![]() ![]() The diagnosis of an STI does not exclude mpox, as a concurrent infection may be present. Specimens should be obtained from lesions (including those inside the mouth, anus, or vagina), if accessible, and tested for mpox and other sexually transmitted infections (STI), including HIV, as indicated. Differential diagnoses include herpes simplex virus (HSV) infection, syphilis, herpes zoster (shingles), disseminated varicella-zoster virus infection (chickenpox), molluscum contagiosum, scabies, lymphogranuloma venereum, allergic skin rashes, and drug eruptions. Doing so can detect lesions of which the patient may be unaware.Ĭonsider mpox when determining the cause of a diffuse or localized rash, including in patients who were previously infected with mpox or vaccinated against mpox. Perform a complete physical examination, including a thorough skin and mucosal (e.g., oral, genital, anal) examination. It is important to take a detailed sexual history for any patient with suspected mpox. Mpox is usually transmitted through close, sustained physical contact and has been almost exclusively associated with sexual contact in the current global outbreak. ![]() Recommendations for Clinicians Evaluating and Treating PatientsĬonduct a thorough patient history to assess possible mpox exposures or epidemiologic risk factors. Clinicians should also refamiliarize themselves with mpox symptoms, specimen collection, laboratory testing procedures, and treatment options. If mpox is suspected, test even if the patient was previously vaccinated or had mpox. To help prevent a renewed outbreak during the spring and summer months, CDC is urging clinicians to be on alert for new cases of mpox and to encourage vaccination for people at risk. Resurgent outbreaks in these communities could be as large or larger than in 2022. The projected risk of a resurgent mpox outbreak is greater than 35% in most jurisdictions in the United States without additional vaccination or adapting sexual behavior to prevent the spread of mpox. Vaccine coverage varies widely among jurisdictions. However, CDC continues to receive reports of new cases and clusters in the United States and internationally.Īlthough approximately 1.2 million JYNNEOS mpox vaccine doses have been administered in the United States since the beginning of the outbreak, only 23% of the estimated population at risk for mpox has been fully vaccinated. This outbreak had a peak of about 460 cases per day in August 2022, and gradually declined, likely because of a combination of temporary changes in sexual behavior, vaccination, and infection-induced immunity. Most patients with mpox have mild disease, although some, particularly those with advanced or untreated HIV infection, may experience more severe outcomes.Īs of May 10, a total of 30,395 cases have been reported in the United States. ![]() Previous outbreaks in places where mpox is not endemic were mostly related to international travel however, this outbreak spread rapidly across much of the world through person-to-person contact, disproportionately affecting gay and bisexual men, other men who have sex with men (MSM), and transgender people. The purpose of this Health Alert Network (HAN) Health Update is to inform clinicians and public health agencies about the potential for new clusters or outbreaks of mpox cases and to provide resources on clinical evaluation, treatment, vaccination, and testing.Ī global outbreak of mpox began in May 2022. Spring and summer season in 2023 could lead to a resurgence of mpox as people gather for festivals and other events. CDC expects new cases among previously vaccinated people to occur, but people who have completed their two-dose JYNNEOS vaccine series may experience less severe symptoms than those who have not. Travel history was available for 9 cases 4 recently traveled (New York City, New Orleans, and Mexico).Īlthough vaccine-induced immunity is not complete, vaccination continues to be one of the most important prevention measures. The median age was 34 years (range 24–46 years). Confirmed cases were in 9 (69%) non-Hispanic White men, 2 (15%) non-Hispanic Black men, and 2 (15%) Asian men. Nine (69%) of 13 cases were among men who had received 2 JYNNEOS vaccine doses. None of the patients have been hospitalized. From April 17 to May 5, 2023, a total of 12 confirmed and one probable case of mpox were reported to the Chicago Department of Public Health. This week, CDC and local partners are investigating a cluster of mpox cases in the Chicago area. The Centers for Disease Control and Prevention (CDC) continues to receive reports of cases that reflect ongoing community transmission in the United States and internationally. In the United States, cases of mpox (formerly monkeypox) have declined since peaking in August 2022, but the outbreak is not over. ![]()
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