Poxvirus: Monkeypox

Anyone can get Monkeypox.

The data currently shows transmission is higher among people in close social networks. People with monkeypox in the current outbreak generally report having close, sustained physical contact with other people who have monkeypox.

Monkeypox is a rare disease caused by infection with the monkeypox virus. Monkeypox virus is part of the same family of viruses as variola virus, the virus that causes smallpox. Monkeypox symptoms are similar to smallpox symptoms, but milder, and monkeypox is rarely fatal. Monkeypox is not related to chickenpox.

For more information on the statewide response, visit the MT DPHHS website

For more information on the national response, visit the CDC’s website. 

Frequently Asked Questions

Jynneos is the vaccine being used in the prevention of smallpox and monkeypox. Find more information on this vaccine on the CDC’s website.

Do you have interest in the monkeypox vaccine or think you might be eligible? Click here to fill out this survey. 

The monkeypox vaccine is available in Montana, but there is a very limited supply. Due to supply, it is limited to people who meet certain criteria.

  • Post-Exposure Prophylaxis (PEP) – People who have had exposure to individuals with confirmed orthopoxvirus/monkeypox virus infection.
  • Expanded Post-Exposure Prophylaxis (PEP++) – People with certain risk factors that might make them more likely to have been recently exposed to monkeypox may be considered for PEP++. This may include people that are identified through case investigations/contact tracing, people who are aware that one of their sexual partners from the past 2 weeks has received a monkeypox diagnosis, and individuals that report group sex/sex with multiple partners in the past two weeks in association with certain events, venues, or geographical areas in which monkeypox transmission has been reported.
  • PRE-Exposure Prophylaxis (PREP)
    • Certain healthcare and public health response teams are also eligible for a 2 dose vaccine as a Pre-Exposure Prophylaxis (PrEP).
    • Certain healthcare and public health response team members designated by public health authorities to be vaccinated for preparedness purposes according to ACIP guidance.
      • At this time, most clinicians in the U.S. and laboratorians not performing the orthopox generic test to diagnose orthopoxviruses, including Monkeypox virus, are not advised to receive monkeypox vaccine PrEP
    • Adults 18 years and older who meet one of the following criteria:
      • Individuals who have recently had sex with multiple or anonymous sexual partners; OR
      • Partners of individuals who have sex with multiple or anonymous sexual partners; OR
      • Sex workers (of any sex); OR
      • Staff (of any sex) at establishments where sexual activity occurs (e.g., bathhouses, saunas, sex clubs); OR
      • Were diagnosed with gonorrhea or early syphilis within the past 12 months; OR
      • Persons experiencing homelessness with high-risk behaviors; OR
      • Are on HIV pre-exposure prophylaxis; OR
      • Are part of high risk cohorts identified by clinical staff in the correctional system; OR
      • Individuals deemed to have high-risk based on individual risk assessments.
    • Note: eligible persons, per the criteria above, who are immunocompromised (e.g., those with advanced or uncontrolled HIV) or those who have underlying medical conditions that confer increased risk for severe disease (e.g., atopic dermatitis, eczema) could be prioritized for vaccination.

Visit the CDC’s website for more details on the ongoing monkeypox outbreak in the United States, and globally.

Infections with the type of monkeypox virus identified in this outbreak—the West African type—are rarely fatal. Over 99% of people who get this form of the disease are likely to survive. However, people with weakened immune systems, children under 8 years of age, people with a history of eczema, and people who are pregnant or breastfeeding may be more likely to get seriously ill or die.

Although the West African type is rarely fatal, symptoms can be extremely painful, and people might have permanent scarring resulting from the rash.

The Congo Basin type of monkeypox virus has a fatality rate around 10%.

**Information provided by the CDC’s website.

Symptoms of monkeypox can include:

  • Fever
  • Headache
  • Muscle aches and backache
  • Swollen lymph nodes
  • Chills
  • Exhaustion
  • Respiratory symptoms (e.g. sore throat, nasal congestion, or cough)
  • A rash that can look like pimples or blisters that appears on the face, inside the mouth, and on other parts of the body, like the hands, feet, chest, genitals, or anus. The rash goes through different stages before healing completely. The illness typically lasts 2-4 weeks.

Sometimes, people get a rash first, followed by other symptoms. Others only experience a rash.

Symptoms usually appear one to two weeks after infection.

  • See a healthcare provider if you notice a new or unexplained rash or other monkeypox symptoms.
  • Remind the healthcare provider that monkeypox is circulating.
  • Avoid close contact (including intimate physical contact) with others until a healthcare provider examines you.
  • Avoid close contact with pets or other animals until a healthcare provider examines you.
  • If you’re waiting for test results, follow the same precautions.
  • If your test result is positive, stay isolated and observe other prevention practices until your rash has healed, all scabs have fallen off, and a fresh layer of intact skin has formed.
  • Remain isolated if you have a fever or respiratory symptoms, including sore throat, nasal congestion, or cough. Only go out to see a healthcare provider or for an emergency and avoid public transportation.
  • If you need to leave isolation, you should cover the rash and wear a well-fitting mask.

Most monkeypox infections last 2 to 4 weeks and resolve without treatment. There are no treatments specifically for monkeypox virus infections. However, the antiviral drug named tecovirimat (TPOXX) was developed to treat smallpox, but the FDA allows CDC to use it to treat monkeypox during an outbreak. The need for treatment will depend on how sick someone gets and whether they are likely to get severely ill, like patients with weakened immune systems. Any treatment will require a visit to a healthcare professional.

You can find more details on the spread of monkeypox, visit the CDC’s website.

Monkeypox spreads in different ways. The virus can spread from person-to-person through direct contact with the infectious rash, scabs, or body fluids. It also can be spread by respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact, such as kissing, cuddling, or sex. In addition, pregnant people can spread the virus to their fetus through the placenta.

Touching items (such as clothing or linens) that previously touched the infectious rash or body fluids is another way monkeypox spreads. It’s also possible for people to get monkeypox from infected animals, either by being scratched or bitten by the animal or by eating meat or using products from an infected animal.

People who do not have monkeypox symptoms cannot spread the virus to others.

Monkeypox can spread from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. The illness typically lasts 2-4 weeks.

**Information taken from the CDC’s website. 

While monkeypox is rare and the threat is low, there are a few things to keep in mind:

  • Avoid close contact with people who have monkeypox symptoms. That includes face-to-face contact, touching, and sex.
  • Practice good handwashing with soap and water after contact with sick animals or humans.
  • Avoid contact with animals or any materials that may have exposure to monkeypox.

If you start showing symptoms of monkeypox, be sure to see your primary care physician and let them know you have suspected monkeypox.

Additional Resources:

5 Things Sexually Active People Need to Know About Monkeypox – CDC

What is Monkeypox? Symptoms, Transmission, and Vaccination – UC Davis

Information For Providers:

Currently, the Montana Public Health Laboratory (MTPHL) will provide free orthopoxvirus testing of skin lesion swabs for suspect patients that have symptoms consistent with monkeypox and meet the CDC epi criteria.

  • For free testing at MPTHL, an epi consult is required prior to submission of specimens to MTPHL to determine if the patient meets the CDC criteria.
  • Please call your local health department (406-582-3100) or CDEpi (406-444-0273) to discuss if a patient is eligible for free testing at MPTHL.
  • If the patient does not meet the stated epi criteria, the test will have a $55 charge at MTPHL.
  • If a patient is a low suspect case based on symptoms and epidemiological criteria for monkeypox, providers should send specimens to commercial reference laboratories including: Sonic Labs, Aegis Labs, Quest Diagnostics, Mayo Clinic, Mako, and LabCorp.
  • Please follow the specimen collection and shipping instructions in the HAN Monkeypox Updates for the State of Montana, July 19, 2022.
    • MTPHL only accepts dry swabs in separate sterile containers, MTPHL cannot accept swabs submitted in transport media.

Need to report a confirmed or suspect case of monkeypox?

  • Please call 406.582.3100.
  • If you need to reach the Gallatin City-County Health Dept after hours to report an urgent public health matter:
    • Call the Gallatin County Sheriff’s office at 406.582.2100, ext. 2

Resources:

Community Health

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