Monkeypox

Vaccination sites for people who are eligible for a JYNNEOS vaccine:

Appointments are required for all clinics except where noted.

  • Oahu residents can contact:
    • Waianae Coast Comprehensive Health Center (in Waianae and Kapolei) at 808-427-0442
    • Hawai’i Health & Harm Reduction Center (in Honolulu) at 808-521-2437
    • Kaiser Permanente, Mapunapuna Medical Office (in Honolulu): Members and non-members should call 808-432-2000 and prompt #1, Monday-Friday 8:30 a.m. – 4:30 p.m. Non-members will be asked to create a temporary Kaiser ID.
    • Waikiki Health at 808-922-4787
    • Project Vision Hawaii, which offers walk-up vaccination at pop-up clinics. No appointment needed. Upcoming clinics are listed at https://www.projectvisionhawaii.org/monkeypox or call Project Vision Hawaii at 808-201-3937.
  • Kauai residents can contact:
    • Malama Pono Health Services (in Lihue) at 808-246-9577
    • Kauai District Health Office at 808-241-3495
  • Maui residents can contact:
    • Malama I Ke Ola Health Center (in Wailuku) at 808-871-7772
  • Hawaii Island residents can contact:
    • Hamakua-Kohala Health Centers (in Honoka’a) at 808-930-2751
    • Kumukahi Health + Wellness (in Hilo and Kona) at 808-982-8800
    • Maika‘i Health (in Hilo) at 808-333-3420
    • Hawai‘i Island Community Health Center (in Kona) at 808-326-5629

If you are a healthcare provider and want to report a monkeypox case, please call our disease reporting line at 808-586-4586.

Hawaii Monkeypox Case Data by County of Diagnosis

Click here for Monkeypox vaccination data

4

Hawaii

27

Honolulu

3

Kauai

2

Maui

4

Out of State

40

Total

Last Updated: Monday, November 14, 2022. Cases reported in Hawaii include two non-residents diagnosed in Kauai county and two non-residents diagnosed in Honolulu county.

About This Disease

Monkeypox is a contagious disease caused by the monkeypox virus. There is currently an outbreak of monkeypox in the U.S. and other countries where the virus is not usually seen. The current monkeypox situation is evolving quickly and is subject to change.

While monkeypox infection is generally not lethal, people can experience severe outcomes. Most of these people have not been hospitalized and have recovered on their own.

  • Monkeypox virus can spread when a person comes into close, intimate contact with the virus from an infected person or materials contaminated with the virus.
  • Common symptoms: Flu-like symptoms; swelling of lymph nodes; rash or sores, often on the hands, feet, chest, face, or genitals.
  • Avoid skin-to-skin and prolonged close contact (touching sores, kissing, sex) with anyone who has an unusual rash or monkeypox symptoms.

People exposed to monkeypox should contact their healthcare provider immediately. Options are available to prevent infection after high-risk close contact.

Examples of monkeypox lesions

Photo credit: CDC, UK Health Security Agency, World Health Organization

Infection begins with flu-like symptoms such as fever, headache, muscle aches, chills, exhaustion and swollen lymph nodes. Infection progresses to a rash or sores, often on the hands, feet, chest, face, or genitals. Individuals generally become ill within 21 days of exposure. Get the facts about monkeypox here.

Infections generally last two to four weeks. Individuals are infectious until all lesions are scabbed over and new skin has grown.

While most people diagnosed with monkeypox experience mild to moderate illness, the rash and sores can be itchy and painful. Treatment for monkeypox is available but must be coordinated through DOH and a physician.

Transmission can occur through:

  • Direct, prolonged contact with body fluids, lesion material, or items used by someone with monkeypox
  • Large respiratory droplets. These droplets are spread when people breathe, cough, sneeze, or talk. These droplets generally cannot travel more than a few feet, so prolonged face-to-face contact is required.
  • Close, prolonged contact with an infected person or animal
  • Sharing a bed with someone who is infected or by sharing items like towels or unwashed clothing
  • Having intimate contact with others, including during sex, kissing, cuddling, or touching parts of the body with monkeypox sores. At this time, it is not known if monkeypox can spread through semen or vaginal fluids.
  • Monkeypox has not been proven to spread through touching items like doorknobs or by walking past someone who is infected.

Monkeypox is diagnosed through laboratory testing. DOH’s State Laboratories Division and commercial labs can test for orthopoxvirus. Confirmatory testing for monkeypox must be performed by the CDC.

Providers should refer to DOH’s August 1st medical advisory for more information on diagnosing monkeypox.

Additional testing resources:

Vaccination & Treatment

JYNNEOS has been approved by the FDA for safe and effective monkeypox prevention in adults. JYNNEOS reduces one’s chances of getting monkeypox and may reduce symptoms after becoming infected. However, no vaccine is 100% effective; therefore, it is important that individuals reduce their risk of potential exposure to monkeypox both before and after receiving a dose of JYNNEOS.

Most people who get the JYNNEOS vaccine have minor reactions. These may include pain, redness, swelling, firmness, or itching where the shot was given, especially for intradermal injection (between layers of the skin). Some people have reported reactions lasting 2-4 weeks, or longer. You also may have muscle pain, headaches, nausea, chills, or may feel tired. There is a small chance of fever.

As with any medicine, there is a very small chance of a vaccine causing a severe allergic reaction. If you have signs of a severe allergic reaction (such as hives, swelling of the face or throat, difficulty breathing, a fast heartbeat, or dizziness), call 911 immediately or go to the nearest hospital. For other concerns, contact a health care provider.

    • Adverse reactions should be reported to the Vaccine Adverse Event Reporting System (VAERS). Your health care provider will usually file this report, or you can do it yourself. Visit the VAERS website or call 800-822-7967. VAERS is only for reporting reactions, and VAERS staff members do not give medical advice.
    • You can visit the FDA website (PDF) to read the package insert for this vaccine. For more information on the vaccine, visit the CDC JYNNEOS Vaccine Statement (PDF) and the CDC’s Consideration on Monkeypox Vaccine site.

DOH ordered its full allocation of the JYNNEOS vaccine from the federal government. As vaccine supplies are currently limited, DOH’s mission is to protect those at increased risk of infection or severe disease.


Current Eligibility for Monkeypox Vaccination

Hawaii residents who:

  • Had close contact in the last 14 days with a person with known or suspected monkeypox infection
  • Are gay, bisexual, and other men who have sex with men (MSM) and transgender individuals who have multiple or casual sex partners (e.g., such as through dating apps)

Parental consent is required for vaccination of individuals under 18 years of age.

Workers in certain occupational groups are also eligible: Clinical laboratory personnel performing diagnostic testing for orthopoxviruses and research laboratory personnel  who directly handle cultures or animals contaminated or infected with orthopoxviruses (see ACIP recommendations).


Vaccine Clinics
  • Oahu residents can contact:
    • Waianae Coast Comprehensive Health Center (in Waianae and Kapolei) at 808-427-0442
    • Hawai’i Health & Harm Reduction Center (in Honolulu) at 808-521-2437
    • Kaiser Permanente, Mapunapuna Medical Office (in Honolulu) at 808-432-2000 and prompt #1 (for members and non-members)
    • Waikiki Health at 808-922-4787
    • Project Vision Hawaii, which offers walk-up vaccination at pop-up clinics. No appointment needed. Upcoming clinics are listed at https://www.projectvisionhawaii.org/monkeypox or call Project Vision Hawaii at 808-201-3937.
  • Kauai residents can contact:
    • Malama Pono Health Services (in Lihue) at 808-246-9577
    • Kauai District Health Office at 808-241-3495
  • Maui residents can contact:
    • Malama I Ke Ola Health Center (in Wailuku) at 808-871-7772
  • Hawaii Island residents can contact:
    • Hamakua-Kohala Health Centers (in Honoka’a) at 808-930-2751
    • Kumukahi Health + Wellness (in Hilo and Kona) at 808-982-8800
    • Maika‘i Health (in Hilo) at 808-333-3420
    • Hawai‘i Island Community Health Center (in Kona) at 808-326-5629

Nationwide, the current cases are primarily spreading among social networks of gay, bisexual and other men who have sex with men. However, anyone who has been in close contact with someone with monkeypox is at increased risk of infection, regardless of a person’s gender, sexual orientation, or travel history.

If you are at increased risk for monkeypox, you may want to postpone having new casual sex partners and avoid events where you have close bodily contact with others, at least during the current outbreak.

If you have symptoms consistent with monkeypox or have an unusual rash or sores, avoid close contact with others. Contact your healthcare provider and let them know ahead of an appointment that you may have been exposed to monkeypox.

Practice proper hand hygiene regularly. Washing your hands with soap and water for at least 20 seconds helps prevent the spread of disease, including monkeypox.

While monkeypox infection is generally not lethal, people can experience severe outcomes. Treatment for monkeypox is available but must be coordinated through DOH and a physician.

Guidance

About the Disease


What is monkeypox?

Monkeypox is a rare, but serious disease caused by the monkeypox virus. It can be spread from infected humans, animals, and materials contaminated with the virus. While generally less severe and much less infectious than smallpox, monkeypox can be a serious illness.


Should I be worried about monkeypox?

The risk to most Hawaii residents remains low. Anyone who has direct skin-to-skin or prolonged close contact with someone with monkeypox is at risk of infection—regardless of who they are, what they do, or if they are sexually active.

Nationwide and in Hawaii, monkeypox cases have been disproportionately reported among social networks of gay or bisexual men, or other men who have sex with men. While many of those affected in the current outbreaks identify as gay or bisexual, anyone who had direct skin to skin or prolonged close contact with someone with monkeypox is at risk of infection.


What are the signs and symptoms of monkeypox?

Infection begins with flu-like symptoms such as fever, headache, muscle aches, chills, exhaustion, and swollen lymph nodes. Infection progresses to a rash or sores, often on the hands, feet, chest, face, or genitals. Individuals generally become ill within 21 days of exposure. People may have all of the symptoms or only a few.


Can vaccines prevent monkeypox?

Yes, vaccines can prevent disease or reduce the severity of monkeypox disease. If administered after exposure to monkeypox, vaccines work best when administered within 4 days.


Are treatments available?

Yes, treatment is available, but it must be coordinated through your healthcare provider and DOH. If you think you’ve been exposed to monkeypox or have symptoms of monkeypox, call your healthcare provider and notify them of your situation. Read more here.


How is monkeypox diagnosed?

Monkeypox is diagnosed through laboratory testing. Your healthcare provider can order testing.


Transmission


How is monkeypox spread?

Monkeypox is primarily spread from person to person through close, prolonged physical contact. It is much harder to spread than COVID-19, colds, or the flu.

  • Monkeypox can be spread through direct skin-to-skin or prolonged close contact with someone who has monkeypox. This can include sexual/intimate contact, cuddling, or kissing while a person is infected.
  • Monkeypox can spread by sharing a bed with someone who is infected or by sharing items like towels or unwashed clothing.
  • Monkeypox can spread through large respiratory droplets. These droplets generally cannot travel more than a few feet, so prolonged face-to-face contact is required.
  • Monkeypox has not been proven to spread through touching items like doorknobs or by walking past someone who is infected.


When is monkeypox infectious?

A person with monkeypox is infectious from the time symptoms start to when the rash has fully healed and a new layer of skin has formed. Monkeypox typically lasts 2-4 weeks. People who do not have monkeypox symptoms cannot spread the virus to others.


How is monkeypox prevented?

Many of the same preventative measures that have protected us in the last two years with the COVID-19 pandemic also prevent the spread of other diseases, including monkeypox. Preventative measures include staying home if you’re sick, washing your hands, and limiting close personal contact with people who have symptoms of monkeypox.


Is monkeypox a sexually transmitted infection?

No, monkeypox is not considered a sexually transmitted infection. However, monkeypox can spread during sex by:

  • Oral, anal, and vaginal sex, or touching the genitals or anus of a person with monkeypox
  • Hugging, massaging, kissing, or talking closely
  • Touching fabrics, shared surfaces, and objects, such as bedding, towels, and sex toys, that were used by a person with monkeypox


What should I do if I think I have monkeypox?

Individuals who have symptoms consistent with monkeypox should contact their healthcare provider. Make sure to call ahead and mention that you may have been exposed to monkeypox.


What do I do if I was informed that I was a close contact to a monkeypox case?

Contact your healthcare provider and let them know that you are a close contact. Your healthcare provider can work with DOH to arrange testing and vaccination if appropriate.


Are barbers, massage therapists, or other personal service providers at higher risk of catching monkeypox?

Monkeypox can spread through direct, prolonged skin-to-skin contact with someone who has monkeypox symptoms.

Personal service providers should consider asking clients about any new or unexplained rash or sores and take precautions.


Are men who have sex with men at higher risk of catching monkeypox?

Nationwide and in Hawaii, monkeypox cases have been disproportionately reported among social networks of gay or bisexual men, or other men who have sex with men. While many of those affected in the current outbreaks identify as gay or bisexual, the risk of monkeypox is not limited to people who are sexually active or men who have sex with men.


Vaccination


Who is eligible for vaccination?

As vaccine supplies are currently limited, DOH has developed a strategy for vaccine allocation in Hawai’i to protect those at increased risk of infection or severe disease:

At this time, DOH is using Hawai’i’s limited vaccine allocation to vaccinate close contacts of people known to have monkeypox, and for people who may have had high-risk exposures in venues or areas where monkeypox is actively spreading. DOH is arranging statewide vaccine distribution and administration. If you believe you have been exposed to monkeypox or have monkeypox, please contact your healthcare provider. Your healthcare provider will work with DOH to arrange vaccination if you are a Hawai’i resident who:

  • Had close contact in the last 14 days with a person with known or suspected monkeypox infection
  • Is gay, bisexual, and other men who have sex with men (MSM) and transgender individuals who have multiple or casual sex partners (e.g., such as through dating apps)

Workers in certain occupational groups are also eligible: Clinical laboratory personnel performing diagnostic testing for orthopoxviruses and research laboratory personnel  who directly handle cultures or animals contaminated or infected with orthopoxviruses (see ACIP recommendations).

Parental consent is required for vaccination of individuals under 18 years of age.

DOH expects to receive additional doses in the coming weeks. At that time, broader vaccination of people who may be at risk of severe illness or future exposure will be considered. DOH will announce when the vaccine becomes more widely available.


What are the side effects?

  • Most people who get the JYNNEOS vaccine have minor reactions. These may include pain, redness, swelling, firmness, or itching where the shot was given, especially for intradermal injection (between layers of the skin). Some people have reported reactions lasting 2-4 weeks, or longer.
  • You also may have muscle pain, headaches, nausea, chills, or may feel tired. There is a small chance of fever. As with any medicine, there is a very small chance of a vaccine causing a severe allergic reaction.

What if I have a severe allergic reaction?

  • If you have signs of a severe allergic reaction (such as hives, swelling of the face or throat, difficulty breathing, a fast heartbeat, or dizziness), call 911 immediately or go to the nearest hospital. For other concerns, contact a health care provider.
  • Adverse reactions should be reported to the Vaccine Adverse Event Reporting System (VAERS). Your health care provider will usually file this report, or you can do it yourself. Visit the VAERS website or call 800-822-7967. VAERS is only for reporting reactions, and VAERS staff members do not give medical advice.
  • You can visit the FDA website (PDF) to read the package insert for this vaccine. For more information on the vaccine, visit the CDC JYNNEOS Vaccine Statement (PDF) and the CDC’s Consideration on Monkeypox Vaccine site.


Monkeypox Infection Prevention Guidelines for Hotels and Dorms/University Housing

Contact Tracing

If you are notified of a case or HDOH is aware of a case, we will be working with you on contract tracing and offering guidance as needed.

Cleaning, Disinfecting and Laundry

Avoid activities that could spread dried material from lesions (e.g., use of fans, dry dusting, sweeping, or vacuuming) in these areas. Perform disinfection using an EPA-registered disinfectant with an Emerging Viral Pathogens claim, which may be found on EPA’s List Q. Follow the manufacturer’s directions for concentration, contact time, and care and handling.

Linens can be laundered using regular detergent and warm water. Soiled laundry should be gently and promptly contained in a laundry bag and never be shaken or handled in a manner that may disperse infectious material. Covering mattresses in isolation areas (e.g. with sheets, blankets, or a plastic cover) can facilitate easier laundering.

Isolation

Isolate staff, volunteers, or students who have monkeypox away from congregate settings until they are fully recovered. Flexible, non-punitive sick leave policies for staff members are critical to prevent spread of monkeypox.

Reduce the number of staff who are entering the isolation areas to staff who are essential to isolation area operations.

Personal Protective Equipment (PPE)

Cleaning and disinfection—Staff, volunteers, or residents should wear a gown, gloves, eye protection, and a well-fitting mask or respirator when cleaning areas where people with monkeypox spent time.

Laundry—When handling dirty laundry from people with known or suspected monkeypox infection, staff, volunteers, or residents should wear a gown, gloves, eye protection, and a well-fitting mask or respirator. PPE is not necessary after the wash cycle is completed.

Additional Resources:
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COLLEGES DORMS/UNIVERSITY HOUSING

Resources

Last reviewed November 14, 2022