Mpox (MPXV): Health Care and Clinical Guidance

Please notify Spokane Regional Health District (SRHD) about patients you are testing for mpox (MPXV) at cdepidutyofficer@srhd.org using encrypted/secure email or call 509.324.1442 during business hours. Please use 509.869.3133 after hours. You may also send notifications via fax at 509.324.3623.

If you suspect mpox but are unsure if you should test, contact the SRHD Communicable Disease Epidemiology (CD Epi) duty officer to discuss.

Laboratories

Mpox testing is available through commercial labs and Washington State Public Health Lab (PHL). Clade determination testing is available at PHL. For testing at PHL, preapproval is required.* Public health approval is not required for testing at commercial labs.

*SRHD must preapprove specimens sent to PHL. Please contact the CD Epi Duty Officer cdepidutyofficer@srhd.org or 509.324.1442 (business hours) or 509.869.3133 (after hours) to arrange preapproval prior to shipping if you have a specimen that you believe should be tested at the PHL.

Please see DOH guidance for testing: Washington State Monkeypox Specimen Testing

Specimen Collection Information

Each lab may have a different requirement for the type of specimen/media that they accept. Health care facilities should ensure that the requirements of the labs they most commonly use are shared with staff who may collect specimens.

Patients who are suspected of having mpox must be given isolation instructions by the clinician. Please see the following Centers for Disease Control and Prevention (CDC) pages for more information.

• Isolation and Infection Control At Home
• If You're a Close Contact

Tecovirimat (TPOXX) is an antiviral treatment approved by the U.S. Food and Drug Administration (FDA) for human smallpox disease caused by the Variola virus. Its use for other orthopoxvirus infections, such as mpox, is not FDA approved. Please refer to the following resources for use and prescribing guidance.Prescribing information (dosing, patient instructions, contraindications):

• U.S. Food and Drug Administration TPOXX Highlights of Prescribing Information
• Centers for Disease Control and Prevention Tecovirimat (TPOXX) for Treatment of Mpox

How to Order Tecovirimat (TPOXX) Antiviral Treatment

TPOXX, an antiviral drug used to treat smallpox, is prescribed under the FDA’s Investigational New Drug (IND) protocol, which outlined on the CDC’s Tecovirimat (TPOXX) for Treatment of Mpox page.

SRHD received a supply of TPOXX from the Strategic National Stockpile. A portion of the local supply has already been distributed to several area health care organizations to have on-hand for quicker administration. Health care organizations and providers may submit requests to SRHD for TPOXX to prescribe for and administer to patients.

To obtain courses of TPOXX for your facility, please email klewis@srhd.org and cdepidutyofficer@srhd.org with your request.

TPOXX Use Reporting

Use SRHD’s TPOXX Use Report Form to notify SRHD when TPOXX is prescribed/administered.

Please review the following resources from the CDC regarding clinical considerations for people who are children or adolescents, pregnant or breastfeeding, or living with HIV.

• Centers for Disease Control and Prevention Mpox Clinical Care and Treatment During Pregnancy
• Centers for Disease Control and Prevention Clinical Considerations for Mpox in Children and Adolescents in the U.S.
• Centers for Disease Control and Prevention Clinical Considerations for Mpox in Immunocompromised People

JYNNEOS vaccine provides protection from the mpox and smallpox viruses. JYNNEOS is licensed for a two-dose series given at an interval of 28 days. If it has been longer than 28 days, the second dose should be given as soon as possible. 

The JYNNEOS vaccine should be considered for individuals meeting the following criteria:

• Known or suspected exposure to someone with mpox
• Had sex in the past two weeks with someone who has been diagnosed with mpox
• Gay, bisexual or men who have sex with other men, or those who have had sex with a gay, bisexual, or other man who sleeps with men who in the past six months has had a new diagnosis of one or more STIs/STDs (e.g. chlamydia, gonorrhea, or syphilis), or more than one sex partner
• Within the last six months, participated in sex at a commercial sex venue or sex related to a large commercial event or in an area where the virus has been transmitted
• Have a sex partner with any of the above risks, who may participate in any of the above events, or intends to travel to a country with a clade I mpox outbreak and intends to participate in sex at a commercial sex venue; sex in association with a large public event; or sex in exchange for services, money, goods, or other trade
• Those with an occupational risk of exposure to orthopoxvirus

Vaccination Clinics

Consistent Care

Consistent Care is currently offering vaccination clinics for the community. Patients may refer to the following page to review recommendations and sign up for an appointment.

Notify the SRHD of all work exposures at cdepidutyofficer@srhd.org and hai@srhd.org using encrypted/secure email or call 509.324.1442 during business hours or 509.869.3133 after hours.

Please refer to Mpox Infection Prevention and Control in Health Care Settings each time an employee exposure occurs at your facility, as guidance is being updated frequently and may change.

You may use the MPXV Daily Symptom Monitoring Form to manage employees with occupational exposure to MPXV.

SRHD’s role in support of the community and local health organizations includes the following functions:

• Case investigation and contact engagement; people who are contacts (and not suspected of having mpox) are recommended JYNNEOS
• Providing support and consultation to clinicians for decision-making regarding testing and treatment
• Approving or denying specimens being sent to PHL; approved specimens are picked up by a courier service at the SRHD main campus, and SRHD staff facilitate that process
• Public communication and education