Mpox Information for Providers

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Information is being updated as it becomes available.

Health Messages:

Please see the following Health Messages for more information on Mpox. These Health Messages have been issued by the Fresno County Department of Public Health (FCDPH). 

How to Report a Mpox Case:

  • Follow disease reporting requirements.
  • Fill out the (PDF, 2MB)CMR form(PDF, 2MB) .
  • Call the FCDPH at (559) 600-3332 during normal hours or (559) 600-3111 after hours.
  • Forms will be completed by the Communicable Disease Investigations (CDI) team.
  • Providers are mandated to report Mpox to local Health Department.

Testing Guidance

  • Mpox rash goes through stages, so it can resemble a number of other conditions. Differential diagnoses of most concern include other vesicular diseases including herpes (HSV) and varicella (VZV). Both HSV and VZV can be diagnosed by swabbing lesions in a similar manner and with similar equipment as described below for Mpox. It is recommended to order HSV PCR and VZV PCR as the diagnostic tests for these conditions. In addition, other sexually transmitted diseases including syphilis and HIV should be considered and tested for, however, testing for Mpox should not be delayed while awaiting other test results. Testing for Mpox with a PCR test from a swabbed lesion is increasingly available through commercial labs; see links below for Quest and LabCorp reordering, preferred swabs, and transport containers/mediums.

Caring for Patient Guidance:

  • Isolate suspected Mpox patients.
  • Use PPE when caring for patients.
  • The prognosis for Mpox depends on multiple factors, such as Mpox vaccination status, initial health status, concurrent illnesses, and comorbidities among others. Supportive care and treatment of symptoms should be initiated for all patients who have Mpox infection. This may include different topical, systemic medications, or other clinical interventions to control pain, itching, nausea and vomiting. Proctitis can occur and progress to become severe and debilitating, that may require prescription medication. 

Treatment for Mpox:

  • Supportive care for Mpox should be used to ease symptoms and manage complications.
  • Patients should be offered fluids and food to maintain adequate nutrition.
  • A vaccine may be considered for those who are close contacts of someone diagnosed with Mpox. Click on link below for more information on treatment guidance:

Mpox Vaccine:

JYNNEOS is a vaccine indicated for both the pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) of Mpox disease in adults 18 years of age and older who are at high risk for smallpox or Mpox infection. JYNNEOS is an attenuated, non-replicating orthopox virus live vaccine.

Since the Mpox vaccine supply and distribution is currently limited, vaccination efforts are focused on individuals in Priority Levels: Tier 1 and Tier 2.

Eligible Population (Tier 1):

  • Post-exposure prophylaxis (PEP) for named contacts (suspected or confirmed case).
  • Pre-exposure prophylaxis (PrEP) for people at occupational risk according to Advisory Committee on Immunization Practices guidance: laboratory workers, selected clinicians, and public health response team members who routinely handle Mpox virus samples for diagnosis or testing purposes or has a high-risk occupational exposure.
  • PEP for attendees of events/venues where known Mpox exposure has occurred within the past 14 days.

Eligible Population (Tier 2):

PrEP for gay, bisexual, and other men or trans people who have sex with men and meet at least one of the following criteria: 

  • Were diagnosed with Gonorrhea, Chlamydia, and/or Syphilis within the past 3 months.
  • New HIV diagnosis within the last 12 months.

*Of note, PrEP for populations at increased risk for Mpox is based on evolving epidemiology and the latest guidance from CDPH, ACIP, and FDA. 

California Department of Public Health (CDPH):

Centers for Disease Control and Prevention (CDC):