Monkeypox 

Overview

Monkeypox is a rare infectious disease that is caused by infection with monkeypox virus. Monkeypox virus belongs to the Orthopoxvirus genus which includes the variola (smallpox) virus as well as the vaccinia virus, which is used in the smallpox vaccine.  Monkeypox 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. There are currently no known cases in Long Beach. 

Monkeypox symptoms are similar to smallpox but less severe. Monkeypox may begin with fever, headache, muscle aches, and exhaustion. 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. Once exposed to monkeypox, symptoms usually develop in 7-14 days, but can range from 5-21 days. 

Monkeypox can be spread from person to person through direct contact with body fluids or lesion, or contaminated materials such as clothing or linens, and through respiratory droplets though 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). 

To review Monkeypox FAQ, please click here.

Examples of Monkeypox Rashes: 
This is a Monkeypox Rash on the back    This is a Monkeypox rash on thumb    This is a Monkeypox Rash on skin    This is a Monkeypox Rash on skin
Photo Credit: NHS England High Consequence Infectious Disease Network and UK Health Security Agency 

Healthcare Providers

To report a suspect case of monkeypox and coordinate testing, immediately call the Communicable Disease Surveillance and Control Division at 562.570.4302.

Healthcare providers should be alert and consider monkeypox virus in patients who present with an unexplained rash or lesions consistent with monkeypox, regardless of whether they have travel or specific risk factors for monkeypox and regardless of gender and sexual orientation.  However, CDC has warned of a potential increased risk for contracting monkeypox among those who:

  1. Traveled to an area outside of the U.S. where monkeypox cases or exposures have been reported 
  2. Reported contact with a person who has similar rash or received a diagnosis of confirmed or suspected monkeypox
  3. Had close or intimate in-person contact with individuals in a social network experiencing monkeypox activity, this includes men who have sex with men who meet partners through an online website, digitial app, or social event
  4. Had contact with a dead or live wild animal or pet that is an African endemic species or used a product derived from such animals 

The current monkeypox situation is constantly evolving and subject to change. Monkeypox risk remains low so it is important for clinicians to also consider other diagnosis, such as syphilis, herpes, and varicella. 

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.

Specimen Collection: Lesions should be swabbed using a sterile nylon, polyester, or Dacron sab with plastic or aluminum shaft. More than one lesion should be sampled, preferably from different body sites. To collect, vigorously swab or brush lesion with two separate sterile dry swabs and place the swab into separate 1.5-2 mL screw-capped tubes with O-ring, or place each swab in a separate sterile container. Alternatively, each swab may be placed in seperate tubes of viral transport media (VTM). No other type of transport medium is acceptable. Store specimens in 4° C and immediately contact the Communicable Disease Surveillance and Control Division at 562.570.4302. 

Information for Public

People who may have symptoms of monkeypox should contact their healthcare providers. This includes anyone who:

  1. Traveled to an area where monkeypox cases or exposures have been reported 
  2. Had contact with a person who has a similar rash or received a diagnosis of confirmed or suspected monkeypox
  3. Had close or intimate in-person contact with individuals in a social network experiencing monkeypox activity, this includes men who have sex with men who meet partners through an online website, digital app, or social event
  4. Had contact with a dead or live wild animal or pet that is an African endemic species or used a product derived from such animals
There are steps individuals can take to protect themselves from monkeypox including: asking intimate and other sexual partners about symptoms, avoiding skin-to-skin or prolonged face-to-face contact with anyone who has symptoms, practicing safer sex (such as reducing the number of sexual partners), keeping hands clean, and maintaining respiratory etiquette.

To learn more about monkeypox, click here

Health Department Response 

The Long Beach Department of Health and Human Services (Health Department) is closely monitoring the situation and has plans in place if there are cases in the City. The Health Department is working closely with federal and state partners to gather all pertinent information and has sent out communications to healthcare providers, including sexual health clinics and LGBTQ+ centers, to provide education and guidance. There are medical countermeasures (MCM) that may be given to exposed individuals to prevent illness or reduce disease severity, which include vaccines and antivirals. Federal partners in the Division of the Strategic National Stockpile (DSNS) have all these MCM in their warehouse. If a need for MCM to prevent or treat monkeypox should arise in the city, Health Department would request the necessary MCM from California Department of Public Health (CDPH), which would be released to the state from DSNS. 

Resources