Mpox (Monkeypox) Clinical Pathway — Emergency Department, Outpatient Specialty Care and Primary Care
Mpox Information
Mpox stories on the news might sound confusing or scary. The good news is that we understand the basics of this disease, and the risk of mpox to our general public appears to be low! If you have any additional questions about mpox, please contact your primary care provider.
What are the signs and symptoms of mpox?
Early signs of mpox include fever, chills, headache, muscle aches, fatigue, and swollen lymph nodes. After a few days, a rash usually develops. The rash starts out as red, slightly raised bumps which can often be painful. The bumps turn into blisters that fill with pus. These blisters will eventually crust over and the scabs fall off. When someone is diagnosed with mpox, they normally have symptoms for about two to four weeks. They are considered contagious during that time, until all the scabs have fallen off.
What are the risk factors for getting mpox?
Mpox is mostly spread by individuals who have had close, intimate contact with others who are contagious. More specifically, it is spread through:
- Direct contact with infectious rash, scabs, or body fluids
- Prolonged intimate or face-to-face contact
- Touching objects which have been touched by others who are contagious; this is a less common form of transmission, but possible
The following types of interactions have not been reported as the cause of any current mpox cases: short interactions with someone who is positive (like a brief conversation); being in close proximity for a long time with someone who is positive (like sitting near them on an airplane); there have also been no cases of transmission in a healthcare setting, existing precautions are working well.
What should I do if someone I know has mpox?
- If someone you know has been diagnosed with mpox, they should be isolating from others. You should avoid all close, skin to skin contact with that person. You should avoid touching any clothes, sheets, towels, or other materials that they might have used. Likewise, you should not use any utensils, plates, or cups that the infected person may have used.
- If the person with mpox lives in the same home as you, the person with the virus should isolate the best they can from those who are not infected, including pets. If the person with the virus is older than 2 and cannot isolate from others at home, we recommend they wear a well-fitting mask. We also recommend that caregivers mask when they are taking care of the person who is sick for more than just a few minutes. To reduce exposure to other household members, the person with mpox should also cover their rash with long sleeves or pants.
- Wash your hands after any contact with the person with mpox. If you use gloves, wash your hands after you remove the gloves.
Who should get the mpox vaccine?
The mpox vaccine should not be given to everyone. Doctors might consult with the local health department to who would benefit from receiving the mpox vaccine. These might include patients who had a high-risk exposure, patients at high risk of getting very sick, or patients with certain jobs that put them at higher risk.
Vaccination is most effective within four days of exposure, but can also help up to 14 days post-exposure. The vaccine is a two-dose series given at least 28 days apart. At this time, most vaccines are given by county departments of public health, so they are a good place to contact for additional information. The Philadelphia Department of Public Health can be reached at (215) 685-5488. The Montgomery County Department of Public Health can be reached at (610) 278-5117.
What should I do if I was exposed to mpox, or think I might have it?
- If you do not have symptoms:
- If you are concerned that you may have been exposed to a person with the mpox virus, you should watch for the following symptoms: fever, muscle-aches, headaches, fatigue, and swollen lymph nodes. Usually, these symptoms develop anywhere from 5 to 21 days after exposure. A rash on the face, hands, and/or feet will usually develop 1 to 4 days after the initial symptoms.
- People are not at risk of infecting others with mpox when the virus is in its “incubation” phase, or before the infected person starts having symptoms. If you do not develop any symptoms, you continue routine daily activities (e.g., go to work, school), but again, remember to closely monitor yourself for any symptoms.
- If you have symptoms:
- If you are concerned that you might have been exposed to mpox and develop any of these symptoms, you should start to isolate from others, and contact your primary care provider (tips on isolating are found in the FAQ “what should I do if someone I know has mpox?”). Your primary care provider, in partnership with your local public health department, will be able to discuss with you the suitability of testing, vaccination, and/or the need for any antiviral treatment.
- People who are diagnosed with mpox should isolate until rash has fully resolved, the scabs have fallen off, and a fresh layer of intact skin has formed.
Who should be tested for mpox?
In Pennsylvania, people have to be seen by a health care provider to get tested for mpox. Your provider will decide if you need a test based on patient-specific information. Not everyone needs to be tested for mpox. If you don’t have a health care provider, you can contact your local department of public health for help.
How do you treat someone who has mpox?
Most people who are diagnosed with mpox will recover without any treatment. Healthcare providers will monitor symptoms and help make sure patients do not become dehydrated. If healthcare providers find out their patient has a bacterial infection, they may prescribe antibiotics. People with weakened immune systems who test positive for mpox may be prescribed a course of an antiviral called Tecovirimat (TPOXX).