Testing patients who have signs and symptoms of mpox even if they do not have a known exposure or epidemiologic risk factors for infection will help find as many cases as possible and help prevent onward transmission.
On this page:
Clinical Recognition
Testing
- Health care providers may submit specimens for testing to either the Alaska State Public Health Laboratory (ASPHL) in Anchorage or certain commercial laboratories.
- People with suspected mpox should be advised to keep lesions covered and to stay home while test results are pending.
- Information about collecting specimens for testing at ASPHL is available in the
test directory. To submit a specimen at ASPHL, use the
Anchorage Lab Request Form and write “mpox” in the field “Specify Pathogen” in the “Biothreat and Emerging Pathogens” section. - Collect 2-4 dry lesion swab specimens as follows:
- Vigorously swab or brush lesion with two separate sterile dry polyester or Dacron swabs
- Break off end of applicator of each swab into a 1.5- or 2-mL screw-capped tube with O-ring or place each entire swab in a separate sterile container
- Do not add or store in viral or universal transport media
- The specimens should be refrigerated or frozen within 1 hour of collection and shipped to the lab on ice packs or dry ice
- If obtaining testing through a commercial laboratory, follow the specimen collection and submission directions specific to that laboratory.
Reporting
- It is no longer necessary to call the Section of Epidemiology (SOE) about every patient being tested for mpox. Providers should report all laboratory-test-positive mpox cases by faxing a
report form and clinical notes to 907-561-4239.
- SOE is available for consultation on testing suspected mpox (or other orthopoxvirus) cases and can assist with routing specimens to the Alaska State Public Health Laboratory (ASPHL) and with obtaining TPOXX. Please call SOE at 907-269-8000, or 800-478-0084 after hours.
Vaccines
Vaccination is available in Alaska for people who self-identify as being at increased risk of exposure to mpox. For details about who might be at risk and on how to find the vaccine, please visit the
CDC Mpox vaccine page.
The Centers of Disease Control and Prevention (CDC) recommends a 2-dose JYNNEOS vaccine series for persons aged 18 years and older at risk of mpox during an mpox outbreak. The JYNNEOS vaccine may be given up to 14 days after exposure to mpox. The sooner it is given, the more likely it is to prevent disease but administration between 4-14 days may still reduce symptoms. Subcutaneous administration is recommended unless supply constraints necessitate intradermal administration. Intradermal injections often leave a wheal or noticeable area of raised skin. The wheal generally heals on its own. Additional details are available in the
Interim Guidance section of the
JYNNEOS Vaccine page.
At this time, the vaccine is primarily being distributed through public health centers. Health care providers should refer vaccine-eligible patients to their
local public health center.
Considerations for Immunocompromised Patients
Patients who are immunocompromised are likely at increased risk for severe outcomes from mpox infection. As such, particular attention should be paid to identifying and offering vaccination to immunocompromised people. Examples of immunocompromising conditions include but are not limited to AIDS, atopic dermatitis or eczema, leukemia, lymphoma, organ transplantation, generalized malignancy, radiation therapy, or receipt of high-dose corticosteroids (>10 mg prednisone/day or equivalent for ≥ 2 weeks) or other immunomodulatory drugs.
Treatment
Currently, there are no products licensed specifically for the treatment of mpox. However, the Alaska Division of Public Health has received a small supply of tecovirimat (TPOXX) from the US government. TPOXX availability varies depending on region and may need to be ordered through Federal channels. This drug is licensed for the treatment of smallpox and may be available for the treatment of mpox under an expanded access Investigational New Drug protocol.
Please see CDC’s Guidance for Tecovirimat Use. Briefly, tecovirimat treatment may be considered for patients with severe disease, those who are at high risk of severe disease (e.g., due to being severely immunocompromised or young age, particularly those younger than 8 years of age), or those with involvement of anatomic areas that might lead to serious sequelae. Contact the Section of Epidemiology at 907-269-8000, or 800-478-0084 after hours to discuss
obtaining TPOXX.
Additional Resources