Mpox Situation Update for EMS Professionals
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Identifying Mpox: An Update for EMS Professionals
As of June 6, 2022, there are 31 confirmed cases of mpox in the U.S. The CDC is tracking several hundred cases in other countries where mpox is not normally reported (CDC, https://www.cdc.gov/poxvirus/monkeypox/response/2022/index.html, Accessed 6/7/2022).
Cases in the multi-country mpox outbreak have presented signs, symptoms, and related risk factors that vary from those typically seen in cases imported from countries where the disease is endemic. While it remains unlikely that EMS clinicians will encounter a person infected with mpox during routine operations, updates to the situation, including new information on how to identify mpox, will be posted to the NETEC website as they become available.
Situation Update
This post is an update to the previously published EMS Response to the Current Outbreak of Mpox post on May 19, 2022. The information on identifying the signs, symptoms, and risk factors has been updated here; all other information on the EMS response to mpox can be found in the earlier post. For the latest information on the mpox outbreak, refer to the CDC website (CDC, https://www.cdc.gov/poxvirus/monkeypox/about.html, Accessed 6/7/2022).
New Information on How to Identify Mpox in Clinical Settings for EMS Professionals
- The signs and symptoms of mpox typically include flu-like symptoms (fever, headache, muscle aches), swollen lymph nodes, and a rash that becomes vesicular/pustular, starting on the face and covering the whole body. Learn more about the clinical signs of mpox (CDC, https://www.cdc.gov/poxvirus/monkeypox/clinicians/clinical-recognition.html, Accessed 6/7/2022).
- In a departure from the typical signs and symptoms of mpox, current cases commonly report genital and perianal lesions, fever, swollen lymph nodes, and pain when swallowing. While oral sores, along with fever and swollen lymph nodes, continue to be common features, recent cases have reported perianal or genital lesions without fever, and in many cases the rash develops in the perianal or genital region and does not spread to other areas of the body. (WHO, https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON390, Accessed 2022)
- Typically, a health care professional should screen individuals presenting with symptoms for recent travel to a country where mpox is endemic, including Central and Western African countries such as Nigeria or the Democratic Republic of Congo, or other areas reporting mpox cases, or for close contact with a person sick with mpox in the last 5-21 days.
- Unlike previous cases reported in non-endemic countries, the current outbreak does not appear to have a strong link to travel to areas where the disease is more common. Anyone who has had close physical contact with someone who has symptoms of mpox, or has traveled to a country with confirmed cases of mpox or where mpox is endemic, is at risk of infection. Several of the cases that have been reported from non-endemic countries have been identified in men who have sex with men, however the risk of mpox is not limited to people who are sexually active or men who have sex with men. (WHO Q&As, https://www.who.int/news-room/questions-and-answers/item/mpox, Accessed 2025)
- The development of genital or perianal rash before or in lieu of the rash spreading to other parts of the body in many cases suggests close physical contact, including sexual contact, as the likely route of transmission. Mpox rashes can resemble some sexually transmitted infections (STI), including herpes and syphilis. Clinicians should consider a mpox diagnosis when presented with an STI-associated or STI-like rash, even if it is localized and not (yet) diffuse. Refer to the CDC’s Case Definitions for use in the 2022 Mpox Response.
NETEC Resources & Recommendations for Mpox Preparedness
NETEC has been actively engaged in supporting U.S. health care agencies that encounter, or may encounter, a case of mpox virus infection with free, ongoing guidance and resources.
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