There’s a renewed risk of mpox outbreaks as people gather for summer festivals and Pride celebrations, the U.S. Centers for Disease Control and Prevention warned.

While overall reported cases in the U.S. remain low, a recent outbreak in Chicago led the CDC and other public health experts to raise concerns about the possibility of new cases. There are very few confirmed cases in the D.C. region, local health officials tell DCist/WAMU, and as of June 5, Montgomery County and Prince George’s County have reported zero cases. That could change, however, as people gather for parades and other LGBTQ events during this month’s Pride celebrations.

“We should be alert,” says Carlos Rodriguez-Diaz, an associate professor in the prevention and community health department at George Washington University’s Milken Institute School of Public Health.

Remind me, what exactly is mpox again? And how does it spread?  

Mpox used to be known as monkeypox but the World Health Organization recommended changing the name to something less stigmatizing. Caused by a virus in the same family as smallpox, it’s endemic to Central and West Africa. It was a rare disease globally until the 2022 outbreak, when the U.S. reported over 30,000 cases and 42 deaths.

People with mpox typically develop flu-like symptoms, such as a fever and chills, followed by a rash and sores a few days later that can be quite painful. Symptoms usually start within three weeks of exposure.

Mpox spreads through close, often skin-to-skin, contact. During the 2022 outbreak, the CDC said the mpox virus spread primarily through sexual contact. As of Feb. 2023, the CDC found that some people can spread mpox one to four days before they become symptomatic. There’s no evidence, however, that people who never develop symptoms can spread the virus.

Who’s most at risk?

Based on the 2022 outbreak, the LGBTQ community is at most risk of infection. Men who had sex with other men had the most confirmed cases, both nationally and locally. Black and Latinx men were hit hardest, due to pre-existing health inequities such as limited access to information and providers.

While the LGBTQ community was most impacted, Rodriguez-Diaz emphasized that it wasn’t because people were doing anything wrong.

“This could have been an outbreak among heterosexual people. It’s just that is not the case. It’s been identified among LGBTQ people and has been contained by the same populations,” says Rodriguez-Diaz. “So this is nothing to be ashamed of.”

How do I protect myself against mpox?

Rodriguez-Diaz says people should first talk to their sexual partner about their sexual history. People should also get the 2-dose vaccine, JYNNEOS, which protects people against mpox and smallpox infections.

CDC-approved studies show the vaccine reduces risk of mpox illness, particularly severe illness. Despite the fact that two doses provide the best protection, many people don’t get their second dose. In D.C., 96% of the local population most at risk of mpox got the first dose, but only 67% got the second, according to the CDC.

Experts emphasized that everyone who qualified for a first dose should get a second. The vaccine is not in short supply, so there’s no need for concern about taking a shot from someone who needs it.

The CDC recommends vaccinations if you’re in the following groups:

• You had a known or suspected exposure to someone with confirmed mpox or you had sex with someone in the past two weeks who has been diagnosed
• You are gay, bisexual, or a man who has sex with other men
• You are transgender, nonbinary, or gender fluid and had a confirmed STI in the past six months
• You are a sex worker
• You had sex at a commercial space, like a sex club or bathhouse, or attended a sex-related event
• You have a sex partner who fits any of the above descriptions or you anticipate any of the above scenarios for yourself
• You are HIV positive
• You work in a setting where you can be exposed to mpox

Some local jurisdictions opened eligibility for more groups. D.C. says “all people, of any sexual orientation or gender, who have had multiple sexual partners in the past 2 weeks” can qualify for the vaccine. Montgomery County too is offering the vaccine to people with “multiple or unknown sexual partners” but says priority will be given to people most at risk. Prince George’s County, which had the highest share of cases in the state during last year’s outbreak, will vaccinate people who are close contacts of people with confirmed mpox, “anyone who has had multiple or unknown sexual partners in the past 14 days,” and health care workers who risk exposure. Meanwhile, both Arlington and Fairfax counties follow the CDC recommendations, and the latter will vaccinate non-county residents.

Where can I get the mpox vaccine?

Local LGBTQ health care provider, Whitman-Walker, has been providing the two-dose vaccine for free. Individuals can schedule an appointment via text, phone call, or email.

After being criticized for insufficient action by local LGBTQ+ groups last time, local governments have teamed up with LGBTQ+ organizers to set up vaccine clinics at some Pride events. D.C.’s health department will be at D.C.’s Capital Pride this weekend, according to the director of the Mayor’s Office of Lesbian, Gay, Bisexual, Transgender and Questioning Affairs, Japer Bowles. Montgomery County’s health department will also be at Silver Spring’s “Pride in the Plaza” later this month. The health departments will also provide HIV/STI testing and PrEP, a once-a-day HIV prevention pill.

Emily Halden Brown, an “Ending the HIV Epidemic” program manager with Montgomery County Public Health Services, says they are also offering wellness conversations at Pride in the Plaza, where people can learn about the mpox vaccine and other health measures. People can get a $15 gift card if they get vaccinated at the pride event, says Brown. She underscored the importance of the health department being at the Pride event, which is run by the local group, Live in Your Truth.

Bowles says they are providing as much health care resources to the LGBTQ community as they can, through partnerships between the government and community-based groups, because they know these issues are top of mind. He also says that if someone is not vaccinated against mpox, they might not be on the highly effective HIV prevention medication PrEP, underscoring the need for a holistic campaign. “They just need to know about access to this life-saving medicine,” says Bowles.

He says that DC Health already partnered with DC Black Pride and Trans Pride, both of which happened at the end of  May. Through partnership with Impulse Group DC, they were able to incentivize people to get vaccinated against mpox, offering swag and even Beyonce tickets.

“No tax dollars are used to purchase Beyonce tickets,” jokes Bowles. “But being able to promote that with a partner, that’s how we get people [vaccinated]. We’re credible messengers. But Impulse Group and these other groups, they’re a part of the community so they also are the credible messengers here.”

Bowles also says they are providing educational sessions about mpox through the city’s Equality Chamber of Commerce, a member organization for the business community.

What if I think I’ve been exposed?

Take a deep breath: Mpox is treatable and very rarely fatal.

The first thing you should do is call your provider. Whitman-Walker says you can reach out to its office too. If you’ve been exposed within the last 14 days, the provider also says to register for a vaccine.

CDC says watch for symptoms of mpox for 21 days from the date of the suspected exposure. Be alert for rashes, including in areas such as genitals, anus, or your mouth. Currently, the federal agency is only recommending testing if you have a rash consistent with mpox.

Unfortunately, there’s no treatment specifically for mpox. But providers can use the antiviral drug tecovirimat (branded as TPOXX) to treat mpox. That drug was developed and approved to treat smallpox, but can shorten the course and severity of the mpox illness. People will be asked to sign a consent form stating they understand TPOXX is an investigational drug, which means there is not enough data to determine the drug’s safety and efficacy for mpox patients. But TPOXX remains the best option, particularly for severe cases.

I plan to go to Pride events and am fully vaccinated, anything else I need to know? 

Enjoy Pride! No reputable health expert is advising anyone avoid Pride festivities. Just be safe and alert of mpox. By the way, here’s our guide to Pride events.

This post has been updated to correct that the Montgomery County Health Department is giving out $15 gift cards for those who get vaccinated at Silver Spring’s “Pride in the Plaza,” not $50.