The Centers for Disease Control and Prevention (CDC) is tracking several cases of monkeypox that have been reported in countries where monkeypox is not endemic. As of June 9, 45 confirmed cases of orthopox/monkeypox in the United States, but no cases have been identified in Indiana
Clinicians should be alert to patients presenting with a new characteristic rash or if the patient meets one of the epidemiologic criteria and there is a high clinical suspicion for monkeypox. The rash associated with monkeypox can be confused including herpes, syphilis, and varicella. Patients co-infected with monkeypox virus and other infectious agents (e.g., varicella zoster, herpes, syphilis) have been reported. Clinicians should have monkeypox on their differential diagnosis when presented with a sexually transmitted infection (STI)-associated or STI-like rash, even if it is localized and not (yet) diffuse. Please refer to CDC’s Case Definitions for use in the 2022 Monkeypox Response.
Cases of monkeypox described in the current outbreak have some atypical features. The rash may start in the genital and perianal areas, the rash may not always disseminate to other parts of the body, and typical prodromal symptoms may be mild or absent. These features of the newest monkeypox cases can easily be confused with STI. It is important to comprehensively evaluate patients presenting with genital or perianal ulcers for STIs. However, co-infections with monkeypox and STIs have been reported and the presence of an STI does not rule out monkeypox.
Patients with a new characteristic rash or who meet one or more of the epidemiologic criteria and in which there is a high suspicion should be tested for monkeypox. If a case of monkeypox is suspected, clinicians are urged to contact the Indiana Department of Health (IDOH) Epidemiology Resource Center at 317-233-7125 during normal business hours (Monday-Friday, 8:15 a.m. - 4:45 p.m. Eastern) or 317-233-1325 after hours for consultation and testing.
Read the full health alert here (PDF file)
Download a patient information sheet: "Monkeypox: Get the Facts" (PDF file)
Download a patient information sheet: "Social Gatherings, Safer Sex, and Monkeypox" (PDF file)