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HEALTH ADVISORY from the Santa Clara County Public Health Officer: Monkeypox Infections in U.S. Residents Without Travel to Endemic Areas


May 25, 2022

All community providers

Sara H. Cody, MD
Health Officer

George S. Han, MD, MPH
Deputy Health Officer

The County of Santa Clara Public Health Department (SCCPHD) is monitoring the spread of monkeypox outside of endemic countries in central or western Africa. Currently there are more than a hundred confirmed cases across a dozen countries, mostly in Europe and Canada. As of May 24, 2022, the U.S. has at least one confirmed and eight probable cases, including a probable case in Sacramento County in an individual with international travel.

We note that: 1) many cases have no history of travel to endemic countries, suggesting community-based transmission, 2) there have been clusters of cases among gay, bisexual, and other men who have sex with men, and 3) some patients have been observed to have an atypical rash distribution starting in the genital area. For more information, please see health advisories released May 20 by both CDC and CDPH.


The risk to the general public remains low, but clinicians are requested to report suspected cases of monkeypox particularly in individuals with recent international travel or in men who have sex with men. If genital lesions or body rash is observed, be sure to also complete evaluation for other sexually transmitted infections as per CDC recommendations.
If monkeypox is suspected, call your infectious disease specialist or infection control practitioner (if available), and then contact SCCPHD Communicable Disease Prevention and Control at 408-885-4214 during regular business hours. If you see a highly suspected case of monkeypox after hours, please call county communications at 408-998-3438 and ask for the Health Officer on call. Please be prepared to share a photo to aid in clinical evaluation. 
Before any specimens can be sent to the County of Santa Clara Public Health Laboratory, please call Communicable Disease Prevention and Control for consultation and approval. Specimen collection instructions are as follows: 1) vigorously swab or brush lesion with two separate sterile dry polyester or Dacron swabs; 2) place each entire swab in a 15 mL sterile tube for a total of two tubes. Do not add or store in viral or universal transport media.
We encourage all providers to sign up for health alerts from SCCPHD and CDC to keep updated on this fast-evolving situation, and to refer to the CDPH and CDC monkeypox websites for updated information.

SCCPHD monkeypox website
CDPH monkeypox website
CDC monkeypox in United States
CDC monkeypox slides including rash photos
CDC Genital Ulcer Evaluation
CDC STI Screening Recommendations

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