Increased Potential for New Mpox Cases with Spring and Summer Travel

Mpox Update: Stay Up to Date on Testing, Treatment, and Vaccination: Webinar Thursday May 18, 2023, Noon to 1:00 PM MDT. See
https://emergency.cdc.gov/coca/calls/2023/callinfo_051823.asp for details.

Due to a new cluster of mpox cases in the Chicago area, clinicians across the country including Idaho are advised to continue mpox vaccination efforts, register their organization in the monkeypox vaccine locator, consider mpox when determining the cause of a diffuse or localized rash, including in patients who were previously infected with mpox or vaccinated against mpox, and report suspected cases to Central District Health at 208-327-8625 or to the Idaho Epidemiology Section at 208-334-5939.

Community mpox transmission is ongoing in the United States and internationally. Oregon Health Authority reports mpox may be endemic in Oregon. The recent cluster of mpox cases in Chicago included 4 patients with a travel history to New York City, New Orleans, and Mexico. No new cases have been reported in Idaho since October 2022.

A resurgence of mpox is possible as people gather for post-graduation celebrations, festivals, and other events. Resurgent outbreaks in communities with low vaccination coverage could be larger than in 2022 without additional vaccination and continued adoption of sexual practices that prevent the spread of mpox. Only 17% of the estimated population at risk for mpox in Idaho has been fully vaccinated.

Because 9 of 13 mpox cases in the Chicago cluster were among men who had received 2 JYNNEOS mpox vaccine doses, some media outlets are reporting a vaccine “flop,” which could increase mpox vaccine hesitancy. Although vaccine- induced immunity is not complete, individuals who have received their 2-dose series may experience less severe symptoms than those who have not, in addition to receiving partial protection from infection.

JYNNEOS mpox vaccine can be given as pre-exposure prophylaxis among people with high potential fo risk of exposure to mpox, including gay, bisexual, and other MSM, and transgender or nonbinary individuals who, in the past 6 months, have had a new diagnosis of one or more sexually transmitted diseases or more than one sex partner. Individuals in the community at risk asking for vaccination is adequate attestation for risk of mpox exposure. To avoid barriers created by stigma, extensive risk assessment should not be conducted with individuals who request vaccination. JYNNEOS can begiven as post-exposure prophylaxis, ideally within 4 days of known or presumed exposure; however, administration 4 to 14 days after exposure may still provide some protection. JYNNEOS is licensed for use in individuals 18 years of age and older as a series of 2 doses administered 4 weeks (28 days) apart. JYNNEOS may be given subcutaneously or intradermally. Please contact Central District Health if you need JYNNEOS vaccine for your clinic.

Mpox PCR for testing lesion swabs is commercially available through many laboratories offering U.S. Food and Drug Administration (FDA)-authorized tests and laboratory-developed tests. Testing at the Idaho Bureau of Laboratories is available for patients who are uninsured or who are at or might have exposed someone at high risk of progression to severe disease. Please report mpox cases to Central District Health or the Idaho Epidemiology Section so possible sources of infection can be investigated, and additional cases prevented.

For More Information on Mpox Diagnosis, Treatment, and Prophylaxis

• Clinical Quick Reference
• Vaccination Basics for Healthcare Professionals
• Strategies for Talking with Patients about Vaccinations for Mpox
• Clinical Recognition
• Clinical Considerations for Treatment and Prophylaxis of Mpox Infection in
  People Who are Immunocompromised
• Treatment Information for Healthcare Professionals
• Risk Assessment of Mpox Resurgence and Vaccination Considerations

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