Mpox public health emergency: Massachusetts healthcare providers will likely have ‘heightened awareness’

With world health officials sounding the alarm about a new mpox strain, Bay State healthcare providers will likely have a “heightened awareness” for the virus as countries boost surveillance.

The World Health Organization has declared a “public health emergency of international concern” in response to a large outbreak of Clade 1 mpox — thought to be more severe than the predominant global Clade 2b disease — in the Democratic Republic of Congo and adjacent central African countries.

There have not been any confirmed cases linked to the Clade 1 outbreak in Massachusetts or in the U.S., but a case has been detected in Sweden, which is the first known case outside of Africa.

The Massachusetts Department of Public Health said it has been “proactive” in response to the Clade 1 outbreak since earlier this year, noting that a clinical advisory was sent to local providers in April.

“Massachusetts healthcare providers have had a high level of awareness since the first US case of mpox in the global outbreak was seen in Massachusetts in the spring of 2022,” DPH said in a statement. “The announcement from WHO will likely result in heightened awareness among providers.”

There have been a total of 516 cases of mpox in Massachusetts since 2022, all thought due to the earlier Clade 2b outbreak — including four cases of mpox detected in the state this summer.

“MDPH has worked closely with partner organizations to enhance awareness of the disease and to promote vaccination through a network of clinics in MA,” DPH said.

Mpox is transmitted by close, usually skin-to-skin, intimate contact from someone with the disease. Avoidance of such exposure will prevent mpox.

There is also a vaccine, Jynneos, which is recommended for individuals who are at risk as defined by the CDC.

The identification of the first mpox Clade 1 infection in Sweden “underscores the need for affected countries to tackle the virus together,” posted WHO Director-General Tedros Adhanom Ghebreyesus.

“We encourage all countries to enhance surveillance, share data, and work to better understand the transmission; share tools like vaccines; and apply lessons learned from prior public health emergencies of international concern in addressing the current outbreak,” the director-general added.

People with mpox often get a rash that may be located on hands, feet, chest, face, mouth, or near the genitals.

The incubation period is 3 to 17 days. During this time, a person does not have symptoms and may feel fine.

The rash will go through several stages, including scabs, before healing. The rash can initially look like pimples or blisters and may be painful or itchy.

Other symptoms of mpox can include: fever, chills, swollen lymph nodes, exhaustion, muscle aches and backache, headache, and respiratory symptoms.

“In the past month, we have seen far fewer cases than we have historically, and case numbers remain low,” said Bisola Ojikutu, Boston’s commissioner of public health and executive director of the Boston Public Health Commission. “We are aware of the global mpox public health emergency and will continue to work closely with our partners at the Massachusetts Department of Public Health to continue to monitor for the virus.

“The best way for people to protect themselves and their community is to get vaccinated against mpox,” Ojikutu added. “Vaccines are an important tool in our efforts to keep people safe and healthy.”

If someone believes they have mpox, they should call or visit their healthcare provider and avoid contact with others while awaiting diagnosis.

“Providers can test for mpox by sending a swab of one or more of the skin lesion to a clinical laboratory,” DPH said. “This is available at commercial clinical laboratories and from the MDPH State Public Health Laboratory (and testing to distinguish Clade 1 and Clade 2 disease can be done at the State Lab).”

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