An increase in cases of mpox has recently been reported in San Diego, leading to an announcement from county officials encouraging mpox vaccination for those at greatest risk. In less than a year, more than 490 cases have been reported here, with nearly a dozen reported in October alone.
Mpox, formerly referred to as monkeypox, is a disease caused by the mpox virus, which is in the same family of viruses as the one that causes smallpox. It is rare, with most cases seen in Central and West African countries, primarily the Democratic Republic of Congo. However, mpox made headlines in 2022 when cases were reported in countries outside of Africa, such as the U.S., in people who have not traveled to Africa.
“Mpox cases are rare, and may be mild,” says Dr. Abisola Olulade, a family medicine doctor with Sharp Rees-Stealy Medical Group. “However, the disease can be dangerous for people with weakened immune systems, including young children and people who are pregnant or breastfeeding.”
Here, Dr. Olulade answers your top questions about mpox risks, symptoms and treatment.
How is mpox spread?
Mpox is usually spread via direct person-to-person contact through skin; the respiratory tract; or the mucous membranes in the eyes, nose and mouth. This can occur during sexual activity, kissing, cuddling or touching parts of the body of a person with mpox. Handling clothing or linens that have been worn or used by someone with mpox can also lead to infection.
Additionally, the mpox virus can be shared from an infected pregnant person to their fetus. And transmission is possible from infected animals to people through a bite or scratch, by handling wild game, or by using products made from infected animals.
What are the symptoms of mpox?
While mpox can cause mild illness and is rarely fatal, it can trigger painful symptoms. According to the U.S. Centers for Disease Control and Prevention (CDC), symptoms of mpox include:
The rash resembles pimples, blisters or sores, and can appear on the face; inside the mouth; or on other parts of the body, including the hands, feet, chest, genitals and anus. Some people notice a rash one to three days after experiencing a fever, with other symptoms following. Others may only have a rash, which can take several weeks to heal and can lead to scarring.
Is there a treatment for mpox?
The County of San Diego Health and Human Services Agency advises people who might have mpox to contact their doctor immediately. Although many people with mpox experience mild illness that will resolve on its own, others may be at high risk of severe illness and require treatment. This will likely include antiviral medications used to treat people with smallpox.
Those at greatest risk for severe illness or death due to mpox include people who:
Have compromised immune systems
Are younger than age 8
Are pregnant or breastfeeding
Have a history of skin conditions, such as eczema, burns, impetigo, herpes or severe acne
Have one or more complications, including bacterial skin infection, gastroenteritis, pneumonia or other conditions
Have mpox rash in the eyes, mouth or other areas of the body where infection might create a greater threat to health, including the genitals and anus
Regardless of the severity of the infection, it is important to cover the rash with clothing, wear a face mask around others, and avoid all close contact. Mpox is highly contagious and can spread until all sores have scabbed over, the scabs have fallen off, and a new layer of skin has formed over the areas of rash — a process that can take up to four weeks.
How can mpox be prevented?
According to San Diego County Public Health Officer Dr. Wilma Wooten, the mpox vaccine is safe and effective at lowering the risk of getting mpox or the severity of symptoms if a person does get sick.
The vaccine, named Jynneos, is given as a two-dose injection and is available to people age 16 and older — or under age 16 with parental consent. The second dose is given 28 days after the first dose for maximum protection. Currently, booster doses are not recommended in those who have received both doses.
County health officials recommend you should get the vaccine — both doses — if you:
Are living with human immunodeficiency virus (HIV)
Are a man or person assigned male at birth who has sex with men or people assigned male at birth
Use or are eligible for HIV preexposure prophylaxis (PrEP)
Are a sex worker
Are the sexual partner of someone in the above groups
Have had direct skin-to-skin contact with one or more people in a community where others have had mpox infection
Have been diagnosed with a sexually transmitted disease (STD) in the past 3 months
Are a close contact of someone who has mpox
Work in settings, such as health care settings or laboratories, where you may be exposed to mpox
Anticipate experiencing the above risks
The county reports no-cost first and second doses of the vaccine are widely available in San Diego through health care providers or public health clinics. Appointments can also be made on My Turn.
In addition to vaccination, the county recommends the following mpox prevention steps:
Limit close contact — including sexual activity, kissing, cuddling or touching — with people who have sores or symptoms or who have been recently exposed to mpox.
Avoid touching items or materials that someone with mpox has used or worn.
Practice good hygiene and wash your hands with soap and water often.
If you are among those at greatest risk of mpox exposure, the CDC also recommends avoiding sexual activity until two weeks after your second vaccine dose; limiting the number of your sexual partners; and avoiding situations involving anonymous or multi-partner sex. The use of condoms alone cannot prevent exposure to mpox.
“The risk of mpox within our population is low overall, but it is vital that people at risk receive both doses of the vaccine, and cases are reported and monitored,” Dr. Olulade says. “If you have traveled recently and believe you may have been exposed to mpox or have symptoms of mpox — even just a rash — seek urgent medical care immediately.”
