As new cases of monkeypox virus infection are identified globally and in the United States, the Alabama Department of Public Health (ADPH), in conjunction with the Centers for Disease Control and Prevention (CDC), continues to monitor the situation. At this time, no cases of monkeypox virus infection have been identified in Alabama, although the ADPH Bureau of Clinical Laboratories (BCL) can perform preliminary testing and has already performed some testing on specimens from patients who had rashes suggestive of monkeypox.

The outbreak is evolving, and information can change. Effective vaccines to reduce the risk of a person catching monkeypox are available, and one of those vaccines, Jynneos, is being used in parts of the United States where there have been cases of monkeypox. Vaccine has to be obtained from the Strategic National Stockpiles (SNS) and ADPH is in regular communication with CDC about vaccines and other countermeasures. ADPH’s investigative teams are on standby to initiate follow-up of any cases and make recommendations for management and prevention. 

Monkeypox is a very rare disease which is usually found in Central and West Africa and does not occur naturally in the United States. Monkeypox does not spread easily from person to person. In this current outbreak, some factors have been different, and the main route of transmission seems to be contact with persons who have direct, close contact with monkeypox skin lesions. Some information from other outbreaks indicate that monkeypox can spread from contact with infected animals or through contact with materials such as clothing or linens used by infected people. The virus typically enters the body through broken skin, respiratory droplets or mucous membranes (eyes, nose or mouth). Some people who have had monkeypox have been men who have sex with men. 

Signs and symptoms of the current monkeypox outbreak in the United States have been different from previous outbreaks. Symptoms in the recent outbreak include the following: 

· Firm, deep seated, painful, itchy vesicles, or pustules 

· Some lesions may have a dimple in the center of the pustule

· Some people may have headache, muscle aches, fatigue after the rash occurs, which is different from other reported outbreaks where a prodrome (general symptoms) occurred before the rash.

The time between exposure to the virus and when the illness begins has been as short as 4 days up to 14 days. Time of exposure to time of rash could be as long as 21 days

Rash associated with monkeypox may appear anywhere on the body. Among cases in the current outbreak, the rash often starts in the genital and perianal areas and may or may not spread to other parts of the body. Once the rash has healed, the person is no longer considered contagious. At this time, CDC has not reported that persons who have no symptoms or have not developed symptoms yet are contagious to others. 

Steps to help prevent monkeypox include: 

• Be educated about monkey pox, including risk factors and the appearance of characteristic skin rashes. 
• Avoid contact with materials, like bedding, that have been in contact with a sick animal or person infected with this virus. 
• Avoid contact with animals that could have the virus (such as animals that are sick or that have been found dead). 
• Keep infected patients away from others. 
• Wash hands with soap and water or use an alcohol-based hand sanitizer after contact with infected animals or humans.

Please contact your healthcare provider if you believe you may have monkeypox.

Monkeypox can cause serious illness lasting 2 to 4 weeks but is rarely fatal. Persons suspected of having monkeypox should remain isolated until the illness and rash have completely resolved. 

For more information on monkeypox, visit alabamapublichealth.gov/monkeypox or cdc.gov/poxvirus/monkeypox/index.html.