Emerging Infections

• Due to stigma in certain communities, monkeypox is now being referred to as mpox.
• Mpox is caused by a virus that is part of the same family of viruses that causes smallpox.
• Mpox is a rare disease; however, since 2022, cases have been reported in in the United States, with most cases
  among men who have sex with men (MSM).

• Mpox can spread from one person to another from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed, typically lasting 2 to 4 weeks. New data also shows that some people can
  spread mpox to others from 1 to 4 days before their symptoms appear. It is not known how many people this pre-symptomatic spread has affected during the current outbreak. There is currently no evidence showing that people who never develop symptoms have spread the virus to someone else.
• Mpox can spread to anyone through close, personal, often skin-to-skin contact, including:
  • Direct contact with mpox rash, scabs, or body fluids from a person with mpox.
  • Touching objects, fabrics (clothing, bedding, or towels), and surfaces used by someone with mpox.
  • Respiratory droplets or secretions from the eyes, nose, and mouth from a person with mpox.
• Direct contact can happen during intimate contact, including:
  • Vaginal, anal, and oral sex or touching the genitals (penis, testicles, labia, and vagina) or anus (butthole) of a person with mpox.
  • Hugging, massage, and kissing.
  • Prolonged face-to-face contact (about 3 hours or more)
  • Touching fabrics and objects during sex that were used by a person with mpox and that have not been disinfected, such as bedding, towels, fetish gear, and sex toys.
• A pregnant person can spread the virus to their baby through the placenta.
• Mpox can also spread from animals to people.

Note: Recent data suggest that some individuals can transmit mpox to others 1 to 4 days before showing symptoms.
More studies are looking into this.

• Mpox symptoms usually start after 3 days to 3 weeks of exposure to the virus.
• If someone has flu-like symptoms, they will usually develop a rash 1 to 4 days later.

Symptoms can last 2 to 4 weeks.

•  Fever
•  Headache
•  Swollen lymph nodes
•  Cough
•  Sore throat
•  Nasal congestion
•  Muscle aches and backache
•  Chills
•  Fatigue
•  A rash can look like pimples or blisters, which typically begin on the face and spread to other body parts.

• Get tested if you have signs or symptoms or have had contact with a person with mpox.
• Testing is done by swabbing a lesion to take a culture for mpox virus.

• Please contact your healthcare provider if you think you have mpox.
• Call 2-1-1 if you do not have health insurance or a medical provider.
• You can also visit any Public Health Sexual Health Clinic.

• Currently, there is no specific treatment for the mpox virus. But because the virus is like the smallpox virus, antiviral drugs used against smallpox have been used and are available. Anyone may qualify for treatment but individuals with mild cases may not need treatment. Individuals who are immunocompromised should be treated to prevent severe disease.
• You can enroll in the Study of Tecovirimat for Human Monkeypox Virus (STOMP). STOMP is a study to collect data o the effectiveness of the antiviral drug called tecovirimat (also known as TPOXX) in the treatment of mpox. If you think you may have mpox and want to participate in this study, visit STOMTPOXX.org or call (855) 876-9997 to connect to a study site.
• There are four LA County sites: Los Angeles LGBT Center, UCLA CARE Center (both offer remote enrollment), Kaiser Permanente Los Angeles Medical Center, and Harbor UCLA Medical Center.
• It is important for all partners to abstain from having sex, close contact, or sharing objects until they have fullyn recovered.
• Even after someone has recovered, it is still possible to get mpox again.

• Get vaccinated — Check the Public Health Vaccination Site or visit Myturn.ca.gov to find a site near you.
• Avoid very close and/or prolonged contact with someone with mpox symptoms, especially:
  • Oral, anal, and vaginal sex, or touching the genitals or anus (butt)
  • Hugging, cuddling, massaging, kissing
  • Skin-to-skin contact with the rash on their body
  • Sharing towels, clothing, bedding, blankets, or other objects and materials (e.g., toothbrushes, cups,
    utensils, and sex toys) that have not been cleaned.
  • Talking very closely face to face for a long time (about 3 hours or more).
• Using barriers can reduce the risk of getting mpox. This includes:
  • Condoms (external, latex, used on a penis)
  • Internal condoms (used in a vagina or anus)
  • A dental dam for oral sex
  • Barriers don’t always cover all infected areas. It is still possible to get or pass mpox, even when condoms
    are used correctly.
• Limit the number of people you have sex with.
• Wash hands with soap and water or use an alcohol-based hand sanitizer after contact with infected animals or
  humans.
• Cover exposed skin in crowds.
• Avoid contact with people who are or may be sick with the virus.

For more information, visit the County of Los Angeles Department of Public Health, mpox webpage:
http://publichealth.lacounty.gov/media/monkeypox/index.htm

• Shigella is a bacteria that causes an infection called shigellosis.
• Shigella can spread easily as it only takes a small number of bacteria to make someone sick.
• There has been a growing number of shigellosis cases in LA County, mostly linked to unprotected oral-anal sex.
• Shigella can cause fever, stomach pain, and diarrhea that can be bloody or prolonged (lasting more than 3 days).

• People with Shigella infection can spread the infection for several weeks, even after their diarrhea stops.
• You can get infected with Shigellosis when poop particles pass from one person to the mouth of another. This can happen by:
  • Exposure to poop during sexual contact with someone with a Shigella infection or who has recently recovered from a Shigella infection.
  • Getting Shigella on your hands and touching your mouth by:
    • Touching surfaces, such as toys, bathroom fixtures, changing tables, and diaper pails, contaminated with Shigella bacteria from someone with an infection.
    • Changing the diaper of a child with a Shigella infection.
    • Taking care of a person with an infection, including cleaning up after the person uses the toilet.
  • Eating food prepared by someone with a Shigella infection.
  • Swallowing water you swim or play in, such as lake water or improperly treated swimming pool water.
  • Swallowing drinking water that’s been contaminated with sewage or flood water.

• Shigella symptoms usually start within 1 to 2 days after exposure.
• Symptoms can last up to 7 days.

Many people may not experience any symptoms.

Symptoms usually last 5 to 7 days, but some people may experience symptoms anywhere from a few days to 4 or more weeks.

For those who do experience symptoms, the most common ones are:

• Diarrhea that can be bloody or prolonged (lasting more than 3 days)
•  Fever
•  Stomach pain
•  Feeling the need to poop even when the bowels are empty. Sometimes, it can take a few months for bowel (poop) habits, like stool frequency and consistency, to return to normal completely.

• Diarrhea can be caused by different germs. Knowing the specific germ causing an illness is important to ensure proper treatment.
• Testing is done by collecting a sample of your stool (poop) and checking to see if they bacteria is present.
• Contact your healthcare provider if you or a family member has bloody or prolonged diarrhea (more than 3 days), severe stomach cramping, tenderness, or fever.
  • If you have other medical conditions or a weakened immune system, let your healthcare provider know as you may be at more risk of becoming severely ill.

• Go to your healthcare provider or visit an urgent care clinic near you.
• Call 2-1-1 if you do not have health insurance or a medical provider.

• If your healthcare provider prescribes an antibiotic, take it exactly as directed and finish taking all the pills even if you feel better.
• People with Shigella infection should stay hydrated by drinking plenty of fluids.
• Avoid anti-diarrheal medicines, like loperamide (Imodium) or diphenoxylate with atropine (Lomotil), for those experiencing bloody diarrhea, as they may make symptoms worse.

• Wash hands with soap and water regularly or use an alcohol-based hand sanitizer:
  • Before sex
  • Before preparing food or eating
  • After going to the bathroom, changing a diaper, or cleaning up after someone who went to the
    bathroom
• Avoid swallowing water from ponds, lakes, orswimming pools.
• Use barriers (i.e., dental dam) when performing oralsex on an anus (butt).
• Avoid having sex for 2 weeks after you or your partner no longer have diarrhea.
• When traveling internationally, follow safe food and water habits.

For more information, visit the Centers for Disease Control and Prevention (CDC) website:
https://www.cdc.gov/shigella/general-information.html