Mpox - Medical Professionals

Key Messages for Medical Providers:

As of Sept. 1, 2022, Shasta County had two probable cases and one confirmed case of Mpox. 

Across California, more than 3,624 probable and confirmed cases of Mpox have been reported by the California Department of Public Health as of Aug. 30, 2022.

In the USA, more than 16,603 total confirmed Mpox/orthopoxvirus cases have been reported. 

The risk of Mpox in the general population continues to be very low based on the information available.

Due to the scarce availability of vaccines in Shasta County the priority for vaccination remains at those identified as being in the highest risk groups. Vaccine eligibility will expand as vaccine supply increases.
Healthcare providers can order Mpox virus testing as they normally would order other tests. People seeking testing for Monkeypox must consult with their healthcare provider first; they cannot separately go to a lab.

Treatment for Monkeypox is available in Shasta County. Tecovirimat can be requested from Shasta County Health and Human Services Agency Public Health Branch (SC HHSA PH) and we can support the logistical and clinical consultation regarding tecovirimat.

Actions Requested from Health Care Systems and Clinicians

1. Isolate patient suspected of monkeypox in single-person exam room or airborne precaution isolation room, if available, as soon as possible. Ensure patient remains masked, if tolerable, and cover any exposed skin lesions with gown or sheet. Health care personnel evaluating patient should wear gloves, gown, eye protection, and N95 or equivalent or higher-level respirator.

2. Report any suspect cases immediately by phone SC HHSA PH at (530) 225-5591.

3. Collect samples for testing as described below.

4. Manage and treat with supportive care and symptom control. Antiviral treatment and prophylaxis are available to request through SC HHSA PH. Many cases are mild enough that they can convalesce at home.

Isolation 

California Department of Public Health recommends that  people with confirmed MPX and those with MPX symptoms while waiting to be evaluated or for test results should isolate at home. For more information click here.

Treatment

What drugs are available in Shasta County for the treatment of MPX?

Tecovirimat (TPOXX) is an investigational new drug available for the treatment of MPX and is available in Shasta County if the patient meets treatment criteria as per CDC clinical guidance. TPOXX is an antiviral medication available through an expanded access Investigational New Drug (EA-IND) protocol for the treatment of MPX infection. Informed consent is required for all patients treated with tecovirimat. Tecovirimat is available in oral and intravenous formulations. Other drugs (brincidofovir, vaccinia immune globulin) are potentially available, but are considered second-line drugs.

How effective is tecovirimat for the treatment of MPX?

Experience with and data for tecovirimat treatment for MPX is currently very limited. Animal studies suggest mortality benefit. The oral drug has been well tolerated in the people who have received it this far and appears to be effective in laboratory studies, but the drug is still considered an investigational new drug. Safety and side effects have not been studied in pregnancy, breastfeeding, and pediatrics.

Vaccine

The federal supply of JYNNEOS remains limited, but more is expected in the coming weeks and months. The priority is to administer a first dose of vaccine to as many people who are at higher risk for Mpox exposure as possible. As soon as federal vaccine supply expands, Shasta County Health and Human Services Agency Public Health (SC HHSA PH) will make second doses available to those who received their initial dose. The local availability of JYNNEOS is extremely scarce.

Eligibility will expand as vaccine supply increases. Due to the scarce availability of vaccine in Shasta County the priority remains at those identified as being in the highest risk groups.

Laboratory Testing Guidance - Update

The Shasta County Public Health Laboratory is not conducting orthopox testing. Locally, Quest and Labcorp are providing Mpox testing.

For more information regarding Quest services visit: Mpox| Quest Diagnostics. Quest’s process employs PCR techniques to aid in the qualitative detection of non-variola orthopoxvirus and monkeypox virus DNA.

For more information regarding Labcorp services visit: Mpox (Orthopoxvirus), DNA, PCR Test | Labcorp. The test is qualitative and will indicate a result for the presence of DNA from non-variola orthopoxvirus species, of which monkeypox is one.

For more information about Mpox click on the links below: