Following a successful drive to get New Yorkers vaccinated against mpox—previously known as monkeypox—last summer, mpox cases in New York City waned just as quickly as they had spiked. The city declared an end to its outbreak in February this year.
However, an uptick of mpox cases in Chicago in May has health experts and officials concerned about a possible return of outbreaks nationwide. The Centers for Disease Control and Prevention issued a health alert in May, informing clinicians and public health agencies about the new clusters and calling on them to raise awareness about treatment, vaccination, and testing.
Between April 17 and May 5, 12 confirmed and one probable case of mpox were reported to the Chicago Department of Public Health. Nine (69 percent) of 13 cases were among men who had received two vaccine doses, and all cases were among symptomatic men. None of the patients was hospitalized.
The virus is most commonly spread through direct contact with a rash or sores of someone who has it. It can also be spread through contact with clothing, bedding, and other items used by someone with mpox.
Symptoms usually start in 3 to 17 days, and can last two to four weeks. Common symptoms include rash or sores that look like blisters—on the face, hands, feet, or inside the mouth, genitals, or anus. Flu-like symptoms such as sore throat, fever, swollen lymph nodes, or headaches are common too.
In this Q&A, Erick Eiting, MD, MPH, Medical Director for the Emergency Department at Mount Sinai Beth Israel and for the Urgent Care Center at Mount Sinai-Union Square, discusses what people can do to protect themselves from mpox and the importance of being fully vaccinated.
What is mpox and should I be worried about it?
Mpox is an orthopox virus (a genus that includes smallpox and cowpox). In spring and summer of 2022, we saw a pretty large number of infections here in New York City, across the country, and even across the globe.
Because of a widespread vaccine campaign, we’re now seeing far fewer infections than we had been seeing in the summer of last year. However, we’ve recently seen a small increase in the number of infections in New York City.
Should I be concerned about it now?
We recently saw a fair number of cases—in fact, there were 13 recent cases in Chicago over a relatively short period of time. And even though the number of infections that we’ve seen across the country has been relatively low, this number has been an increase from what we’re used to seeing.
And that’s really causing us to pay more attention to what’s going on and to make sure that we’re being vigilant in case those numbers continue to rise.
Fast facts about mpox
3,821
Cumulative mpox cases in New York City in 2022
70
Number of daily cases at the peak of mpox outbreak
20
Number of cases in New York City from February to May 2023
45%
Percentage of fully vaccinated at-risk individuals in New York City
Top Three Most Vaccinated Regions
- California (306,000 doses)
- New York City (153,000 doses)
- Florida (94,000 doses)
What can I do to prevent it?
The first, and probably most important, is to make sure that if you are concerned about mpox—if you believe you may have risk factors—you really need to get fully vaccinated. Fully vaccinated means that you received two doses of the JYNNEOS® vaccine, at least four weeks apart.
Two weeks after you’ve received that second dose of the vaccine, you are considered to be fully vaccinated. So if you’re not fully vaccinated, that is probably one of the most important steps that you can take to prevent getting mpox.
The next part is making sure that you’re having conversations with people like sexual partners. Anybody who may have symptoms at the time could potentially pose a risk for infection, and it’s important to have those conversations.
We don’t consider mpox to be a sexually transmitted disease, but we do know that it comes from close physical contact. So having those conversations is really important, and even asking sexual partners about their vaccination status is also an important step.
The third thing is, if you’re concerned that you may have symptoms that are consistent with an mpox infection—and that could be a rash, which is often very painful, as well as fever, body aches, and chills—then it’s really important that you seek medical care as soon as possible. Some studies have shown that that the vaccine can be helpful in preventing mpox infection even after you’ve been exposed. Or that it can make the infection less severe.
If I have only taken one dose of the vaccine and have not completed the series, do I only need to take one more dose? Or do I have to go through the whole series again?
Anybody who’s received one dose already of the JYNNEOS® vaccine only needs one additional dose. You want to make sure that at least four weeks have passed since you’ve got the first dose. You need to get that second dose of the JYNNEOS vaccine in order to be fully vaccinated.
If I had taken both doses last year, should I consider taking another dose?
At this time there is no recommendation for getting a “booster” shot for the JYNNEOS® vaccine, and possibly there may not even be any additional benefit. So at this time we’re not recommending any further doses: two doses are fully sufficient, and if you’ve gotten both of those doses, you’re considered to be fully vaccinated.
Am I adequately protected if I complete my vaccine series now? Am I still protected if I had completed my series last year?
Yes, you will absolutely be protected. You have to keep in mind that no vaccine is perfect; no vaccine will prevent 100 percent of infections. But this is about the best protection that you could potentially have. So if you’ve already gotten those two doses, and two weeks or longer have passed since then, you are fully protected.
Can I stay home if I have symptoms? Who should be seeking treatment?
If you are presenting with symptoms, you should absolutely be seeking treatment. One of the most important steps is getting tested and making sure that we’re confirming the diagnosis of mpox. One of the beneficial parts about this disease is that very few people will go on to have very severe symptoms.
It’s only a very small number of people who have died. The people who are most at risk are people who have some kind of advanced weakened immune system, people who are pregnant, and children.