Mpox: BCH's Infectious Diseases team warns of expected rise in cases

Although the mpox (formerly called monkeypox) epidemic has slowed, local cases are expected to trend upward.

The BCH Infectious Diseases (ID) team is closely monitoring mpox transmission in Colorado, as well as nationally, and stays in close contact with Boulder County Public Health.

Mpox is likely now endemic, meaning infection will occur regularly in the U.S. The slowdown in cases may be due to herd immunity, vaccination and changes in behavior. Nonetheless, BCH’s ID team expects to see cases in our community with spikes throughout the year. An example of this includes the recent increase in cases in Mesa County and Denver County. The best way to reduce transmission of mpox is vaccination and early identification of infection.

What is mpox?

Mpox is a condition caused by a virus related to the smallpox virus. The type of mpox we have seen in the U.S. is rarely deadly, with a fatality rate of less than 1%. Even though the mpox virus is not usually fatal, it can cause severe illness and rarely death for people with weakened immune systems, children under 1-year-old, people with a history of eczema, and people who are pregnant or breastfeeding.

Symptoms of mpox.

The infection causes a rash or skin bumps that initially look like pimples or blisters and can be painful or itchy. Other symptoms can include fever, chills, swollen lymph nodes, fatigue, muscle or back aches, headache, or upper respiratory symptoms such as sore throat, or nasal congestion. If you have any of the symptoms, seek evaluation at one of BCH's urgent care, emergency department locations in Boulder or Lafayette or your primary care provider. Read more about symptoms here.

How mpox spreads.

Close contact is the most common way to spread mpox. Close contact could include physical contact with sores, bumps, or lesions of someone who has mpox, including through sex, kissing or other forms of close physical contact. Rarely, mpox can also spread by touching surfaces that a person with the virus has touched. It may take between three days and three weeks for symptoms to appear after infection. Read more about how mpox spreads.

Who is at risk?

Anyone can get mpox if they have close contact with someone who has mpox. People who are at heightened risk are individuals who have recently traveled to a country where mpox has been reported or men who are gay, bisexual, or other same-gender-loving men who have sex with men. Learn more about who is at risk here.

How can I protect myself from mpox?

• Avoid skin-to-skin contact with people who have a rash, especially if it looks like mpox
• Wash your hands often with soap and water or use an alcohol-based hand sanitizer
• Vaccination

Who can get vaccinated for mpox and why should I get vaccinated?

An mpox vaccine is available (Jynneos) which can significantly reduce your chances of getting mpox, but no vaccine is 100% effective. Infections after vaccination are still possible but are typically milder with a lower chance of hospitalization.

If an individual is exposed, the vaccine may prevent infection if given soon enough after exposure. Click here for detailed recommendations for who should be vaccinated. 

If you already have symptoms of mpox, vaccination is not recommended.

Where can I get an mpox vaccine, and how is it delivered?

We are working hard to make mpox vaccine easily available to our community. If you are already a patient of Beacon Center for Infectious Diseases and are at risk of getting mpox, ask your provider for the two-dose vaccine series. You can also ask your BCH primary care provider to write an order for the mpox vaccine. Click here to find a provider or to make an appointment to discuss mpox vaccine.

BCH carries the two-dose Jynneos vaccine. The vaccine is delivered between the top layers of your skin (intradermal). You can choose where you would like the vaccine placed: forearm, upper back just below the shoulder blade or the skin of your shoulder above the deltoid muscle.

Where can I get tested for mpox?

If you think you could have been exposed to mpox or are experiencing symptoms, please call your BCH primary care provider or present to the BCH urgent care or ED to get tested. Click here to find a provider or to make an appointment. Providers in these areas have been trained in the diagnosis of mpox and can easily consult with the ID team for additional guidance.

Click here for other testing sites in Colorado.

Submitted by: Amie Meditz, MD and Alicia Maltzman, FNP, RN