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Monkeypox Information for Healthcare Providers

The monkeypox (MPV) outbreak is escalating rapidly, and healthcare providers are asked to establish plans at their organizations in regards to staff and patient education, testing for patients with symptoms of MPV, vaccination of eligible staff and patients, and treatment of eligible cases.

Please be alert for patients who have rash illnesses consistent with monkeypox.

The first symptoms of MPV include fever, malaise, headache, and sometimes sore throat and cough. A distinguishing feature of MPV from smallpox is lymphadenopathy (swollen lymph nodes). This typically occurs with fever onset, 1 to 2 days before rash onset, or rarely with rash onset. Lymph nodes may swell in the neck (submandibular & cervical), armpits (axillary), or groin (inguinal) and occur on both sides of the body or just one. See more information on CDC’s website.

Reporting and Testing

Testing is now available via commercial labs: Aegis Science, Labcorp, Mayo Clinic Laboratories, Quest Diagnostics and Sonic Healthcare. No approval is needed by IDPH or CCDPH to test through commercial labs. Please work with your healthcare organization leadership to ensure there is a clear plan for testing for MPV at your site.

  • Positive MPV tests from commercial laboratories are generally reported to the Illinois Department of Public Health via electronic lab reporting.
    • Providers affiliated with acute care hospitals should coordinate with their Infection Prevention departments to ensure positive MPV case details are entered into I-NEDSS (which gets routed to CCDPH).
    • Outpatient facilities should report details of positive cases of suburban Cook County residents to CCDPH during normal business hours (8:30 am – 4:30 pm) by calling 708-836-8699. Alternatively, completed MPV case reports can be faxed to 708-836-8697 via this CCDPH Monkeypox (MPV) Investigation Form.
  • Providers should pursue commercial laboratory testing for suspect MPV cases; CCDPH can authorize testing at IDPH lab only in limited circumstances (outbreaks, high risk exposures for uninsured or underinsured patients where the facility cannot absorb the cost)
  • It is critical that providers notify patients of their results, provide infection prevention guidance to MPV cases, and whether additional treatment may be indicated.
    • For MPV contacts, providers should assess whether their patients may benefit from PEP to prevent MPV or lessen symptoms.
  • See “CDC Preparation and Collection of Specimens

Post-Exposure Prophylaxis via Vaccination

When properly administered before an exposure, vaccines are effective at protecting people against MPV. ACAM200 and JYNNEOS (also known as Imvamune or Imvanex) are the two currently licensed vaccines in the United States to prevent smallpox. Because MPV is closely related to the virus that causes smallpox, the smallpox vaccine can protect people from getting MPV.

Past data from Africa suggests that the smallpox vaccine is at least 85% effective in preventing MPV.

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 in order to prevent onset of the disease. If given between 4–14 days after the date of exposure, vaccination may reduce the symptoms of disease, but may not prevent the disease.

CCDPH currently only has JYNNEOS on hand. If you are healthcare organization interested in pursuing vaccination for eligible patients (PEP or PEP++), email [email protected]

IDPH and CCDPH have been focusing on Post-Exposure Prophylaxis (PEP). See the Monkeypox Exposure Risk Degree & Recommendations, or download the graphic below.

IDPH and CCDPH have been working to expand JYNNEOS vaccinations to those eligible for Expanded Post-Exposure Prophylaxis (PEP++) as vaccine supply increases – see the “Who should get vaccinated for MPV?” graphic below and the CCDPH PEP++ Screening Tool

Indications for Post-Exposure Prophylaxis

Who should get vaccinated for MPV?

Treatment Considerations

Per the CDC, there are no treatments specifically for MPV infections. However, MPV and smallpox viruses are genetically similar, which means that antiviral drugs and vaccines developed to protect against smallpox may be used to prevent and treat MPV infections.

  • Tecovirimat (AKA TPOXX) may be considered for treatment in people infected with MPV with severe disease (e.g. hemorrhagic disease, sepsis) or high risk of severe disease (e.g. poorly controlled HIV, cancer, transplant, pregnant).
  • TPOXX is available for ordering through the CDC, but a physician must be included in the decision and treatment process using this drug, as it is an investigational new drug use. If you are interesting in pursuing treatment, please contact your local health department (for treatment in suburban Cook County, you can email [email protected]) See more information on CDC’s website.

Updated August 5, 2022, 10:48 AM