Human Mpox Virus in College and University Settings Guidance

Mpox infections across the United States continue to increase and the mpox outbreak will remain active when colleges and universities are back in session. It is possible that tight-knit social and sexual contacts/activity on college campuses may lead to additional spread of the mpox virus. Even if spread does not occur, awareness and educational efforts are needed to address student concerns and misinformation.  To ensure you are prepared to respond appropriately, IDPH recommends that the following capabilities be established before students return for fall classes, consistent with CDC’s Considerations for Reducing Mpox Transmission in Congregate Living Facilities:

• Stay updated on the latest guidance from  the Centers for Disease Control and Prevention, your local health department (LHD), and IDPH, as this is an evolving outbreak.
• Develop a Mpox messaging strategy with input from impacted groups. Mpox can spread from person to person through direct contact with the infectious rash, scabs, or body fluids.  It also can be spread by respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact, such as kissing, cuddling or sex.   Currently, most confirmed cases in the U.S., according to the CDC, are among gay and bisexual men, however anyone can get mpox and additional groups may be impacted as the outbreak evolves. This situation creates challenges for direct, targeted, and non-stigmatizing messaging to at-risk individuals as well as the community at large.  CDC has created guidance for messaging to the general population and gay and bisexual men. IDPH has also produced an infographic available at IDPH Mpox Messages.  A rave, party, or club where there is minimal clothing and where there is direct, personal, often skin-to-skin contact has some risk. Festivals, events, and concerts where attendees are fully clothed and unlikely to share skin-to-skin contact are safer. However, attendees should be mindful of activities (like kissing) that might spread mpox. Avoid any rash you see on others and consider minimizing skin-to-skin contact. Enclosed spaces, such as saunas, sex clubs, or private and public sex parties where intimate sexual contact with multiple partners occurs, may have a higher likelihood of spreading mpox.
  
• Make sure students who meet criteria for receipt of Jynneos vaccine as part of Illinois’ expanded prophylaxis strategy (PEP++) are informed about Jynneos and where they can be vaccinated.  If you would like to discuss offering Jynneos vaccine on site, contact your local health department.
  
• Ensure that students are comfortable seeking and have access to medical evaluation, testing and treatment for possible mpox infection. Partnering with, or seeking input from, local community health centers, university clinics, and community/student organizations that specialize in treating and supporting the lesbian, gay, bisexual, transgender, queer, and/or questioning (LGBTQ+) community can help ensure students obtain judgment-free health care, whether it be on- or off-campus.
  
• Be prepared with the necessary supplies, trained staff, and policies/procedures needed to operationalize CDC’s guidance for preventing mpox spread in congregate living settings, such as dormitories at institutes of higher education, to respond to a case and assist the LHD in identifying person exposed. This will include:
  
  • Consulting with your LHD
    
  • Preparing to provide housing where cases can isolate away from others either on-site or off-site
    
  • Ensuring that residents with mpox wear well-fitting masks and cover lesions with close, gloves or bandages if leaving isolation
    
  • Managing cleaning/disinfection and waste from isolation areas using appropriate PPE (For information on respirator fit-testing, contact your facility’s occupational health unit)
    
  • Assisting the LHD in identifying persons exposed, assessing levels of exposure, monitoring for symptoms, and assisting in providing post-exposure prophylaxis to those with high or intermediate risk
    

• Clinical service providers who may see patients with sexually transmitted infection (STI) or rash symptoms that may be due to mpox should have access to the training and supplies needed for evaluation of patients with suspect mpox infection, including personal protective equipment (PPE), and the supplies and equipment necessary for specimen collection, storage, and shipping.
• Make sure you know where specimens for mpox testing will be sent and the specific specimen collection, storage, and shipping requirements for the laboratory(ies) you will be utilizing.  IDPH will test specimens meeting certain criteria. However, because not all specimens may be approved for testing at IDPH, college and university health services should have arrangements in place for mpox testing at commercial labs. (Labs currently offering mpox testing are Aegis Science, ARUP, Labcorp, Mayo Clinic Laboratories, Quest Diagnostics, and Sonic Healthcare)
  
• Train clinical staff in recognition of possible Mpox infection (e.g., staff should be able to determine if a patient has recognized risk factors for mpox infection, able to obtain sexual and travel histories, and be familiar with mpox syndromes and their overlap with other conditions [infectious and non-infectious]).
  
• Designated staff should be familiar with specimen storage and shipping requirements.
  
• Be prepared to report confirmed and probable mpox cases and check with your LHD.  to determine if reporting of suspect cases is needed.
  
• Be prepared to identify and manage mpox exposures among clinical staff. Staff who use recommended PPE when evaluating mpox patients are not considered exposed, so ensuring use of proper PPE can reduce or eliminate the burden of evaluating and monitoring exposures.
  
• Be familiar with criteria for use of post-exposure prophylaxis (PEP and PEP++) for high-risk exposures or those at high risk for infection and how to request vaccine.
  
• Be familiar with the criteria for use of TPOXX (available under CDC’s investigational new drug [IND protocol] to treat mpox illness). Information about how to request TPOXX is available through your local health department. The FDA specifies that TPOXX treatment must be overseen by a licensed physician.
  

Contact your local health department with questions or concerns.