Mpox (Monkeypox)

Overview

Since late May 2022, the Denver Department of Public Health & Environment (DDPHE), along with other agencies in the state of Colorado, have been monitoring and investigating cases of mpox (monkeypox) in the Denver metro area. Mpox is rare and the transmission risk to the public is relatively low, however it is important to know the signs and symptoms of mpox and how it spreads.

What is mpox (monkeypox)? 

Mpox is a virus in the orthopoxvirus family, the same family of viruses that includes smallpox.

Mpox has recently been spreading in locations that do not typically report cases or local transmission of the virus, including the U.S., Canada, Europe, and Australia. Mpox is endemic in Central and Western Africa, and prior to 2022 almost all cases reported occurred in that region or had recent travel there. This type of mpox infection frequently resolves on its own and has a fatality rate of less than 1%.

Mpox symptoms

Symptoms often begin as flu-like symptoms that can include fever, headache, muscle aches, swollen lymph nodes, and exhaustion. Typically, a rash or bumps on the skin develop within 1-3 days after the onset of fever, but sometimes individuals only experience a rash and no other symptoms. The rash or bumps can look like pimples, blisters, or lesions that can appear in many places on the body including on the face, inside the mouth, other parts of the body like hands, feet, or chest, as well as in the genital or anal area.   

How does mpox spread? 

Mpox is primarily spread person-to-person when someone who has mpox has close, physical contact with someone else. Close contact with mpox means: 

  • Physical contact with a sick person’s rash, bumps, or lesions.
  • Contact with respiratory secretions during prolonged, face-to-face contact (3 hours or more without face coverings).
  • Intimate physical contact such as kissing, cuddling, or sexual contact.
  • Touching bed linens, clothing, bandages, or other materials of someone who is sick, especially materials that came in contact with lesions.  

Brief interactions with someone without physical contact are unlikely to result in spreading the virus. Direct physical contact (typically contact with lesions or lesion material) or prolonged close contact for more than 3 hours is how mpox spreads.  

The rash associated with mpox goes through different stages before healing completely. An individual sick with mpox is considered contagious from the onset of their symptoms until their rash, bumps, or lesions have fully scabbed, healed, and new skin has formed. This typically lasts 2-4 weeks. 

 

Videos

What is mpox and what are the symptoms?

How does mpox spread?

Should I change my routine because of mpox?

How is mpox different from COVID-19?

What should I do if I think myself or someone I know has a mpox?

 

Vaccination Clinics

The Colorado Dept. of Public Health & Environment (CDPHE) will be hosting mpox vaccine clinics. Please refer to CDPHE’s mpox webpage for information about the clinics and how to request an appointment.

Who is eligible for mpox vaccination? 

Those who currently qualify for vaccination are:

  • Anyone (any sexual orientation or gender identity) who has had close physical contact with someone who has mpox in the last 14 days.
  • Anyone (any sexual orientation or gender identity) who: 
    • Has multiple or anonymous sexual partners, or 
    • Has close physical contact with other people in a venue where anonymous or group sex may occur, or
    • Was diagnosed with gonorrhea or syphilis in the past six months, or
    • Is living with HIV, or
    • Already uses or is eligible for HIV PrEP (medication to prevent HIV, e.g. Truvada or Descovy or Apretude), or
    • Engages in commercial and/or transactional sex (e.g. sex in exchange for money, shelter, food, and other goods or needs).
    • Anyone (any sexual orientation or gender identity) identified by public health as a known high-risk contact of someone who has monkeypox.

Anyone who meets these criteria should talk with a health care provider to determine whether vaccination is right for them. 
 
Due to limited data on the safety and effectiveness of the Jynneos vaccine in children, Coloradans should consult with their child’s primary care provider and/or local public health agency before seeking vaccination for their child, especially for younger children. Shared decision-making between the family, the child’s health care provider, and/or the local public health agency should take into account the level of risk from the child’s exposure to mpox and risk of severe disease. 
 
Some children may benefit from alternative options for post-exposure prophylaxis. Data shows the Jynneos vaccine may not work well to protect infants under the age of six months from mpox illness. In these cases, public health will consult with Centers for Disease Control and Prevention and the child’s primary care provider to discuss available options.

 

Vaccination Eligibility

Those who currently qualify for vaccination:

  • Anyone (any sexual orientation or gender identity) who has had close physical contact with someone who has mpox in the last 14 days.
  • Anyone (any sexual orientation or gender identity) who: 
    • Has multiple or anonymous sexual partners, or 
    • Has close physical contact with other people in a venue where anonymous or group sex may occur, or
    • Was diagnosed with gonorrhea or syphilis in the past six months, or
    • Is living with HIV, or
    • Already uses or is eligible for HIV PrEP (medication to prevent HIV, e.g. Truvada or Descovy or Apretude), or
    • Engages in commercial and/or transactional sex (e.g. sex in exchange for money, shelter, food, and other goods or needs).
  • Anyone (any sexual orientation or gender identity) identified by public health as a known high-risk contact of someone who has monkeypox.
  • Anyone whose sexual partner identifies with any of the above scenarios.

Anyone who meets these criteria should talk with a health care provider to determine whether vaccination is right for them. 
 
Due to limited data on the safety and effectiveness of the Jynneos vaccine in children, Coloradans should consult with their child’s primary care provider and/or local public health agency before seeking vaccination for their child, especially for younger children. Shared decision-making between the family, the child’s health care provider, and/or the local public health agency should take into account the level of risk from the child’s exposure to mpox and risk of severe disease. 
 
Some children may benefit from alternative options for post-exposure prophylaxis. Data shows the Jynneos vaccine may not work well to protect infants under the age of six months from mpox illness. In these cases, public health will consult with Centers for Disease Control and Prevention and the child’s primary care provider to discuss available options.

Mpox (Monkeypox) Cases in Denver 

* Numbers are updated on Monday of each week by 5 p.m.

Treatment

There are no treatments specifically for mpox virus infections. However, mpox and smallpox viruses are genetically similar, which means that antiviral drugs and vaccines developed to protect against smallpox may be used to prevent and treat mpox virus infections.

Antivirals, such as tecovirimat (TPOXX), may be recommended for people who are more likely to get severely ill, like patients with weakened immune systems.

If you have symptoms of mpox, you should talk to your healthcare provider, even if you don’t think you had contact with someone who has monkeypox.

Prevention

Take the following steps to prevent getting mpox:

Avoid close, skin-to-skin contact with people who have a rash that looks like mpox.

  • Do not touch the rash or scabs of a person with mpox.
  • Do not kiss, hug, cuddle or have sex with someone with mpox.
  • Do not share eating utensils or cups with a person with mpox.

Do not handle or touch the bedding, towels, or clothing of a person with mpox.

If you are sick with mpox:

  • Isolate at home

If you have an active rash or other symptoms, stay in a separate room or area away from people or pets you live with, when possible

Vaccine Information

Vaccines can be used to reduce the likelihood of infection in people who may have been exposed to mpox or reduce the severity of symptoms if someone does get sick. The vaccine must be administered prior to onset of symptoms to be effective against becoming infected. Currently, JYNNEOS vaccine is the only mpox vaccine available to Colorado residents to limitations in supply.

Getting vaccinated lowers your chance of getting mpox if you are exposed to the virus. The sooner an exposed person gets the vaccine, the better. The vaccine can also reduce the severity of your symptoms if you do get sick later. People who already have symptoms of mpox, or are confirmed to have been infected with mpox, should not get vaccinated.

The Colorado Department of Public Health & Environment (CDPHE) is managing mpox vaccine distribution in Colorado. CDPHE is hosting free vaccine clinics for eligible Coloradoans who meet the criteria. The clinics and number of appointments are based on the availability of vaccine, which is limited in supply. Please refer to CDPHE’s Mpox webpage for information about the clinics and how to request an appointment. 

Frequently Asked Questions

Who is eligible for a mpox vaccine in Colorado?

Eligibility for mpox vaccination may change as the outbreak evolves and based on vaccine supply. People who meet the following conditions are currently eligible to be vaccinated in Colorado:

  • Gay, bisexual, or other men who have sex with men aged 18 years and older who have had multiple sexual partners, and/or sexual partners they did not previously know, in the last 14 days.
  • Anyone aged 18 years and older who believes they have been in close contact with someone who has mpox in the last 14 days.
  • Anyone identified by a state or local health department as having had close contact with a confirmed or probable mpox case.

What should I do if I suspect myself or someone I know has mpox?

If an individual has skin lesions and suspects they have mpox, they should contact their doctor or seek medical attention. A medical provider can help determine if testing is appropriate, and if there are other possible explanations for a person’s illness. 

If you think you have been exposed to mpox or are experiencing symptoms, see a healthcare provider or call 1-877-462-2911.

Where to get tested for mpox

If you have symptoms and are concerned about mpox, contact your healthcare provider for an evaluation or go to a nearby Urgent Care location.  Samples collected by a healthcare provider can now be tested at most commercial labs. People with symptoms who do not have a healthcare provider and have had known contact to someone with monkeypox or are at increased risk from sexual exposure, can visit the CDPHE's mpox testing page to find an updated list of available providers and their contact information.

If you have a rash or sores, cover them with long sleeves, pants, or a bandage until otherwise told by a doctor. Wear a well-fitting mask over your nose and mouth during your appointment.  

Denver Sexual Health Clinic

Phone: (303) 602-3540
Address: 660 N. Bannock St., Pavilion L, 2nd Floor, Denver, CO 80204

Jefferson County Public Health Sexual and Reproductive Health Clinic
Phone: (303) 239-7040
Address: 645 Parfet St., Lakewood, CO 80215