DOVER, DE (Aug 15, 2022) ­– The Delaware Division of Public Health (DPH) is announcing five additional cases of monkeypox (MPX), bringing the state’s total to 11. All cases are considered probable pending confirmatory testing by the Centers for Disease Control and Prevention (CDC).

The five most recent cases are all males.  Two, a 23-year-old and a 57-year-old are from Sussex County. The other three, a 28-year-old, a 34-year-old, and a 37-year-old, are from New Castle County. All cases are unrelated to the others.  The 23, 37 and 57-year-olds all reported intimate contact with an individual confirmed to be positive for MPX. The 34-year-old had recent intimate contact with another person, but the person was not known to have MPX. No contact information is known for the 28-year-old. None of the individuals reported travel.

Currently, there is no specific treatment for MPX​. However, antivirals can be prescribed. 

Delaware is also announcing that starting today, Monday, Aug. 15, it will expand access to the vaccine used for MPX to individuals who are living with HIV, as well as those receiving pre-exposure prophylaxis (PrEP) for HIV. Individuals living with HIV or receiving HIV PrEP should first contact their medical provider or PrEP treatment center to ask if they are offering the vaccine. If the provider is not, the person may contact the DPH Hotline at 866-408-1899 to schedule an appointment with a DPH clinic. Walk-ins for vaccination will not be accepted. Vaccinations at DPH clinics will continue to be prioritized first for the following individuals at highest risk who have been receiving vaccine thus far based upon DPH evaluation: persons known or presumed to be exposed to someone with MPX in the last 14 days, and certain individuals who have sex with men and who have had multiple sex partners within the past 14 days. As a result, appointments may need to be scheduled a few days out.

As a result of the White House announcement on Tuesday, Aug. 9, allowing states to stretch their vaccine supplies by administering one-fifth of the dose via a different injection method (just under the skin rather than into the muscle), DPH is now able to plan for further expansion of vaccine access. Delays in roll out are due to the need to support training in the alternate administration method, and obtain supplies needed for this method as well. 

Beginning Aug. 22, individuals in the following higher risk categories will have access to the vaccine. More details about where vaccines will be available will be shared later in the week. Access will be expanded to include those engaging in high-risk activities, including sexual practices, that increase exposure to MPX such as:

• Gay, bisexual, and other men who have sex with men and have had multiple (more than one) or any anonymous sexual partners
• Transgender women or nonbinary persons assigned male at birth who have sex with men
• Sex workers (of any sexual orientation/gender)
• Staff (of any sexual orientation/gender) at establishments where sexual activity occurs (e.g., bathhouses, saunas, sex clubs)

Individuals should be aware that the vaccine, a two-dose series given 28 days apart, is not considered effective until two weeks after the second dose. Particularly those at higher risk should continue to use preventive measures and reduce engaging in any high-risk behaviors until that time.

While MPX vaccine will be expanding, not everyone needs the vaccine. Unlike with COVID-19, the spread is primarily through direct contact with an infected person and not airborne transmission. Those engaging in behaviors, including intimate contact with multiple partners are at higher risk than the general public.

There are things that each person in the general public can do to protect themselves regardless of their ability to access the vaccine, such as limiting direct contact with anyone with a concerning rash, limiting the number of intimate partners, talking openly with intimate contacts about recent behaviors, and not sharing bedding, towels and eating or drinking utensils with anyone who does.

The vaccine, JYENNOS, used to prevent MPX, is fully FDA approved for use against smallpox. However, if you received a previous smallpox vaccine more than three years ago, it may not provide protection now. During the 2003 outbreak and current outbreaks, people who have been infected with MPX had previously been vaccinated against smallpox decades prior.

Most people with monkeypox do not require hospitalization and may isolate at home. Monkeypox spreads between people through direct contact with an infectious rash, body fluids, or by respiratory secretions during prolonged, face-to-face contact. The transmission of the monkeypox virus is possible from the onset of the first symptoms until the scabs have separated and the skin has fully healed.

As fall sports practices begin, individuals who participate in sports should practice preventive measures whenever possible. This includes laundering uniforms after each game or practice, seeking advice from their primary care provider concerning rashes, sanitizing team spaces when they are not in use, not sharing sweat towels, water bottles, mouth guards or other gear, and refraining from leaving unused personal gear laying around. Organizations should consider separate seating during games from fans for players; players not playing should avoid sharing benches with fans. Isolated seating will reduce close contact with possible rashes from fans to players.

Signs and Symptoms

The symptoms of MPX are similar to but milder than the symptoms of smallpox. Symptoms usually start within three weeks of exposure to the virus. Most people who contract MPX will develop a rash, and some will develop flu-like symptoms beforehand. The flu-like symptoms may include fever, headache, muscle aches and backache, sore throat, cough, swollen lymph nodes, chills, or exhaustion. If someone has flu-like symptoms, they usually will develop a rash one to four days later.

If you suspect you are experiencing any symptoms associated with MPX you should immediately:

• Contact your health care provider and discuss your symptoms and concerns.
• Self-isolate until all lesions have resolved, the scabs have fallen off, and a fresh layer of intact skin has formed.
• Avoid being intimate with others.
• Make a list of your close and intimate contacts in the last 21 days.

DPH launched a hotline for individuals with questions or concerns about MPX. The hotline number is 866-408-1899 and is operational Monday – Friday from 8:30 a.m. to 4:30 p.m. Questions may also be emailed to DPHCall@delaware.gov. Both the hotline number and email address share staff with the COVID-19 Call Center. To learn more about MPX prevention programs and resources, visit de.gov/monkeypox.

Upcoming Town Halls

Beebe Healthcare is inviting the public to a virtual town hall for a discussion on Monkeypox virus in Sussex County at 5:30 p.m. Monday, Aug. 15.  David A. Tam, MD, MBA, CPHE, FACHE, President & CEO, and Bill Chasanov, DO, Beebe’s Chief Population Health Officer, will share updates on Monkeypox as a public health concern. To watch, join Beebe’s Facebook or YouTube page for the live presentation. Recordings will be published for viewing after the town hall ends. Live ASL interpretation will be available on screen.

CAMP Rehoboth Community Center will hold a town hall on Tuesday, Aug. 16, from 7 p.m. to 8:30 p.m. addressing the MPX situation in Delaware. This town hall is in partnership with the Delaware Department of Health and Social Services. DHSS Secretary Molly Magarik will be discussing Delaware’s response to the virus in the CAMP community and will field questions and concerns from community members. The event will be held at CAMP Rehoboth, 37 Baltimore Avenue, Rehoboth Beach. Registration is required: https://www.eventbrite.com/e/town-hall-addressing-hmpvx-virus-in-our-community-tickets-400799531187

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