Monkeypox (MPX)

What is MPX?

MPX is a rare disease caused by infection with the MPX virus. MPX virus is part of the same family of viruses as smallpox. MPX symptoms are similar to smallpox symptoms, but milder; and MPX is rarely fatal. MPX is not related to chickenpox.
Screen regularly for sexually transmitted infections. Syphilis and herpes are much more common than MPX – they appear similar and should be treated too.
Learn more about MPX

Fever
Headache
Muscle aches and backache
Swollen lymph nodes
Chills
Exhaustion
A rash that can look like pimples or blisters that appears 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.

Monkeypox key characteristics Collage of monkeypox characteristics including rashes and lesions on different parts of the body

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

Avoid close, skin-to-skin contact with people who have a rash that looks like MPX.
Do not touch the rash or scabs of a person with MPX.
Do not kiss, hug, cuddle or have sex with someone with MPX.
Do not share eating utensils or cups with a person with MPX.
Do not handle or touch the bedding, towels, or clothing of a person with MPX.
Wash your hands often with soap and water or use an alcohol-based hand sanitizer.

If you are experiencing severe pain, trouble urinating, rectal pain, sores on or near your eyes, or other highly concerning symptoms, please go to your nearest emergency room or call 9-1-1 and notify them of your concern for MPX.
Otherwise, contact your primary care doctor right away. You should only get tested for MPX if you are experiencing symptoms. Only your provider can give you the test result, not the Public Health Department. Isolate from others, including intimate partners and household members, while you wait for your test result.
Your doctor may also test you for sexually transmitted infections, since the symptoms may be similar.
While you are waiting, be sure to take steps to care for yourself and others:
- Stay home and away from others
- Put off travel on public transportation
- Call, text, or contact your sex partners and people you have had close contact with since the start of your symptoms
- Protect any pets
If you test positive for MPX contact your provider to be released from isolation.

Men or trans people who have sex with men or trans people, including gay or bisexual men and gender diverse people, especially persons who have had two or more partners within the last 14 days.
Sex workers and people who have survival sex or exchange sex, of any sexual orientation or gender identity.
Persons who have had close contact with someone with suspected or confirmed MPX.
Persons who had close contact with others at a venue or event or within a social group where a suspected or confirmed MPX case was identified. This includes persons who received notice from a venue or event of a potential exposure.
Second doses of JYNNEOS vaccine should be administered to anyone who received a first dose at least 28 days prior.
Clinicians who have had a high-risk occupational exposure (e.g., examined MPX lesions or collected monkeypox specimens without using recommended personal protective equipment).
Laboratory workers who routinely perform MPX virus testing.

County of Sonoma MPX vaccine eligibility aligns with the vaccine strategy set by CDPH. This approach prioritizes vaccinating the individuals at highest risk right now, which most effectively prevents spread in communities. Please note, Jynneos vaccine supplies are limited at this time.
All Jynneos vaccine doses have been distributed to providers within Sonoma County. The Public Health Department does not have any vaccine to administer.
If you have already received a first dose of the Jynneos vaccine, you will be contacted about a second dose as soon as sufficient supply is received. You do not need to restart the series if more than four weeks have passed since your first dose.

Testing is available through Sonoma County Public Health Lab, Quest, LapCorp and others.
Instructions for orthopox/monkeypox testing at Sonoma County Public Health Lab:

Clinical Steps for Suspected Orthopox/Monkeypox Cases

Swab the lesions using the Sonoma County Public Health Lab Specimen Form as a guide:
- Store and maintain all specimens at 4°C if delivering to lab within 72 hours; store at or below -20°C if delivery will be delayed.
Send specimen to Sonoma County Public Health Lab using the Specimen Requisition and place order in Orchard account (Sonoma County Public Health lab portal).

If you have questions regarding testing, please call Sonoma County Public Health Laboratory

Sonoma County Public Health Disease Control:

Email: phnurse@sonoma-county.org
Phone: (707) 565-4568