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Mpox resources for health care providers

Last updated February 5, 2025.

Mpox is a one working day reportable condition

The Colorado Department of Public Health and Environment monitors cases of mpox statewide. Mpox cases should be reported within one working day of diagnosis or positive laboratory results. Cases should be reported through EpiTrax, the Reportal, fax, ELR, or telephone to CDPHE or local public health agency. For additional reporting guidance, go to CDPHE’s Report a Disease webpage. CDPHE also requests that providers report suspected clade I mpox cases immediately (303-692-2700, or after hours at 303-370-9395).

There are two main clades of mpox: clade I (endemic in Central Africa) and clade II (endemic in Western Africa). Clade IIb is responsible for the global mpox outbreak, which began in 2022 and is ongoing. Clades Ia and Ib are responsible for ongoing outbreaks in Central Africa; travel-associated cases of clade I without sustained transmission have been seen in other parts of the world, including the U.S. It is important that clinicians recognize suspected clade I cases of mpox and notify public health immediately.

At this time, the cases currently seen in the U.S. due to clade II are predominantly occurring in gay, bisexual, and other men who have sex with men. However, anyone who has had close contact with someone with mpox can get the illness. Mpox spreads through close or intimate contact with a person with mpox, direct contact with an infected animal, or contact with contaminated objects.

When clinically evaluating someone with symptoms of mpox, health care providers should follow CDC’s Mpox Infection Prevention and Control in Healthcare Settings. This guidance applies to both mpox clades. Infection prevention measures include, but are not limited to:

  • Placing suspected mpox patients in a single-person room.
  • Adhering to standard precautions and using personal protective equipment when entering the patient's room, which includes:
    • Gown,
    • Gloves,
    • Eye protection (i.e., goggles or a face shield that covers the front and sides of the face),
    • NIOSH-approved particulate respirator equipped with N95 filters or higher.
  • Using standard cleaning and disinfection procedures including use of an EPA-registered hospital-grade disinfectant with an emerging viral pathogen claim. See EPA List Q.
  • Avoiding activities that could resuspend dried material from lesions (e.g., use of portable fans, dry dusting, sweeping, vacuuming).

If a health care worker is suspected to be exposed to a patient with mpox (e.g., did not use appropriate PPE), perform a risk assessment using CDC’s Interim Community Exposure Risk Assessment and Recommendations. Consult CDPHE or your local public health agency for additional support.

Clinicians should consider the need for pain management and the need for treatment for patients with suspected or confirmed mpox, regardless of suspected or confirmed clade.

Medical countermeasures are available for use in the treatment of mpox when indicated. The most commonly used treatment is tecovirimat (TPOXX), which is an antiviral medication that is available for some people with severe illness with mpox. Oral and IV tecovirimat formulations are available under an Investigational New Drug (IND) protocol. The EA-IND protocol has been simplified to ease the administrative burden. However, a treating health care provider must still complete some IND paperwork when administering tecovirimat to patients via this method.

On December 10, 2024, the National Institutes of Health, which ran the STOMP trial, announced that enrollment to the STOMP trial had been closed as of November 27, 2024. Oral tecovirimat is no longer available via the STOMP trial. The trial found that tecovirimat was safe but did not improve mpox resolution or pain in patients with mild to moderate clade II mpox and a low risk of developing severe disease.

Additional information on tecovirimat, including indications for treatment, can be found on CDC’s Guidance for Tecovirimat Use. Other therapeutics may also be available through public health for severe cases or those at high risk (for example, due to severe immunocompromise).

Role of public health

CDPHE does not administer or dispense medication directly to patients. Medical epidemiologists at CDPHE are available to discuss treatment with providers and consult CDC clinical experts as appropriate. Consultation with CDC is recommended in severe cases, pediatric cases, pregnant cases, cases with ocular involvement, or other complicated cases. Call 303-692-2700 or 303-370-9395 (after hours for urgent and/or time-sensitive needs only), or email tpoxx@state.co.us Monday through Friday to request clinical consultation.

CDPHE currently has medication on-hand to facilitate timely administration and can courier IV tecovirimat as needed. Providers can contact public health to request oral or IV tecovirimat or other therapeutics. CDPHE will coordinate with CDC to obtain therapeutics, when indicated. Call 303-692-2700 or 303-370-9395 (after hours for urgent and/or time-sensitive needs only), or email tpoxx@state.co.us to request treatment.