longbeach.gov/monkeypox
Monkeypox
(MPX):
Study Session
Anissa Davis, City Health Officer
Kelly Colopy, Director
1 longbeach.gov/monkeypox
Situation Update
Monkeypox Overview
Transmission
Testing
Treatment
Resources
Symptoms
Vaccine
Response
2 longbeach.gov/monkeypox
Situation
Update
3 longbeach.gov/monkeypox
May 7 First MPX case identified in the United Kingdom
May 17 The U.S. announces the first MPX case in Massachusetts May 23 California's first case of MPX was reported in Sacramento June 16 Long Beach received first shipment of Jynneos Vaccine July 16 Long Beach announces first case
July 22 CDC announces two pediatric cases of MPX in the U.S.
July 23 WHO declares MPX outbreak a global health emergency July 26 US cases surpass all other countries
August 1 California declared a state of emergency to combat the MPX outbreak August 2 Long Beach announces first confirmed pediatric MPX and a local emergency proclamation (still needs to be ratified)
August 4 First Large-Scale POD at Main Health
4 longbeach.gov/monkeypox
Globally: Over 34,000
confirmed cases as of 8/12/22
- From 92 countries*
- 12 deaths**
USA: 11,117
confirmed cases as of 8/12/22
- 51 states and territories*
- No deaths reported545
710
957
959
1721
2423
2858
2916
4942
8934
Italy
Portugal
Canada
Netherlands
Brazil
France
United Kingdom
Germany
Spain
United States
Confirmed cases among countries with highest number of cases reported
Confirmed Cases as of 8/8/22
* Global and USA case count from CDC; **deaths as of 8/5/22 reported by WHO 2022 Monkeypox Outbreak: Global Trends (shinyapps.io) 5 longbeach.gov/monkeypox
1,945 confirmed/probable
cases
32 local health jurisdictions
48 hospitalizations
No deaths
Hospitalized N Percent*
Yes 48 3.5
No 1,321 96.5
Missing/Unknown 576 -
*among cases with reported hospitalization status
6 longbeach.gov/monkeypox
49 cases reported
as of 8/15
No hospitalizations
or deaths 0
2 4
6 8
10 12
14Count
Episode Date
MPX Cases by Week in Long Beach
7 longbeach.gov/monkeypox
Total Cases: 49
• 100% of cases are male
• Majority (84%) self-identify as gay/same-gender loving or bisexual o There have been cases who identify as heterosexual or sexual orientation is unknown • Most are among Latinx (47%) and White (31%) residents o Cases in African-American/Black populations (16%) are overrepresented compared to their percentage of the population (12%)
• Most are between 30 - 49 years of age (70%)
• At least one case in the pediatric (under 18) population • 76% cases reported sexual or intimate contact during the 3 weeks before symptoms started
• 18% of cases reported travel during the 3 weeks before symptoms started 8 longbeach.gov/monkeypox
Monkeypox
Clinical
Overview
9 longbeach.gov/monkeypox
MPX is an infectious disease that is caused by
infection with the monkeypox virus
• It belongs to the samefamily as the virus that causessmallpox and causes a similar but milder illness than smallpox
• Monkeypox virus is zoonotic (passed from animals to humans); humans can then transmit to others
• Animal reservoir unknown
• Monkeypox was first recognized in research monkeys in Denmark in 1958 • First human case was in a 9-month-old in Democratic Republic of Congo (DRC) in 1970
10 longbeach.gov/monkeypox
Monkeypox virus is endemic to Central and West Africa
• Two clades (cousins) of monkeypoxvirus
o Central Africa (Congo) clade responsible for most cases in the past and is more severe
o Western Africa clade milder, less severe disease and less transmissible • Current global outbreak result of Western Africa clade Over last 50 years, sporadic outbreaks occurred in Central and West Africa due to contact with infected animals and then person to person spread Cases outside of Africa have typically been due to international travel, or contact with imported infected animals
• 2003 outbreak in US from pet prairie dogs who had been housed with infected imported African rodents caused 47 human infections and no person to person spread 11 longbeach.gov/monkeypox
Transmission
12 longbeach.gov/monkeypox
MPX can spread to anyone through close, personal,skin-to-skin contact, including:
• Direct contact with MPX rash, scabs, or body fluids from an infected person • Touching objects, fabrics (clothing, bedding, or towels) and surfaces thatare contaminated
• Contact with respiratory secretions
This direct contact can happen during intimate contact, including:
• Oral, anal, and vaginal sexor touching the genitals (penis, testicles, labia, and vagina) or anus of a person with monkeypox
• Hugging, massaging, and kissing
• Touching fabrics and objects during sex that were used by a person with MPX and that have not been disinfected, such as bedding, towels,fetish gear and sex toys
• Prolonged (3hrs+) face to face contact
13 longbeach.gov/monkeypox
A pregnant person
can spread the virus to their
fetus through the placenta.
A person with monkeypox can spread it
to others from thetime symptoms start until the
rash has fully healed and afresh layer of skinhas
formed. The illness typically lasts 2-4 weeks.
From infected animals
either by being scratched or bitten by the
animal, or by preparing, eating meat or
using products from aninfected animal.
Scientists are still researching:
o If the virus can be spread when someone has nosymptoms o How often monkeypox is spread through respiratorysecretions, orwhen a person with monkeypox symptoms might be more likely tospread the virus through respiratorysecretions o Whether monkeypox can be spread through semen, vaginalfluids, urine or feces 14 longbeach.gov/monkeypox
• MPX not as transmissible or easy to catch as COVID19
o Requires really close skin-to-skin contact
o Prolonged contact with infected materials
o Prolonged close face to face contact
o Not airborne
• Healthcare workers at low risk of transmission from patients provided wearing basic PPE
• Similar to COVID-19 in regard to household transmission 15 longbeach.gov/monkeypox
Risk Assessment
16 longbeach.gov/monkeypox
Symptoms
17 longbeach.gov/monkeypox
A rash that starts flat, then becomes bumpy and fluid -filled―it can appear in many places including the face, arms, legs and/or genitals Chills Swollen
lymph
nodes
Fever Muscle
and back
aches
Headache Exhaustion
Symptoms usually start 1-2 weeks after being exposed
18 longbeach.gov/monkeypox
1 4
6 7
8 5
2 3
19 longbeach.gov/monkeypox
Throat swelling Chest pain
Hemorrhagic disease Disseminated disease
Sepsis (Bloodstream
involvement)
Encephalitis (Brain
involvement)
Severe pain
Eye involvement
20 longbeach.gov/monkeypox
Testing
21 longbeach.gov/monkeypox
• Early in the outbreak testing was limited to certain public health labs
o 10 in CA
• Currently numerous commercial labs performing testing o Including Labcorp, Quest, ARUP
o 80,000 samples per week
• PCR of lesion
22 longbeach.gov/monkeypox
Treatment
23 longbeach.gov/monkeypox
• In order to use TPOXX, the healthcare clinician must go through a process and request it through their local health department • Treatment has been provided to the state through the Strategic National Stockpile
• Reports that treatment decreases the number and severity of lesions within 24hrs and helps greatly with pain; lessens time and severity of illness • TPOXX recommended for those with severe disease (bloody, encephalitis, confluent), at high risk for severe disease or complications, location (eyes, mouth, genital region)
24 longbeach.gov/monkeypox
Vaccine
25 longbeach.gov/monkeypox
26 longbeach.gov/monkeypox
LB Health &
Human
Services
Response
Efforts
27 longbeach.gov/monkeypox
• Established Website: longbeach.gov/monkeypox
• Expanded capacity of Public Health Info Line to be able to field monkeypox-related calls o Spanish, Khmer and Tagalog Available
• Established a pre-registration system for the monkeypox vaccine • Increased Case investigation and Contact tracing capacity • Providing Post Exposure Prophylaxis (PEP) to individuals who were in close contact with a confirmed case • Hosting monkeypox vaccine clinics and mass vaccination clinics • Coordinating TPOXX access and distribution
• Educating the public and healthcare providers―including a townhalland Provider Health Alerts • Social media outreach
• Planning for specialized outreach
• Press conference and press releases
28 longbeach.gov/monkeypox
• Developed a monkeypox
Community Toolkit for Community
Based Organizations and trusted
partners to share with
their constituents, including LGBTQ
providers
• Toolkit is available on website
• All graphics have been/will
continue to be shared across all
social media channels
• To request link to the materials or
provide feedback, please email:
[email protected]
• Content in alternative formats
available on request
29 longbeach.gov/monkeypox
The JYNNEOSTM vaccine supply remains limited in the United States. As of August 2nd, vaccine is only available for the following groups in Long Beach:
• People who were exposed to someone with confirmed monkeypox and do not have symptoms • Gay or bisexual men and transgender persons who:
Had multiple or anonymous sex partners in the last 14 days including engaging in survival and/or transactional sex (e.g., sex in exchange for shelter, food and other goods and needs) Note: Those who are immunocompromised (including if you have advanced or uncontrolled HIV), may be at high risk for severe disease and will be prioritized for vaccination Anyone who met the prior eligibility criteriais still eligible for vaccination(i.e., you are a gay or bisexual man or a transgender person and you had gonorrhea or early syphilis in the past 12 months; or you are on HIVPrEP; or you had anonymous sex or sex with multiple partners within the past 21 days in a commercial sex venue or other venue). 30 longbeach.gov/monkeypox
Race/Ethnicity % Vaccinated
Hispanic or Latinx 41%
White 36%
Asian 10%
Black or African American 7%
Multiracial 2%
Unknown 2%
Vaccination Summary
Total vaccinated in LB
Total (with demographic data)
2,288
1,770
Long Beach Residents 1,183
Non-Long Beach Residents 587
Age % Vaccinated
18-24 6%
25-34 30%
35-44 28%
45-54 18%
55-64 14%
65+ 4%
Figure 1: Long Beach Residents with one dose of the JynneosTM vaccine (N = 1,183) *Total number of vaccinated individuals where vaccine data is available. Due to data entry backlog this total does not match the true number of vaccines administered in Long Beach. 31 longbeach.gov/monkeypox
Number of people vaccinated in the
City: 2,288*
Vaccinated by Health Department : 1,694
• Vaccinated through partners: 594
Pre-Registration System
• Total Entries: 4,688
• Total Eligible: 3,827
• Total invited from list: 2,950
• At least 1,229 have been vaccinated from the list
*Number of people vaccinated in the city includes doses administered by the health department, APLA, AHF , Long Beach Comprehensive, St Mary CARE Clinic, and The LGBTQ Center . 32 longbeach.gov/monkeypox
Once the Pre-Registration System closes, we will prioritize those on the list with an appointment.
Will be transitioning to the State's Vaccination system, Myturn, in the coming weeks.
Those who sign-up and meet the eligibility criteria will be contacted with additional information on how to get vaccinated when it is their turn.
Individuals should fill out the pre-registration survey to join a vaccine waitlist. 33 longbeach.gov/monkeypox
• Multiple languages available on the information line
• Connecting with trusted community partners to
provide vaccine:
o AIDS Health Foundation (AHF)
o APLA Long Beach
o Long Beach Comprehensive Health Center
o St Mary's CARE Clinic
o The Center
• Onboarding additional vaccine providers to increase access • Collaborated on a mobile vaccination clinic with The
Center as well as a Townhall Discussion
• Collecting feedback from community partners (HIV Planning Group, Providers, and CBOs) to help address concerns from community members and to help tailor messaging
34 longbeach.gov/monkeypox
Resources
35 longbeach.gov/monkeypox
Public Health Information Line
• 562.570.7907 Monday – Friday 9:00 am – 5:00 pm
Website: Updated Daily
• www.longbeach.gov/monkeypox
o Pre-registration System
Follow us on social media
• Facebook, Instagram & Twitter: @LBHealthDept
Questions and Feedback
• [email protected]
36