Health & Human services

Mpox is an infectious disease caused by the monkeypox (mpox) virus. There are two types: clade I, associated with more severe illness, and clade II, which was linked to the 2022–2023 outbreak in the U.S.

The City of Long Beach has confirmed a case of clade I mpox in a resident with no recent travel history. This is the first such case in the United States. The City is actively investigating and coordinating with state and federal health partners. Read full press release here.  

For guidance related to vaccination, symptoms or reporting concerns, please contact the City of Long Beach’s public health information line at 562.570.4321.

Symptoms

Once exposed to mpox, symptoms usually develop within 21 days. Symptoms of mpox can include:

• Fever
• Chills
• Headache
• Muscle aches
• Swollen lymph nodes
• Exhaustion
• Respiratory symptoms such as a sore throat, nasal congestion or cough. 

Within 1 to 4 days after fever, a rash develops. Most people will recover on their own, but those who are immunocompromised may have severe disease and additional complications such as sepsis, pneumonia, encephalitis, and loss of vision.

Mpox can look like other diseases, such as syphilis. For more information on sexual health services available in the city, please visit the Sexual Health (STD) Clinic website.

Transmission

• Direct skin-to-skin contact with mpox rashes or scabs
• Contact with bodily fluids or lesions around the anus, rectum, or vagina from a person with mpox
• Contact with contaminated materials such as clothing or linens
• Through respiratory droplets through prolonged face-to-face contact
• Pregnant women with mpox can pass the virus to the fetus during pregnancy or to the newborn during and after birth.

• Oral, anal, or vaginal sex, or touching the genitals (penis, testicles, labia, and vagina) or anus
• Hugging, massage, and kissing

VACCINATIONS

The vaccines are now typically given in the back of the upper arm. Previously, mpox vaccines were commonly given in the forearm. While it was also effective, some people had more skin reactions, including discoloration of the skin, at this injection site. 

• Jynneos Frequently Asked Questions
  

• Gay or bisexual men, men who have sex with men, transgender and non-binary people or
• People who are immunocompromised (e.g. those with HIV) or
• People taking/eligible for HIV PrEP or doxy PEP or
• Those with occupational exposure or
• People planning to travel to countries with ongoing mpox outbreaks or

• If you have engaged or plan to engage in any of the following activities

  • Have sex at a commercial sex venue (e.g., a sex club, a bathhouse, a sex party)
  • Have sex in exchange for money, goods, drugs, or other trade
  • Have sex in association with a large public event (e.g., a rave, party, or festival)
• Sex with a new partner(s) or partner(s) with any of above risks factors or
• Someone who was exposed to a person with mpox or
• Individuals that request mpox vaccination, even if they have not disclosed any risks listed above

• Medi-cal for members 18 years of age and older
• Pre-Exposure Prophylaxis Assistance Program (PrEP-AP) 
• AIDS Drug Assistance Program (ADAP) 

• Youth ages 12 through 17 may consent to receiving the vaccine.
• Children under the age of 12 must be accompanied by their parent, legal guardian, or a responsible adult. If the child is accompanied by a responsible adult, the consent form must name the responsible person and be signed by the parent or legal guardian.

• Health Providers

  
  
  
  

  Healthcare providers must report positive cases of mpox within 24 hours. To report a case, complete a mpox Confidential Morbidity Report (CMR) and fax with laboratory results to 562.570.4374 or send by secure email to LBEpi@longbeach.gov.  

  Healthcare providers should be alert and consider mpox in patients who present with an unexplained rash or lesions consistent with mpox: 

  1. Instruct patient to isolate and avoid contact with other people while waiting for test results 
  2. Submit specimens for mpox testing through commercial laboratories if possible.

  Specimen Collection: Vigorously swab or brush the base of the lesion with a sterile dry polyester, rayon, or Dacron swab. Collect a second swab from the same lesion. Insert both swabs into the sterile plastic aliquot tube or sleeve and break off the end of the swabs, if required, to tightly close the sample. More than one lesion should be sampled, preferably from different body sites. Store specimens in 4° C. 

  A combination of standard, contact, and droplet precautions should be applied in all healthcare settings when a patient presents with fever and vesicular/pustular rash. The patient should be placed in an isolation room (negative air-pressure if available). PPE should be donned before entering the patient’s room and disposed of prior to leaving the isolation room. PPE measures include: disposable gown and gloves, N95 (or comparable) filtering disposable respirator, and eye protection.

• K-12 Schools and ECEs

  • K-12 School and ECE Recommendations for Mpox
  • Mpox Information for Schools, ECEs and Other Settings Serving Children or Adolescents

• Isolation and Quarantine

  • Isolation Instructions for People with Mpox
  • Guidance for People Who Have Been Exposed to Mpox : English | Spanish |

• Frequently Asked Questions

  What should I do if I think I have mpox?

  If you have symptoms and think you may have mpox, please call your healthcare provider who will determine the need for testing. If you do not have a healthcare provider and are experiencing symptoms, please contact the City of Long Beach’s public health information line at 562.570.4321 for assistance with finding healthcare services.

  If you have a rash that might be due to mpox, your healthcare provider will evaluate you and, based on their evaluation, may swab your rash for testing. The swabs are sent to a commercial lab, and the test result should be available in a few days. There are no self-tests or home-tests for mpox at this time. 

  What does the rash look like?

  Photo Credit: NHS England High Consequence Infectious Disease Network and UK Health Security Agency

  What should I do if I was diagnosed with mpox?

  Stay home unless it is necessary to see a healthcare provider. Do not resume activities outside of the home and do not return to work until all lesions are fully healed and a fresh layer of skin has formed at lesion sites and other symptoms have improved.  
  

  • Individuals who have been diagnosed with mpox should seek medical attention as soon as possible.
  • Most people fully recover within 2 to 4 weeks without the need for specific medications, but symptom relief can be managed at home.
  • Those who have weakened immune systems, existing skin conditions, or who are pregnant or breastfeeding may require additional medical treatment.
  • Notify close contacts and take measures to prevent others from getting sick.

  When can I return to work if I have mpox?

  Workers may return to work when:

  • • Fever or respiratory symptoms have resolved for at least 48 hours; AND
    •  No new lesions have appeared for at least 48 hours; AND  
    • Any lesions that cannot be covered, such as those on the face, are fully healed; AND 
    • Employment doesn’t involve direct physical care or contact with others, (i.e. massage therapy, estheticians, sex worker); AND  
    • Employment is not in a setting of concern (i.e. homeless shelter, healthcare setting, senior care facilities, correctional facilities/detention centers, childcare or preschool, K-12 schools); AND   
    • Virtual work is not possible  

  Persons with mpox who work in a setting of concern should not return to the workplace until all skin lesions have healed (i.e., scabs have fallen off and a fresh layer of skin has formed at the lesion sites) and any other symptoms have been resolved for at least 48 hours. Before returning to a setting of concern, consultation in a healthcare provider is advised.  

  Can I get vaccinated if I have been exposed to someone with mpox?

  Yes. If given before exposure or within 4 days of exposure, JYNNEOS may reduce the chance of infection. If given between 5 and 14 days of exposure, it may lower the severity of symptoms.

  Do I still qualify for JYNNEOS if I have been vaccinated against small pox?

  Individuals who were previously vaccinated with ACAM2000 can be vaccinated with JYNNEOS without precaution.

  When am I considered fully vaccinated?

  You will be fully vaccinated and received the most benefit from the vaccine two weeks after your second dose.  

  Should I still get vaccinated if I've had mpox?

  An individual who is diagnosed with mpox after their first dose of JYNNEOS are not recommended to receive a second dose of JYNNEOS, at this time.

  Is it safe for me to get vaccinated if I am immunocompromised or have eczema?

  JYNNEOS is safe to administer to people with HIV and eczema or other exfoliative skin conditions.
  

  Can I still get vaccinated if I am pregnant or breastfeeding?

  While there are no data in people who are pregnant or breastfeeding, animal data do not show evidence of reproductive harm; pregnancy and breastfeeding are not contraindications to receiving JYNNEOS
  

  Do I have to wait to get JYNNEOS after getting the COVID-19 Vaccine?

  If Orthopoxvirus vaccine (JYNNEOS) is administered first, consider waiting 4 weeks after your second dose before receiving a COVID vaccine. 

  If COVID vaccine is administered first, there is no waiting period to receive orthopoxvirus vaccine (Jynneos). 

  What do I do after getting vaccinated?

  Once you are vaccinated, you should continue to protect yourself from infection by avoiding close, skin-to-skin contact, including sex or other intimate contact, with someone who has mpox.
  

  Can I get the mpox virus from the Jynneos vaccine?

  Jynneos is a live, non-replicating vaccine. This means you cannot become infected with orthopoxviruses by touching the injection site.
  

  How many doses will I receive?

  Two doses are required, as this is the FDA-approved regimen, however, there are some exceptions to this rule: 

  • • An individual who is diagnosed with mpox after their first dose of JYNNEOS are not recommended to receive a second dose of JYNNEOS, at this time. 
    • An eligible individual who has been diagnosed with mpox during this outbreak starting on May 17, 2022, are not recommended to get vaccinated at this time.

• Communications Toolkit

  FAQ: English | Spanish | Tagalog | Khmer

  Social Media Graphics:

  • What you need to know about mpox
  • What should I do if I have symptoms of mpox?
  • What should I do if I have been exposed to mpox?
  • What to know about the mpox vaccine

• Resources

  • Monkeypox (ca.gov)
  • 2022 United States Monkeypox Case | Monkeypox | Poxvirus | CDC 
  • Pets in the Home | Monkeypox | Poxvirus | CDC