Last updated: 8/5/22. Short URL for this page: www.sfcdcp.org/monkeypoxhcp
Report All Suspect Monkeypox Cases to SFDPH
All suspect monkeypox cases must be reported within 1 working day to SFDPH Communicable Disease Control, preferably by email or fax. Please submit a Confidential Morbidity Report form (CMR) by email to firstname.lastname@example.org or by fax to (415) 554-2848 and write “suspect monkeypox” in the disease field at the top of the form. 24/7 reporting of suspect monkeypox by telephone is no longer required and is not the preferred method.
Testing and Specimen Submission
- For most SF healthcare providers outside of SFDPH, a commercial reference laboratory will be the best option for streamlined monkeypox testing and resulting.
- Please check with the reference lab regarding their lab-specific submission forms and requirements for specimen collection, labeling, and transport.
- There is no need to contact SFDPH for approval to test at commercial laboratories but providers must still report all suspect cases to SFDPH within 1 working day.
San Francisco Public Health Lab is still accepting specimens for monkeypox testing and has improved turn-around-time with the addition of on-site monkeypox PCR assay.
All providers are requested to review and follow this SF-specific guidance for monkeypox evaluation, including infection control, specimen collection, and patient isolation.
Jynneos monkeypox vaccine continues to be in short supply. SF receives vaccine allotments from the state health department based on a formula using current monkeypox case counts and eligible population size. SFDPH continues to request as many doses as possible in the shortest timeframe available to address the critical shortage of local vaccine needed to stem the outbreak.
Eligibility. Please review and adhere to current eligibility guidance for 1st doses and 2nd doses of Jynneos vaccine. SF policy is to prioritize 1st doses to maximize impact while vaccine is still in very limited supply. 2nd doses are to be deferred for now, with the exception of persons with moderate-to-severe immune compromise who may develop a full immune response to the first dose. See memo for details. Updated 8/4/2022 to clarify limited 2nd dose eligibility. SF Updated Monkeypox Vaccine Eligibility
Storage, Handling, and Expiration. Jynneos prescribing information has been superseded in part by additional regulatory updates. See Jynneos may be stored refrigerated for up to 8 weeks – do not refreeze and this Jynneos storage and expiration Q&A.
Administration. See updated SFDPH sample protocol/standing orders document for Jynneos administration (7/28/2022). Jynneos screening forms and other related documentation is available on the CDPH monkeypox resources site. New as of 8/2/22: CDC standing orders for Jynneos vaccine. Providers seeking to administer Jynneos vaccine may email email@example.com to sign up and learn more.
Pediatric Vaccination. Jynneos has an FDA indication for ages 18 years and up. An expanded access program (EA-IND) for pediatric Jynneos is in development. Meanwhile, if Jynneos is needed for a pediatric contact to a monkeypox case, CDC has made an S-IND (single patient) process available. See instructions and informed consent form.
Are you a provider interested in vaccinating your patients? Please fill out this survey as a first step to request being considered. For any questions, email firstname.lastname@example.org
Treatment with Tecovirimat
Tecovirimat (TPOXX) has an FDA indication for treating smallpox and is available to treat cases of monkeypox via Expanded Access Investigational New Drug (EA-IND) protocol. Tecovirimat efficacy for treatment of monkeypox disease in humans is unknown and undergoing evaluation. Criteria used in SF as indications for tecovirimat are aligned with those used in other jurisdictions with high case numbers.
Prescribing tecovirimat requires regulatory paperwork and patient informed consent. Providers may need approval from their local Institutional Review Board (IRB) to participate. Instructions to become tecovirimat prescribers can be found here; SF clinicians seeking furhter assistance can email email@example.com
Many patients experience subjectively severe symptoms of monkeypox disease that do not meet current criteria for tecovirimat administration. Provider experience supports the use of supportive care and symptomatic treatment for what is in most cases a self-limited illness, including pain relievers, topical cortisone and benzocaine/lidocaine gels for painful proctitis.
- Webinar: SFDPH Monkeypox Update for SF Clinicians-July, 28, 2022
- CDC monkeypox pages for healthcare providers
- CDPH monkeypox pages and CDPH monkeypox resources site
Most recent Monkeypox Health Advisories
- SFDPH Advisory-July 15th, 2022
- SFDPH Media Statement-July 13th, 2022
- SFDPH Advisory-June 30th, 2022
- CDPH Advisory June 23rd, 2022
- SFDPH Advisory June 14th, 2022
- CDPH Advisory-May 27th, 2022
- SFDPH Advisory-May 24th, 2022
- CDPH Advisory-May 20th, 2022
- CDC Advisory-May 20th, 2022
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