Effective communication and precautionary measures between specimen collection teams and laboratory staff are essential to maximizing safety when manipulating specimens suspected to contain Monkeypox virus.

As noted in Sutter County Public Health CAHAN ALERT, please keep monkeypox in your clinical diagnostic differential and initiate timely testing and management to minimize Monkeypox transmission in our community.

Health providers should NOT wait for laboratory results to report a case. As stated in Title 17 CCR 2500, healthcare providers are mandated to immediately report any confirmed or suspected case to the local health jurisdiction where the patient resides.

Resources:

• CDC Preparation and Collection of Specimens
• CDC Testing Patients for Monkeypox

Home Isolation Instructions for People with MPX

If a patient tests positive for MPX you are required to:

1. Isolate - stay home and avoid contact with others.
2. Provide us (Sutter County Public Health) with contact information for your close contacts so we can notify them confidentially and provide them instructions for self-monitoring.
3. Follow the steps outlined in the home isolation instructions for people with MPX.

For more information, view the CDPH MPX Home Isolation Guidance for the General Public.

For Providers:

Patients with severe MPX or MPX complications, including those with pain that interferes with daily activities, and those at high risk of severe disease should be considered for Tecovirimat (TPOXX) treatment. Most patient with MPX who require treatment are being managed as outpatients.

Which patient should be considered?

Treatment consideration are provided in the CDC EA-IND protocol. The decision to treat is clinical discretion of the provider. A positive lab result is not necessary to initiate treatment. Tecovirimat treatment may be initiated for patients with laboratory confirmed non-variola orthopoxvirus infection or suspected infection based on known exposure(s) and/or clinical manifestations of disease.

Treatment considerations:

1. Patients with severe disease
2. Patients at risk of severe disease
   • Patients with immunocompromising conditions
   • Pediatric populations, particularly patients younger than 8 years
   • Pregnant and breastfeeding women
   • Patients with atopic dermatitis or other active exfoliative conditions
3. Patients with one or more complication such as pain uncontrolled with supportive care; secondary bacterial infections, proctitis, oropharyngitis or infection in or near areas that present a special hazard such as the eyes or genitals

What does CDC require Tecovirimat providers to do?

Providers interested in offering Tecovirimat to patients should review the EA-IND protocol and CDC requirements with their clinical facility

More information on Tecovirimat: CDPH MPX Tecovirimat Treatment Information for Providers

As of August 17th, Sutter County Public Health has started offering PEP++ to individuals deemed at high-risk for monkeypox. Appointment slots of 15 minutes can be given to each Sutter County or Yuba County resident who self-attests and qualify.

To determine eligibility, the MPX Vaccine Qualification Survey can be completed.