Consider Mpox in Patients with Rash Illness and Recent Travel to Democratic Republic of the Congo

An mpox outbreak caused by Clade I Monkeypox virus (MPXV) is spreading through sexually associated transmission in the Democratic Republic of the Congo (DRC). Clade I MPXV is more transmissible and causes more severe infections than Clade II MPXV seen in the 2022-23 global outbreak.

Clinicians who have a patient with symptoms of mpox and travel to the DRC within 21 days prior to symptom onset are requested to:

• Collect two separate specimens for orthopox virus testing at the Idaho Bureau of Laboratories (IBL). Contact the IBL LRNB Program at 208-334-0515 for information.
• Notify Central District Health at 208-327-8625. Public health staff can provide guidance on specimen submission and obtaining tecovirimat, and will work to help prevent spread to others.

Available vaccines and antivirals are expected to be effective for both Clade I and II MPXV infections. Clinicians are requested to continue to encourage people at risk for mpox to be vaccinated. Patients can use the mpox vaccine locator at https://www.cdc.gov/poxvirus/mpox/vaccines/vaccine-recommendations.html to find a site offering mpox vaccine.

Clade I MPXV has not yet been reported in the United States. CDC has issued a Travel Health Notice for people traveling to DRC https://wwwnc.cdc.gov/travel/notices/level2/mpox-democratic-republic-of-congo. People who have recently traveled to DRC should be advised to seek medical care at once if they develop a new, unexplained skin rash (lesions on any part of the body), with or without fever and chills, and avoid contact with others.

For More Information

Contact Central District Health at 208-327-8625 or the DPH Epidemiology Section at 208-334-5939 if you have any questions or suspect a patient may have mpox. For urgent clinical consultation after hours, clinicians may contact CDC’s Emergency Operations Center (770-488-7100) to discuss the case with a clinician.

Resources

CDC: Mpox Clinical Recognition and Vaccine Information for Healthcare Providers https://www.cdc.gov/poxvirus/mpox/clinicians/index.html

Clade I-Associated Mpox Cases Associated with Sexual Contact, the Democratic Republic of the Congo. Article in Emerging Infectious Diseases. November 29, 2023. doi:10.3201/eid3001.231164

World Health Organization. Mpox (monkeypox) in the Democratic Republic of the Congo. November 23, 2023. https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON493