SMALLPOX
WHAT IS SMALLPOX?
Mpox is a viral disease caused by infection with the monkeypox virus. It is a zoonotic disease that can spread between animals and people.
Transmission
Mpox can spread to anyone through close, personal, often skin-to-skin contact.
Close Contact
Mpox can spread through direct contact with mpox rash and scabs from a person with mpox, as well as contact with their saliva, upper respiratory secretions (snot, mucus), and areas around the anus, rectum, or vagina.
Oral, anal, or vaginal sex, or touching the genitals (penis, testicles, labia, and vagina) or anus of a person with mpox
Hugging, massage, and kissing
Prolonged face-to-face contact
Anyone, regardless of sexual orientation or gender identity, who has been in close, personal contact with someone who has mpox is at risk.
Respiratory Spread
Although the risk is lower, mpox virus can spread through contact with objects, fabrics, and surfaces that have not been disinfected after use by someone with mpox.
This includes items like clothing, bedding, towels, or sex toys.
Infected Animals
It is possible, though less likely, to get mpox from a pet. Petting, cuddling, hugging, kissing, licking, and sharing sleeping spaces or food with an infected pet can spread mpox to a person.
Avoid close contact with an animal that might have mpox.
If you have mpox, you should avoid contact with animal and pets to prevent spreading the virus to them.
Symptoms
People with mpox get a rash that may be located on or near the genitals (penis, testicles, labia, and vagina) or anus (butthole) and could be on other areas like the hands, feet, chest, face, or mouth.
Initial and Additional Symptoms
The rash will go through several stages, including scabs, before healing. The rash can initially look like pimples or blisters and may be painful or itchy.
Other symptoms of mpox can include:
Fever, chills, swollen lymph nodes
Exhaustion
Muscle aches and backache
Headache
Respiratory symptoms (e.g. sore throat, nasal congestion, or cough)
You may experience all or only a few symptoms
Sometimes, people have flu-like symptoms before the rash.
Some people get a rash first, followed by other symptoms.
Others only experience a rash.
New or Unexplained Symptoms
If you have a new or unexplained rash or other mpox symptoms, see a healthcare provider.
Avoid close contact, including sex or being intimate with anyone, until you have been checked out by a healthcare provider.
Do not touch or scratch the rash. This can spread the rash to other parts of your body, increase the chance of spreading the virus to others, and possibly cause open lesions to become infected by bacteria.
When you see a healthcare provider, wear a mask, and remind them that this virus is circulating in the area.
If you don’t have a provider or health insurance, contact your local health department to find out how to access the healthcare services in your community.
How Long Mpox Lasts
Mpox symptoms usually start within 3 weeks of exposure to the virus.
If someone has flu-like symptoms, they will usually develop a rash 1-4 days later.
Mpox can be spread from the time symptoms start until the rash has healed, all scabs have fallen off, and a fresh layer of skin has formed.
The illness typically lasts 2-4 weeks.
Prevention and Treatment
There is no treatment specifically for mpox. Because the viruses that cause mpox and smallpox are closely related, drugs and vaccines developed to treat and protect against smallpox may be effective for mpox.
Prevention
Reduce mpox exposure by avoiding behaviors that increase risk of mpox exposure.
Exchange contact information with any new partner to allow for sexual health follow-up, if needed.
Consider how much close, personal, skin-to-skin contact is likely to occur at events you attend.
Spaces like back rooms, saunas, sex clubs, or private and public sex parties, where intimate, often anonymous sexual contact with multiple partners occurs—are more likely to spread mpox. (CDC)
Vaccine
CDC recommends vaccination against mpox if:
Are a gay, bisexual, or other same-gender loving man who has sex with men or are transgender, gender non-binary, or gender-diverse.
Have had sexual or intimate contact with someone who may have mpox. Get vaccinated as soon as possible after exposure, regardless of your sexual or gender identity.
You have had any of the following in the last 6 months:
One or more sexually transmitted infections
A weakened immune system because of another illness, like HIV
Sexual or intimate contact with a person who is at risk of mpox
Anonymous sexual or intimate contact, or more than one sexual partner
Currently, it is not recommended for the general population to receive the mpox vaccination.
Treatment
The type of treatment for a person with mpox will depend on how sick someone gets or whether they’re likely to get severely ill.
Most people with mpox recover fully within 2 to 4 weeks without the need for medical treatment.
Some people, like those with a weakened immune system or genital or rectal rashes, may need treatment.
Drugs used to treat mpox require a prescription and must be requested by a healthcare provider through the local or state health department.
Taking Care of Yourself with Mpox
The type of treatment for a person with mpox will depend on how sick someone gets or whether they’re likely to get severely ill. Most people with mpox recover fully within 2 to 4 weeks without the need for medical treatment.
Caring for Rash
Use gauze or bandages to cover the rash to limit spread to others and to the environment.
Don’t lance (pop) or scratch lesions from the rash. This can spread the virus to other parts of the body and increase the chance of spreading the virus to others. ]
Do not shave the area with the rash until the scabs have fallen off and a new layer of skin has formed.
Keep skin lesions/rash clean and dry when not showering or bathing.
If you have rash on your hands, wear disposable gloves that are non-irritating when handling common objects or touching surfaces in shared spaces.
Topical benzocaine/lidocaine gels can be used for temporary relief. Oral antihistamines such as Benadryl and topical creams such as calamine lotion or petroleum jelly may help with itching.
Soaking in a warm bath (using oatmeal or other over-the-counter bath products for itchy skin) may offer some relief to the dry, itchy sensations that can come with the rash.
Notify Close Contacts
It’s important to notify your close contacts that they may have been exposed to mpox immediately, so they can watch for signs and symptoms, get tested and isolate if they have symptoms, and consider getting vaccinated.
Determine if someone is considered a close contact. A close contact is anyone, since the start of your mpox symptoms you:
Have had sex with; this includes oral, anal, and vaginal sex.
Have hugged, cuddled, or kissed.
Shared cups, utensils, towels, clothing, bedding, blankets, or other objects and materials with.
Have touched or who came in contact with the rash on your body.
Think about:
Who are your sex partners?
Who lives with you?
Have you recently played sports where you had skin-to-skin contact?
Who else have you recently had direct skin-to-skin contact with?
In-person meetings or gatherings you attended, people you work with, etc.
Managing Symptoms
Medicines like ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) can help you feel better. Your healthcare provider may prescribe stronger pain relievers as well.
For rash in the mouth, rinse with salt water at least four times a day. Prescription mouthwashes, sometimes called miracle or magic mouthwash, or local anesthetics like viscous lidocaine can be used to manage pain. Oral antiseptics like chlorhexidine mouthwash can be used to help keep the mouth clean.
Wash hands often with soap and water or use an alcohol-based hand sanitizer, especially after direct contact with the rash.
Wear a well-fitting mask around other people until the rash and all other symptoms have resolved.
Eat healthy and get plenty of rest to allow your body to heal.
Mpox Information for Providers
Free testing is available on a case by case basis through the Texas Department of State Health Services (DSHS) lab. Please contact Amarillo Public Health or your local health department to learn more about testing through the state lab. Turnaround time is currently 24hrs. This timeline is subject to change.
CDC recommends testing for cases that meet at least suspect case criteria: https://www.cdc.gov/poxvirus/monkeypox/clinicians/case-definition.html
Additionally testing is available at various commercial labs.
If you suspect your patient has mpox, please notify Amarillo Public Health or your local health department immediately.
If you decide to use a commercial lab to test, please contact the commercial lab to determine information on collection, shipping, and turnaround time.