An outbreak of mpox in the Democratic Republic of the Congo has led the Centers for Disease Control and Prevention (CDC) to issue a health advisory.

Mpox, formerly known as monkeypox, is related to the smallpox virus and causes a rash that can look different in different people. It typically shows up after a 2- to 21-day incubation period as lesions that are firm or rubbery, are deep-seated, and often develop umbilication with a dot on the top of the lesion.

In addition to the rash with lesions often developing simultaneously on any part of the body, symptoms can include headache, muscle aches, swollen lymph nodes, and sometimes fever.

Once a rash appears, a person is contagious until all the scabs on the skin have fallen off and a fresh layer of intact skin has formed underneath, according to the CDC report.

“Clinicians should continue to consider mpox when evaluating the cause of rashes,” the CDC health alert states.

The current outbreak in the Congo, where the virus is endemic in humans and animals in some densely forested areas of the country, involves the Clade I monkeypox virus, which is more contagious and causes more severe infections than the Clade II strain that was linked to the 2022/2023 global outbreak.

There is currently no known risk for Clade I mpox in the United States, but with outbreak numbers on the rise, the CDC recommends that people with risk factors for mpox be vaccinated with the two-dose JYNNEOS vaccine; one dose will not provide the best protection.

As of November, cases have been documented in 22 of 26 provinces in the Congo, including in urban centers. Person-to-person transmission can occur through sexual contact and household contact and in healthcare settings.

Since January, the Congo has reported more than 12,500 clinically diagnosed, but not laboratory-confirmed, cases of mpox, and nearly 600 deaths are suspected of being related to the virus.

“This is a substantial increase from the median 3767 suspected mpox cases reported annually in the Democratic Republic of the Congo” from 2016 to 2021, according to the CDC.

Because the number of annual cases is the highest ever reported and new cases are appearing in unprecedented regions, the CDC has issued a Travel Health Notice, urging travelers to the Congo to minimize contact with people who are ill, to steer clear of wild animals, and to refrain from eating or preparing wild game.

For anyone who experiences the onset of mpox in the 21 days after traveling to the Congo, the CDC recommends pursuing clade-specific testing, starting with a consultation with state health departments.

More than 31,000 Americans were diagnosed with mpox during the 2022/2023 outbreak and 55 died, according to CDC data.

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