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What to Know About Mpox

What is Mpox and how does it spread?

Mpox (formerly monkeypox) is a viral infection caused by the mpox virus, which is related to smallpox though much less severe. The Centers for Disease Control (CDC) tracks cases counts across the country.

Mpox spreads primarily through sex and other close skin-to-skin contact with the infectious rash or lesions. Other less common ways the virus is spread is through contact with an infected persons respiratory secretions or touching objects or fabrics that have come in contact with infectious lesions. Most cases to date have been related to sexual activity in the prior 1-3 weeks. At this time, mpox is not known to spread by the airborne route or by people who do not have symptoms.

What are the symptoms?

Symptoms include:

  • Rash that can look like pimples, bumps, or blisters. Lesions may appear on the face, inside the mouth, or other parts of the body including hands, feet, genitals, or anus and rectum. The lesions may be itchy or painful and may be associated with rectal pain or bleeding. The CDC provides  images of the rash.
  • Mouth, genital, or anal pain.
  • Body aches, swollen glands, sore throat, fatigue, and headache.

What should I do if I have symptoms?

Isolate and contact your healthcare provider as soon as possible to be tested. Specimens for testing must be obtained by a healthcare provider, who will swab a lesion and submit the sample to either a commercial lab or the state of Connecticut for testing. Results may take several days to process.

Yale Health is prepared to provide clinical evaluation, testing, treatment, and vaccination guidance for members. Please call your primary care provider if you develop symptoms of mpox or have been exposed. Those with other insurance should seek care through their own healthcare provider.

Who is at risk for infection?

Anyone can get mpox if they have been exposed. Currently, mpox is disproportionately affecting some gay and bisexual men, transgender, and non-binary people. Infection is not limited by gender or sexuality and can spread to anyone where there may be close, personal, and often skin-to-skin contact. Behaviors linked to higher risk of mpox transmission include multiple sex partners and anonymous sexual encounters in the previous 1-3 weeks.

What if I test positive?

Yale Health (for students or members) or your healthcare provider will work with you on an appropriate treatment plan including mental health support if needed.

You are infectious until your lesions are fully resolved, which can take 2- 4 weeks. You will also need to isolate until your lesions have healed, scabs have fallen off, and a fresh layer of skin has formed. Wear a well-fitting mask, cover lesions when around others, and avoid skin or mucosal contact with household members and pets, especially mammals. The CDC provides guidance for preventing the spread to others.

If you are a student living on campus and test positive, you may go home, or an appropriate location will be provided on campus. Students living off campus will be provided with guidance for safe isolation practices.

Your healthcare provider is required by law to report cases of mpox to the DPH. The DPH or your local health department will reach out to you to conduct contact tracing so that anyone at risk can be notified and vaccinated as soon as possible. You will be asked where you have been since your symptoms started. The health department will contact the university if you have been on campus (including for work) so that any spaces you have occupied, including a dorm room, can be specially cleaned by university staff.

How is it treated?

In most cases, mpox infection is mild and resolves without treatment. However, medications developed to treat smallpox (tecovirimat or TPOXX) are available for patients who are at risk for more severe disease from mpox. Standard treatments are available for symptoms of pain and itching from lesions and can be prescribed by a healthcare provider.

Is there a vaccine that can help prevent infection?

Vaccines developed for use against smallpox are being used to prevent mpox following exposure, or to reduce the likelihood of infection in those at increased risk of exposure. Jynneos vaccine is available for those at increased risk of infection, or for those with known or likely exposure to mpox. The vaccine is administered as two doses 28 days apart, with full protection effective by 14 days after the second dose.

Newly published data confirms that vaccination with Jynneos is 66-86% effective at preventing disease compared to no vaccine. Vaccination also appears to reduce disease severity for those who do become infected. Two doses of vaccine are better than one dose; those who have had only one dose should get the second dose now.

Infection after vaccination is possible, as no vaccine is 100% effective, but symptoms may be milder and less likely to result in hospitalization. Completing the 2 dose series is recommended for best protection. Learn more.

Eligibility for vaccination

Consult the DPH website for the most current eligibility requirements.

You are eligible to be vaccinated if you are residing, attending school, or stationed in Connecticut and meet one of the following criteria. Vaccination is highly recommended for those at risk who also have HIV infection or other conditions that weaken the immune system:

  • People who engage in sex with multiple partners, anonymous partners, or participate in group sex; OR
  • People whose partners engage in sex with multiple partners, anonymous partners, or participate in group sex; OR
  • People who engage in transactional sex (including sex in exchange for money, food, shelter or other goods); OR
  • People who know or suspect that they have been exposed to mpox in the last 14 days; OR
  • Anyone else who considers themselves to be at risk for mpox through sex or other intimate contact.

Yale Health is now able to administer the mpox vaccine on site to Yale Health members and students, including waived students. An appointment in our Allergy and Immunization Department is required. You can schedule an appointment directly without an order from your clinician through MyChart. Go to Menu > Schedule an appointment > Yale Health Center > answer yes when asked if you are scheduling an immunization or vaccination and select mpox (Jynneos) from the list. You may also call the department at 203-432-8797 to make an appointment.

For faculty and staff with Aetna or another insurance provider, the mpox vaccine continues to be available at a variety of other locations throughout Connecticut, including pop-up clinics. 

Are there other preventive measures?

Other health and safety measures can reduce the likelihood of either infection or transmission, including:

  • Avoiding close physical contact with anyone who has been diagnosed with mpox or has a suspicious rash.
  • Taking steps to reduce your risk of exposure during activities where there is likely to be skin-to-skin contact, such as sex and certain social gatherings.
    • Temporarily reduce your number of sexual partners.
    • Talk with your partner about any rash or other symptoms.
    • Notify close contacts if you test positive.
  • Avoiding handling bedding, towels, or clothing of someone who has or may have mpox
  • Washing hands frequently.