Health & Human services

Mpox is a historically rare viral infection, that is caused by infection with the monkeypox virus that is similar to smallpox, but milder. Mpox 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. Mpox can affect all people in every community, regardless of gender identity or sexual orientation. It is a public health concern for all.

Symptoms

Mpox symptoms are similar to smallpox but less severe. Once exposed to mpox, symptoms usually develop in 7-14 days, but can range from 5-21 days. Symptoms of mpox can include:

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

Mpox 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.

Transmission

Mpox 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 mpox are available in the form of vaccines and antivirals (additional information below). 

The risk of mpox 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 Mpox, 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 mpox infection.

• Jynneos Frequently Asked Questions

Location:	Date & Time:	Make an Appointment
Immunization Clinic Main Health Facility (2525 Grand Ave., Rm 145)	Monday - Friday 8 a.m. to 5 p.m.	(562) 570-7912
Mobile Vaccination Free service offered on weekdays to persons who are not able to travel to the Immunization Clinic, such as persons who are not able to leave their home, persons with disabilities, access or functional needs, those in skilled nursing, elder care, sober living and in other long-term care facilities.	Tuesday and Thursday 8 a.m. to 5 p.m.	To view eligibility requirements and submit a vaccination request, click here or call (562) 570-4636.

• Youth ages 12 through 17 may consent to receiving the vaccine.
• Children under the age of 12 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.

• Health Providers

  
  
  
  

  Healthcare providers must report positive cases of mpox within 24 hours. To report a case, complete a mpox Confidential Morbidity Report (CMR) and fax with laboratory results to 562.570.4374 or send by secure email to LBEpi@longbeach.gov.  

  Healthcare providers should be alert and consider mpox in patients who present with an unexplained rash or lesions consistent with mpox: 

  1. Instruct patient to isolate and avoid contact with other people while waiting for test results 
  2. Submit specimens for mpox testing through commercial laboratories if possible. Testing is now available through commercial laboratories including:
     1. •  Labcorp
        • Quest Diagnostics
        • ARUP Laboratories
        • Aegis Sciences Corporation
  3. 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 | Mpox | Poxvirus | CDC. 

• K-12 Schools and ECEs

  • K-12 School and ECE Recommendations for Mpox
  • Mpox Information for Schools, ECEs and Other Settings Serving Children or Adolescents

• Isolation and Quarantine

  • Isolation Instructions for People with Mpox
  • Guidance for People Who Have Been Exposed to Mpox : English | Spanish |

• Frequently Asked Questions

  What should I do if I think I have mpox?

  If you have symptoms and think you may have mpox, 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 mpox, 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 mpox at this time. 
  
  For patients who test positive for mpox, 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 mpox?

  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 Mpox Home Isolation Guidance for the General Public for additional information.  
  

  When can I return to work if I have mpox?

  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 mpox 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 mpox?

  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 mpox?

  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 mpox.
  

  Can I get the mpox 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 mpox 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 mpox during this outbreak starting on May 17, 2022, are not recommended to get vaccinated at this time.

• Resources

  • Monkeypox (ca.gov)
  • 2022 United States Monkeypox Case | Monkeypox | Poxvirus | CDC 
  • Pets in the Home | Monkeypox | Poxvirus | CDC
  • Monkeypox Communications Toolkit