CDC Suggests Mpox Could Make a Comeback During Festival Season

After experiencing a sharp decline in cases, mpox is predicted to make a comeback in the coming months, according to the Centers for Disease Control and Prevention (CDC). The CDC warned in particular about higher rates of transmission as we get further into festival season (which we all know can bring about easily spreadable illnesses, like Coachella cough).

"Spring and summer season in 2023 could lead to a resurgence of mpox as people gather for festivals and other events," the CDC stated in an alert memo published May 15.

"In the United States, cases of mpox (formerly monkeypox) have declined since peaking in August 2022, but the outbreak is not over," the CDC stated, adding that it has continued to receive ongoing reports of the disease's spread.

This announcement comes just days after the World Health Organization (WHO) declared an end to the mpox emergency. Meanwhile, the CDC recorded 12 confirmed cases and one probable case of the disease over a recent 18-day period.

The CDC maintains that vaccination "continues to be one of the most important prevention measures." Ahead, find useful information on mpox, including symptoms, treatments, vaccine options, and how to stay safe.

What Is Mpox?

Monkeypox, now referred to as mpox, is a very rare disease that falls within the family of pox viruses, which includes smallpox and cowpox. It was discovered in 1958 in Denmark among monkeys kept for research, per the WHO. The virus didn't spread to humans initially. The first reported human case of mpox was found in a 9-month-old boy in the Democratic Republic of the Congo in 1970, the WHO reports. Since then, the majority of mpox cases have occurred in central, east, and west Africa or among people who've traveled to those areas. But what's different about the recent outbreak is that the cases appear to be spreading among people who didn't travel to Africa.

What Are the Symptoms of Mpox?

According to the CDC, traditional symptoms of mpox are similar to smallpox but are milder and include:

  • Fever
  • Headache
  • Muscle aches
  • Swollen lymph nodes
  • Chills
  • Fatigue
  • Rash beginning on the face and hands (one to three days after the fever starts), then spreading to other parts of the body, including the genitals. It initially looks similar to chicken pox or syphilis lesions before forming a scab, which then falls off.

However, recent cases of mpox have differed in symptom arrival and presentation. Traditionally, the early signs of mpox included a fever, swollen lymph nodes, headache, and muscle aches followed by a rash resulting in firm lesions, spreading from the face and mouth to the hands and feet, per the CDC.

Recent US cases of mpox have also included a rash, but it has often begun in the genital or anal region, and sometimes in the mouth. The lesions have also begun spreading to areas beyond the face, hands, or feet.

Additionally, "symptoms including fever, malaise, headache, and lymphadenopathy [swollen lymph nodes] have not always occurred before the rash if they have occurred at all," per the CDC.

Another non-traditional aspect of the recent cases? US patients are reporting pain in and around the anus and rectum, tenesmus (or the feeling that you need to pass a bowel movement even though your bowels are empty), and rectal bleeding. "None of those symptoms were commonly associated with monkeypox before," per NBC.

"Any patient who meets the suspected case definition should be counseled to implement appropriate transmission precautions," advised the CDC in its updated guidelines. Precautions for patients who are suspected and confirmed to have been infected include remaining in isolation for the duration of the infectious period (i.e., until all lesions have resolved, the scabs have fallen off, and a fresh layer of intact skin has formed). "Patients who do not require hospitalization but remain potentially infectious to others should isolate at home. This includes abstaining from contact with other persons and pets, and wearing appropriate personal protective equipment (e.g., clothing to cover lesions, face mask) to prevent further spread," per the CDC.

How Is Mpox Spread?

People usually catch mpox from animals through a bite or scratch. From there, it's possible to pass on the disease to other people through saliva from coughing or via contact with pus from the rash's lesions or items such as clothing or bedding that are contaminated with the virus. But recent evidence shows a new possible route of transmission: through sexual contact.

Although mpox is typically not spread through sex, most of the recent cases in the UK involve men who've had sex with other men. And since it can be spread through contact with bodily fluids, Dr. Susan Hopkins, the United Kingdom Health Security Agency's chief medical adviser, said, "We are particularly urging men who are gay and bisexual to be aware of any unusual rashes or lesions and to contact a sexual health service without delay."

That said, "Anyone, regardless of sexual orientation, can spread monkeypox through contact with body fluids, monkeypox sores, or shared items (such as clothing and bedding) that have been contaminated with fluids or sores of a person with monkeypox," per the CDC. "Monkeypox virus can also spread between people through respiratory droplets typically in a close setting, such as the same household or a healthcare setting."

Another cause for concern is that the cases in each country are not connected, so scientists are monitoring the outbreak to see if there are other methods of transmission that are causing the virus to spread faster.

What Is Mpox Treatment?

The drug tecovirimat, or Tpoxx, is currently the only available drug to treat mpox. However, due to bureaucratic barriers (such as requiring a doctor to fill out a 27-page application for each patient), it has become increasingly difficult to receive it as cases continue to rise. The NYT reported that Tpoxx melts away skin lesions within 24 hours, compared to untreated mpox with symptoms that last about two to four weeks.

Most people will get over mpox without needing to be hospitalized. But unfortunately, it can be fatal for one in 10 people who get it, with more severe cases found in children, according to the CDC.

Is There an Mpox Vaccine?

There is no vaccine for mpox exclusively. But the smallpox vaccine, under the brand name Jynneos in the US, is licensed to prevent mpox, which can also be effective after a person is infected, according to the CDC. That being said, after smallpox was eradicated, countries stopped vaccinating children against smallpox. So younger populations who haven't received the smallpox vaccine don't have immunity against mpox either.

Do I Need an Mpox Vaccine?

Prior to the recent vaccination rollout announcement, immunizations were only offered to those with known exposure. Now the US vaccination campaign offers the mpox vaccine to anyone with a known or presumed exposure. This includes anyone "who had close physical contact with someone diagnosed with monkeypox, those who know their sexual partner was diagnosed with monkeypox, and men who have sex with men who have recently had multiple sex partners in a venue where there was known to be monkeypox or in an area where monkeypox is spreading," according to an HHS statement. The vaccine is administered in two doses and given 28 days apart.

How Concerned Should I Be About Mpox?

Mpox is no longer considered a public health emergency in the US, but the CDC is concerned about a resurgence this spring and summer. That said, it can't hurt to be mindful of the best safety practices.

It's important to remember that anyone can get mpox through exposure and skin-to-skin contact, not just men who sleep with men. The CDC has advised, "People who may have symptoms of monkeypox, such as unknown rashes or lesions, should contact their healthcare provider for assessment." Anyone with new lesions related to illnesses like chickenpox, herpes, or syphilis should also be checked for mpox, as symptoms are quite similar, per the CDC.

Risk factors for mpox include in-person contact with someone who has a similar rash or someone who has received a diagnosis of confirmed or suspected mpox, anyone who has contact with individuals in a social network experiencing mpox infections, and those who have traveled to countries where cases have been reported. Additionally, people experiencing flu-like symptoms and the above risk factors should self-quarantine. "If a rash does not appear within five days, the illness is unlikely to be monkeypox," the CDC said.

— Additional reporting by Alexis Jones, Melanie Whyte, and Sara Youngblood Gregory