNNEOS.
Should I still get vaccinated if I got Monkeypox (MPX)?
An individual who is diagnosed with Monkeypox after their first dose of JYNNEOS are not recommended to receive a second dose of JYNNEOS, at this time.
Is it safe for me to get vaccinated if I am immunocompromised or have eczema?
JYNNEOS is safe to administer to people with HIV and eczema or other exfoliative skin conditions.
Can I still get vaccinated if I am pregnant or breastfeeding?
While there are no data in people who are pregnant or breastfeeding, animal data do not show evidence of reproductive harm; pregnancy and breastfeeding are not contraindications to receiving JYNNEOS
Do I have to wait to get JYNNEOS after getting the COVID-19 Vaccine?
If Orthopoxvirus vaccine (JYNNEOS) is administered first, consider waiting 4 weeks after your second dose before receiving a COVID vaccine.
If COVID vaccine is administered first, there is no waiting period to receive orthopoxvirus vaccine (Jynneos).
What do I do after getting vaccinated?
Once you are vaccinated, you should continue to protect yourself from infection by avoiding close, skin-to-skin contact, including sex or other intimate contact, with someone who has monkeypox.
Can I get the MPX virus from the Jynneos vaccine?
Jynneos is a live, non-replicating vaccine. This means you cannot become infected with orthopoxviruses by touching the injection site.
How many doses will I receive?
Two doses are required, as this is the FDA-approved regimen, however, there are some exceptions to this rule:
- An individual who is diagnosed with Monkeypox after their first dose of JYNNEOS are not recommended to receive a second dose of JYNNEOS, at this time.
- An eligible individual who has been diagnosed with Monkeypox during this outbreak starting on May 17, 2022, are not recommended to get vaccinated at this time.