While cases of mpox have been at low levels this year, mpox transmission has continued to occur in California and clusters have been reported in other states. Last week routine surveillance testing identified mpox in wastewater specimens in Orange County. No recent clinical cases have been reported to OCHCA, but we want to remind providers to continue to be vigilant in recognizing potential cases, particularly during the LGBTQ Pride Event Season. The diagnosis of mpox should be considered when evaluating patients with rash illness. Patients presenting with sexually transmitted infections should be assessed for mpox rash. Most cases of mpox infections have been among gay, bisexual, same-gender-loving, and other men who have sex with men (MSM).

On May 30, 2023, CDPH released a Health Advisory reviewing current mpox epidemiology and guidance. Current county data associated with the mpox outbreak and current guidance can be found online at ochealthinfo.com/mpox.

Providers should continue to consider mpox in patients presenting with either localized and generalized rashes including in patients who were previously infected with mpox or vaccinated against mpox.  Mpox rash may be confused with syphilis, herpes, molluscum contagiosum, shingles, chickenpox and other skin conditions. Providers caring for a patient with suspected or confirmed mpox should:

• Collect appropriate specimens, following the guidance of your testing laboratory.
• Consider treatment, particularly for those who may be immunocompromised. Tecovirimat for the treatment of mpox is available from OCHCA following these linked directions.
• Follow recommended infection prevention and control measures for mpox,
• Notify OCHCA Communicable Disease Control Division immediately at 714-834-8180.

In conjunction with other prevention measures, vaccination is the most effective way to prevent disease and reduce transmission. Patients 18 years or older are eligible for JYNNEOS - there are no longer eligibility criteria. Mpox vaccine may be given either subcutaneously or intradermally. Providers seeking JYNNEOS vaccine for their practice can contact IAP@ochca.com. If you are not offering vaccine, patients can be referred to either call 1-800-914-4877 or book an appointment for vaccine at https://myturn.ca.gov/.