Commonground
Senior Moderator
December 5, 2024
Dear Clinicians,
On November 15, 2024, the California Department of Public Health confirmed the first reported case of clade I mpox in
the United States. The individual, who sought medical care for mpox symptoms in San Mateo County, had recently
traveled to areas in Eastern Africa experiencing clade I mpox transmission.
Consistent with recent travel-associated clade I mpox cases in other countries, the patient has relatively mild illness and
is recovering. CDC and the local and state health departments are tracing the individual’s potential contacts; no
additional cases in the United States have been detected as of December 5, 2024. A Health Alert Network (HAN) Health
Advisory was issued on November 18, 2024, that included recommendations for clinicians and public health practitioners
for mpox clinical recognition, diagnosis, testing, prevention, and surveillance.
Given the ongoing global outbreaks of clade I and clade II mpox, we are sharing CDC’s current recommendations to help
inform clinical practice for patients at risk for mpox, those with symptoms consistent with mpox, and patients traveling
to areas in Africa that are experiencing sustained clade I mpox transmission, including eligibility for mpox vaccine. While
the risk to the general population of the United States posed by the clade I mpox outbreak remains low, as providers,
you are the country’s first line of defense in preventing the spread of mpox.
Recommendations for Clinicians and Public Health Practitioners
1. Discuss mpox prevention and risk reduction strategies with all your patients traveling to countries with
ongoing human-to-human transmission of clade I mpox.
2. Take a comprehensive sexual health history and discuss your patient’s travel plans, including if your patient
anticipates any sexual or direct skin-to-skin contact (e.g., hugging, kissing, massage) with individuals in
areas with ongoing mpox clade I transmission.
3. Recommend vaccination with the 2-dose JYNNEOS vaccine series to any adult, regardless of gender
identity or sexual orientation, if they are traveling to a country where clade I mpox is spreading between
people AND they anticipate experiencing any of the following:
a. Sex with a new partner
b. Sex at a commercial sex venue, like a sex club or bathhouse
c. Sex in exchange for money, goods, drugs, or other trade
d. Sex in association with a large public event, such as a rave, party, or festival
4. Consider mpox as a possible diagnosis in patients with epidemiologic characteristics and lesions or other
clinical signs and symptoms consistent with mpox.
Several countries in Central and Eastern Africa, including the Democratic Republic of the Congo and neighboring
countries, are experiencing outbreaks of clade I mpox. Travel-associated clade I mpox cases have been reported in
countries in Africa, Asia, and Europe (see CDC’s website for an up-to-date list of the countries affected by clade I mpox
outbreaks). Clade I mpox has historically caused a higher proportion of people with mpox to get severely ill or die
compared to clade II. However, recent data demonstrate that infections from clade I mpox in the current outbreak may
not be as clinically severe as in previous outbreaks.
In September 2024, CDC issued a HAN Health Update and an updated Level 2 Travel Health Notice (practice enhanced
precautions) for travelers to Central and Eastern Africa to provide recommendations to clinicians and public health
practitioners regarding prevention strategies for mpox for U.S. travelers visiting countries with clade I mpox outbreaks,
including vaccinating people at risk via sexual exposure.
Continued: https://dhhs.ne.gov/han Documents/UPDATE12092024.pdf
Dear Clinicians,
On November 15, 2024, the California Department of Public Health confirmed the first reported case of clade I mpox in
the United States. The individual, who sought medical care for mpox symptoms in San Mateo County, had recently
traveled to areas in Eastern Africa experiencing clade I mpox transmission.
Consistent with recent travel-associated clade I mpox cases in other countries, the patient has relatively mild illness and
is recovering. CDC and the local and state health departments are tracing the individual’s potential contacts; no
additional cases in the United States have been detected as of December 5, 2024. A Health Alert Network (HAN) Health
Advisory was issued on November 18, 2024, that included recommendations for clinicians and public health practitioners
for mpox clinical recognition, diagnosis, testing, prevention, and surveillance.
Given the ongoing global outbreaks of clade I and clade II mpox, we are sharing CDC’s current recommendations to help
inform clinical practice for patients at risk for mpox, those with symptoms consistent with mpox, and patients traveling
to areas in Africa that are experiencing sustained clade I mpox transmission, including eligibility for mpox vaccine. While
the risk to the general population of the United States posed by the clade I mpox outbreak remains low, as providers,
you are the country’s first line of defense in preventing the spread of mpox.
Recommendations for Clinicians and Public Health Practitioners
1. Discuss mpox prevention and risk reduction strategies with all your patients traveling to countries with
ongoing human-to-human transmission of clade I mpox.
2. Take a comprehensive sexual health history and discuss your patient’s travel plans, including if your patient
anticipates any sexual or direct skin-to-skin contact (e.g., hugging, kissing, massage) with individuals in
areas with ongoing mpox clade I transmission.
3. Recommend vaccination with the 2-dose JYNNEOS vaccine series to any adult, regardless of gender
identity or sexual orientation, if they are traveling to a country where clade I mpox is spreading between
people AND they anticipate experiencing any of the following:
a. Sex with a new partner
b. Sex at a commercial sex venue, like a sex club or bathhouse
c. Sex in exchange for money, goods, drugs, or other trade
d. Sex in association with a large public event, such as a rave, party, or festival
4. Consider mpox as a possible diagnosis in patients with epidemiologic characteristics and lesions or other
clinical signs and symptoms consistent with mpox.
Several countries in Central and Eastern Africa, including the Democratic Republic of the Congo and neighboring
countries, are experiencing outbreaks of clade I mpox. Travel-associated clade I mpox cases have been reported in
countries in Africa, Asia, and Europe (see CDC’s website for an up-to-date list of the countries affected by clade I mpox
outbreaks). Clade I mpox has historically caused a higher proportion of people with mpox to get severely ill or die
compared to clade II. However, recent data demonstrate that infections from clade I mpox in the current outbreak may
not be as clinically severe as in previous outbreaks.
In September 2024, CDC issued a HAN Health Update and an updated Level 2 Travel Health Notice (practice enhanced
precautions) for travelers to Central and Eastern Africa to provide recommendations to clinicians and public health
practitioners regarding prevention strategies for mpox for U.S. travelers visiting countries with clade I mpox outbreaks,
including vaccinating people at risk via sexual exposure.
Continued: https://dhhs.ne.gov/han Documents/UPDATE12092024.pdf
