8/24/2022 CDPH released updated and consolidated provider letter regarding treatment with Tecovirimat which includes guidance on utilizing CDC's reliance agreement.
8/23/2022 Santa Cruz County Public Health JYNNEOS Monkeypox Vaccine Clinical Guidance has been updated
8/23/2022 JYNNEOS Vaccine Information Statement has been updated
8/17/2022 Providers do not need to report contacts to cases or potential exposures to Santa Cruz County Public Health.
8/15/2022 CDPH guidance recommends Intra-Dermal (ID) administration of JYNNEOS vaccine for 18 & older. CDPH Interim guidance
8/12/22 CDPH has paused the process of Pre-Positioning all TPOXX. Providers that have a patient identified that needs treatment, please follow the above process to receive treatment course.

Report all Suspect Monkeypox Cases to Santa Cruz County Public Health.

All suspect monkeypox cases must be reported within 1 working day to Santa Cruz County Communicable Disease Control, preferably by email or fax. Please submit a Confidential Morbidity Report form by email to HSACD@santacruzcounty.us or by fax to (831) 454-5049. 24/7 reporting of suspect monkeypox by telephone is no longer required and is not the preferred method.

Please note, providers do not need to report contacts to cases or potential exposures to Santa Cruz County Public Health.

Diagnosis:

For patients presenting with concern for monkeypox infection:

Commercial Reference Labs. Monkeypox testing is now available through LabCorp, Quest, ARUP and other reference labs are rapidly developing capacity to test.

  • For most Santa Cruz County Healthcare providers 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 Santa Cruz County Public Health for approval to test at commercial laboratories, but providers must still report all suspect cases within 1 working day.

Santa Clara County Public Health Lab is still accepting specimens for monkeypox testing reserved for abnormal clusters of cases and severely ill individuals, and uninsured or underinsured patients where other testing options are not available. For Public Health Lab specific submission forms and requirements for specimen collection please reference the Monkeypox PHL Testing Guidance.

Eligibility. Contacts of confirmed or suspect cases of monkeypox, members of certain Occupational Groups, or those who are in Tier 1 or Tier 2 for eligibility are being prioritized for both 1st and 2nd doses of JYNNEOS vaccine. The two doses should be given 28 days apart. CDC recommends patients getting a second dose on time or preferably within 35 days after the first dose.

CAIR. It is vital that providers enter all JYNNEOS doses in CAIR. CDPH is watching CAIR closely to determine the future allocation of MPX vaccine to Santa Cruz County.

Storage, Handling, Expiration and Administration. Please see Santa Cruz County Public Health JYNNEOS document (8/23/2022) which includes information on:

Pediatric Vaccination. As of 8/9/2022, the FDA authorized emergency use of JYNNEOS vaccine for persons under 18 for subcutaneous administration. Please review the EUA fact sheet.

If you are a provider in need of JYNNEOS vaccines or have any questions, please reach out immunizations@santacruzcounty.us.

People with suspected monkeypox should isolate while awaiting testing results and if confirmed positive, continue isolation until all lesions are healed or criteria are met per the CDPH Monkeypox Home Isolation Guidance for the General Public.

Supportive care and treatment of symptoms should be initiated for all patients with suspected MPX infection. This may include topical medicines or other clinical interventions to manage symptoms with particular focus on management of pain and pruritis. Please see NYC Health treatment guidance and CDC resources below.

Tecovirimat (also called TPOXX), an antiviral medication available through an expanded access Investigational New Drug (EA-IND) protocol for the treatment of MPX infection, is available—see ordering information below.

Providers should consider tecovirimat treatment for high-risk suspect cases who have pending lab testing results and suspect cases who are experiencing severe symptoms.

Antiviral treatment of MPX infection should be considered for people with severe infection, illness complications (including pain not controlled with supportive care), and risk factors for progression to severe infection (children <8 years of age, immunocompromised or pregnant people, or those with a history of atopic dermatitis or eczema). Antiviral treatment (such as with TPOXX) should not be considered a substitute for pain management.

CDC TPOXX Required Paperwork

Ordering TPOXX

To place an order for TPOXX, please fill out the linked TPOXX Resource Request Form and CDPH’s TPOXX Request and Data Collection Form and email it to immunizations@santacruzcounty.us. A member of our team will confirm receipt of your request and begin processing your order. Orders will be shipped directly to the address listed on your resource request form. Please note, the CDC required TPOXX paperwork must be completed within seven (7) days of TPOXX treatment initiation.