Mpox infections, from Clade II Monkeypox virus, continue to be endemic in the United States. Orange County has had an increase in mpox cases over the summer. Orange County Pride Parade and Festival is scheduled for October 5th. Pride events have been associated with an increase in risk behaviors and mpox transmission. Los Angeles County Department of Public Health recently had a press release reporting a significant increase in mpox cases in their jurisdiction. Providers should remain vigilant for people presenting with signs of mpox, test appropriately and notify OCHCA Communicable Disease Control Division (CDCD) at 714-834-8180 with any suspect cases.   

In addition, providers should continue to monitor the evolving situation of Clade I mpox in Africa and educate patients traveling to Africa about the risk and prevention strategies. The CDC recently released a Health Alert - Prevention Strategies for Mpox, including Vaccinating People at Risk via Sexual Exposure, for U.S. Travelers Visiting Countries with Clade I Mpox Outbreaks.

• Providers should be alert to test for mpox in patients who have compatible illness. See Mpox Clinical Recognition and Testing Overview and Quicksheet.
• Providers should report suspect cases to CDCD at 714-834-8180 so that contact investigations can be initiated.
• Testing is available through most commercial laboratories. Alternatively, providers can contact CDCD and we can facilitate testing through the state public health laboratory.
• The CDC has guidance on the Clinical Treatment of Monkeypox provides information on available therapeutics and how they may be accessed.
• Vaccination is a safe and effective way to reduce the risk of mpox infection in at-risk individuals.
• Vaccine distribution has transitioned to the commercial marketplace
• Providers can order vaccines from their usual distributors. 
• Many local commercial pharmacies can administer vaccine
• Patients can also check the CDC’s Find Mpox Vaccines site for additional options.
• Those recommended to be vaccinated against mpox include people who:
• Had known or suspected exposure to someone with mpox.
• Had a sex partner in the past 2 weeks who was diagnosed with mpox
• Are a gay, bisexual, or other man who has sex with men or a transgender, nonbinary, or gender-diverse person who in the past 6 months has had any of the following:
• A new diagnosis of one or more sexually transmitted diseases (e.g., chlamydia, gonorrhea, or syphilis)
• More than one sex partner
• Have had any of the following in the past 6 months:
• Sex at a commercial sex venue (like a sex club or bathhouse).
• Sex related to a large commercial event or in a geographic area (city or county for example) where mpox virus transmission is occurring.
• Have a sex partner with any of the above risks.
• Anticipate experiencing any of the above scenarios.
• Are at risk for occupational exposure to orthopoxviruses (e.g., certain people who work in a laboratory or a healthcare facility).
• There is not a general recommendation for additional (booster) doses for those who have previously completed the two-dose series with JYNNEOS.
• There is no recommendation for giving mpox vaccine to those with previously documented mpox disease.

Providers with questions or to report confirmed and probable cases of MPX should contact OCHCA Communicable Disease Control Division at 714-834-8180.