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Information for the Public

CDC Monkeypox Website
Press Release: Health department provides monkeypox update (7/29/22)
Monkeypox Fact Sheet - CDC
Social Gatherings, Safer Sex and Monkeypox - CDC


Frequently Asked Questions

  • What are the signs and symptoms of monkeypox?

    Symptoms of monkeypox can start with:monkeypox

    • Fever, headache, muscle aches and backache, swollen lymph nodes, chills, exhaustion

    These symptoms usually appear 7-14 days after someone is exposed to monkeypox. About 1-3 days later, a rash that can look like pimples or blisters appears, usually on the face, inside the mouth, and on other parts of the body, like the hands, feet, chest, genitals, or anus.

    The rash goes through different stages before healing completely. The illness typically lasts 2-4 weeks.

    Sometimes, people get a rash first, followed by other symptoms. Others only experience a rash.

  • If I was exposed, when should I expect to see symptoms?

    flowchart

    Symptoms usually appear 7-14 days after exposure but can occur up to 21 days after exposure.

    If you know that you have been exposed (close physical contact) to a person who had symptoms of monkeypox at the time of your exposure, you should contact your healthcare provider as you may be eligible for a post-exposure prophylaxis vaccine. Receiving the vaccine within 4 days of exposure can prevent infection and within 14 days of exposure can reduce symptoms.

    You need to watch for symptoms, and if a rash develops, isolate and then seek medical attention for evaluation and testing.


  • How does monkeypox spread?

    mpx risk levels

    Monkeypox spreads in different ways. The virus can spread from person to person through:

    • direct contact with the infectious rash, scabs, or body fluids
    • respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact, such as kissing, cuddling, or sex
    • touching items (such as clothing or linens) that previously touched the infectious rash or body fluids
    • pregnant people can spread the virus to their fetus through the placenta

    It’s also possible for people to get monkeypox from infected animals, either by being scratched or bitten by the animal or by preparing or eating meat or using products from an infected animal.

    Someone who has monkeypox can spread infection to others from the time symptoms start until the rash has fully healed (scabs have fallen off) and a fresh layer of skin has formed. The illness typically lasts 2-4 weeks. People who do not have monkeypox symptoms cannot spread the virus to others. At this time, it is not known if monkeypox can spread through semen or vaginal fluids.

    Here's guidance from the Centers for Disease Control and Prevention about how to clean at home.


  • Who is at risk for monkeypox infection?

    Anyone with a rash that looks like monkeypox should talk to their healthcare provider, even if they don’t think they had contact with someone who has monkeypox. People who may be at higher risk might include, but are not limited to, those who:

    • Had contact with someone who had a rash that looks like monkeypox or someone who was diagnosed with confirmed or probable monkeypox
    • Had skin-to-skin contact with someone in a social network experiencing monkeypox activity; this includes men who have sex with men who meet partners through an online website, digital application (“app”), or social event (e.g., a bar or party)
    • Traveled outside the U.S. to a country with confirmed cases of monkeypox or where monkeypox activity has been ongoing
    • Had contact with a dead or live wild animal or exotic pet that exists only in Africa or used a product derived from such animals (e.g., meat, creams, lotions, powders, etc.)
  • Where do I go to get tested for monkeypox?

    Call your healthcare provider. They can set up an appointment for testing or direct you to where you can be tested.  If you do not have a provider and you have a rash or symptom that you are concerned about, you may go to an urgent care or emergency department for care and evaluation.

  • Where can I go to get a vaccine?
    • IDOH had consulted its statewide vaccine allocation committee about the equitable and ethical distribution of the JYNNEOS vaccine.
    • Indiana has only been allocated a small amount meant to be used primarily to treat people who have been a close contact of a case to prevent severe disease.
    • If you are a close contact of a confirmed monkeypox case, please reach out to your local health department and or provider.
    • Postexposure prophylactic vaccination must be given within 14 days of exposure.
    • IDOH has begun to vaccinate people who are at high risk for severe illness and high risk for exposure with the limited remaining vaccine and has been contacting those patients directly.
    • If you would like to be notified when more vaccine is available, please click this link or point your smart phone at the QR code and register.vaccine registration

Information for Clinicians

Clinical Guide for Monkeypox Testing, Specimen Collection and Submission (printable) - updated 8/10/22

Statewide Standing Order for Administration of Jynneos Vaccine by Eligible Providers
Statewide Standing Order for Administration of Jynneos Vaccine by Eligible Providers - Protocol

Frequently-asked Questions

  • How do patients present with monkeypox?

    Patients with a new characteristic rash or who meet one or more of the epidemiologic criteria and in which there is a high suspicion should be tested for monkeypox.

    Risk Factors

    Monkeypox spreads between people primarily through direct contact with infectious sores, scabs, or body fluids. It can also spread by respiratory secretions during prolonged, face-to-face contact. People who may be at higher risk might include, but are not limited to, those who within 21 days of illness onset:

    • Had contact with someone who had a rash that looks like monkeypox or someone who was diagnosed with confirmed or probable monkeypox
    • Had skin-to-skin contact with someone in a social network experiencing monkeypox activity;
    • Traveled outside the United States to a country with confirmed cases of monkeypox or where monkeypox activity has been ongoing
    • Had contact with a dead or live wild animal or exotic pet that exists only in Africa or used a product derived from such animals (e.g., game meat, creams, lotions, powders, etc.)

    Monkeypox Clinical Recognition - CDC

  • How do I collect and submit specimen for testing?

    Materials Needed for Collection and Handling Instructions - CDC

    How to Collect Specimen and Protect Clinical Staff - CDC

    Several commercial labs are now testing for orthopox virus which detects monkeypox. Please work with your lab staff to send specimen to these commercial labs: Aegis Science, Labcorp, Mayo Clinic Laboratories, Quest Diagnostics and Sonic Healthcare. Results will be transmitted to the IDOH. Prior IDOH authorization is not required to submit specimens to commercial laboratories.

    If you are unable to submit to one of these five labs, complete a Monkeypox Specimen Testing Request for testing through the Indiana Department of Health (IDOH)

    Once approved, specimens should be submitted via LimsNet, an online system that will make results available as PDF files the minute they are released at IDOH Laboratories. Specimens should be submitted through the Biothreat submission page in LimsNet. To get a free LimsNet account established at your facility for electronic submission and results reporting, call the help desk at (317) 921-5506 or email LimsAppSupport@isdh.in.gov.

    Monkeypox Specimen Submission Instructions - IDOH (updated 8/10/22)

  • What should I tell my patient about home isolation, contact tracing and contact monitoring?

    Home Isolation Guidance - CDC
    Contact the local health department for wraparound services to individuals in isolation.

    Contact Tracing Guidance - CDC
    Contact the local health department for assistance with contact tracing.

    Contact Monitoring Guidance - CDC

  • How do I get and administer vaccine?

    JYNNEOS (also known as Imvamune or Imvanex) is a  vaccine licensed by the U.S. Food and Drug Administration (FDA) for preventing monkeypox infection. In the United States, there is currently a limited supply of JYNNEOS, although more is expected in coming weeks and months.

    On Aug. 9, the FDA authorized emergency use of JYNNEOS vaccine to increase vaccine supply by allowing healthcare providers to use the vaccine by intradermal injection for individuals 18 years of age and older who are determined to be at high risk for monkeypox infection.

    The EUA now allows for an alternative regimen with an injection volume of 0.1mL to be administered between the layers of the skin (intradermally). Two doses of the vaccine given four weeks (28 days) apart will still be needed. This expanded EUA will means that each vial will have five doses rather than one, expanding the number of doses available to help contain the spread of monkeypox.

    The EUA also allows the standard subcutaneous administration regimen for JYNNEOS with an injection volume of 0.5mL for anyone under 18 years old.

    Use the Vaccine Administration and Consent (English)(Español) to ensure doses provided to your clinic have been administered and accounted for.

    Ensure documentation for each JYNNEOS dose administered is documented here: Vaccine Administration and Consent Form. Providers do not have to fill out the separate CDC vaccine accountability form.

    If you are a provider who has already been approved to receive and administer JYNNEOS vaccine, please use this link to reorder. Please note, upon receipt, we will be cross-referencing the doses administered and entered into the Vaccine Administration and Consent Form to ensure doses provided to your clinic have been administered and accounted for prior to distributing additional vaccine.

    Pre-exposure Prophylaxis

    • The Indiana Department of Health (IDOH) has consulted its statewide vaccine allocation committee about the equitable and ethical distribution of the JYNNEOS vaccine.
    • Indiana has only been allocated a small amount meant to be used primarily to treat people who have been a close contact of a case to prevent severe disease.
    • If you are a close contact of a confirmed monkeypox case, please reach out to your local health department and or healthcare provider.
    • Postexposure prophylactic vaccination must be given within 14 days of exposure.
    • IDOH has begun to vaccinate people who are at high risk for severe illness and high risk for exposure with the limited remaining vaccine and has been contacting those patients directly.
    • When the state is allocated more vaccine, we will expand vaccine eligibility to groups at high risk for exposure. Please continue to monitor this page for updates.

    This form should be used for providers interested in administering JYNNEOS vaccine (PrEP) to their patients and/or community: Provider Enrollment for JYNNEOS Vaccine

    Post-exposure Prophylaxis

    The Centers for Disease Control and Prevention (CDC) recommends post-exposure prophylaxis for high or intermediate risk contacts of monkeypox cases.

    JYNNEOS (also known as Imvamune or Imvanex) is licensed by the U.S. Food and Drug Administration (FDA) for preventing monkeypox infection. The sooner an exposed person gets the vaccine, the better. CDC recommends that the vaccine be given within 4 days from the date of exposure to prevent onset of the disease. If given 4–14 days after the date of exposure, vaccination may reduce the symptoms of disease but may not prevent the disease.

    There is a limited supply of JYNNEOS, although more is expected in coming weeks and months. Please submit a PEP request form to order JYNNEOS for patients who have been exposed to a confirmed case.

    Quick Reference Guide to Post-exposure Prophylaxis
  • How do I get TPOXX for treatment?

    Treatment

    Tecovirimat (also known as TPOXX or ST-246) is FDA-approved for the treatment of human smallpox disease caused by Variola virus in adults and children. However, its use for other orthopoxvirus infections, including monkeypox, is not approved by the FDA. Therefore, CDC holds a non-research expanded access Investigational New Drug (EA-IND) protocol that allows for the use of tecovirimat for primary or early empiric treatment of non-variola orthopoxvirus infections, including monkeypox, in adults and children of all ages.

    This request form is to be utilized by providers or local health departments (LHDs) only. Patients should contact their providers to inquire about obtaining TPOXX for treatment.

    A unique survey entry must be completed for each individual TPOXX request.

    Click for Information for Healthcare Providers on Obtaining and Using TPOXX (Tecovirimat) for Treatment of Monkeypox from the CDC.

  • What are the recommendations for healthcare personnel?

    Treatment Information for Healthcare Professionals - CDC
    If a probable case (orthopox positive) is identified, IDOH will report the result to the clinician and facilitate a consultation call with CDC and the clinician for treatment assessment and ordering.

    Information for Healthcare Professionals - CDC


Additional Resources

Monkeypox in 2022 - What Clinicians Need to Know - Jeannette Guarner, MD,  Carlos del Rio, MD and Preeti N. Malani, MD, MSJ (6/13/22)
Update for Clinicians on Monkeypox in People with HIV, Children and Adolescents and People who are Pregnant or Breastfeeding (7/30/22)
Vaccine Adverse Event Reporting System (VAERS)
Monkeypox Outbreak: 2022 Clinician Outreach and Communication Activity (CDC)
Indiana Health Alert Network Advisory, Monkeypox - IDOH (6/10/22)
Clinical Guidance (CDC) 
Clinical Considerations for Monkeypox in People Who are Pregnant or Breastfeeding (CDC)
Clinical Considerations for Monkeypox in Children and Adolescents (CDC)