Mpox Treatment

Supportive Home Care Guide for Mpox

Keep rashes clean and dry when not in the shower/bathing to prevent bacterial infections.
Stay hydrated during your illness, especially if you are also experiencing diarrhea.
For painful genital and anorectal lesions or inflamed prostate, warm sitz baths* lasting at least 10 minutes several times per day may help with pain and inflammation.
Consider over the counter medication options, as needed:
- For pain and fever (e.g., acetaminophen, ibuprofen)
- For itchiness (e.g., antihistamine medication, calamine lotion, or petroleum jelly)
- For lesions in the mouth (e.g., Chlorhexidine mouthwash to keep lesions clean)
- For nausea and vomiting (e.g., antinausea or nausea relief medication)
- For inflamed prostate (e.g., stool softeners to help with relieving pain or pressure when using the restroom)
Talk with your healthcare provider about other prescription medications which may help with symptoms or illness:
- “Magic” or “miracle” mouthwash or numbing gels which may help with pain from mouth lesions
- Antinausea or constipation medication
- Numbing gels which may be able to help with rectal or genital pain
- Antibiotics if you develop a bacterial skin infection
Consider also getting tested for sexually transmitted infections (e.g., gonorrhea, chlamydia, syphilis), which may require treatment.
Contact your healthcare provider if you are experiencing bleeding from your rectum or if you are experiencing other concerning symptoms which are not helped by your homecare practices.

*What is a sitz bath?

A sitz bath involves sitting in warm water to help relieve pain in your bottom or around your private parts. Sitz baths do not take a lot of water, only a couple of inches. Don't add shower gel, bubble bath, or any type of soap to a sitz bath as it may cause additional irritation. The water temperature should be lukewarm and comfortable to the touch. You can soak up to three times a day for 10 to 15 minutes.

TPOXX

Tecovirimat may be considered for treatment in people infected with Monkeypox virus:

With severe disease (e.g., hemorrhagic disease, confluent lesions, sepsis, encephalitis, or other conditions requiring hospitalization)
Who are at high risk of severe disease:
- People with immunocompromising conditions (e.g., HIV/AIDS, leukemia, lymphoma, generalized malignancy, solid organ transplantation, therapy with alkylating agents, antimetabolites, radiation, tumor necrosis factor inhibitors, high-dose corticosteroids, being a recipient with hematopoietic stem cell transplant <24 months post-transplant or ≥24 months but with graft-versus-host disease or disease relapse, or having autoimmune disease with immunodeficiency as a clinical component)
- Pediatric populations, particularly patients younger than 8 years of age
- Pregnant or breastfeeding women
- People with a history or presence of atopic dermatitis, people with other active exfoliative skin conditions (e.g., eczema, burns, impetigo, varicella zoster virus infection, herpes simplex virus infection, severe acne, severe diaper dermatitis with extensive areas of denuded skin, psoriasis, or Darier disease [keratosis follicularis])
- People with one or more complication (e.g., secondary bacterial skin infection; gastroenteritis with severe nausea/vomiting, diarrhea, or dehydration; bronchopneumonia; concurrent disease or other comorbidities)
With aberrant infections involving accidental implantation in eyes, mouth, or other anatomic areas where Monkeypox virus infection might constitute a special hazard (e.g., the genitals or anus)
TPOXX can also be considered for early empiric treatment prior to testing confirmation if monkeypox is highly suspected. Patients should still meet the clinical criteria listed on above.
Full guidance can be found online.
If patients meet the criteria above, healthcare providers in Riverside County should direct all requests for TPOXX, call RUHS Public Health's Disease Control Program at 951.358.5107 for consultation and guidance on monkeypox testing, treating, and infection control measures.

Find Additional Information Below

Interim Guidance for Prevention and Treatment of Monkeypox in Persons with HIV Infection — United States, August 2022 | MMWR (cdc.gov) Supportive Care Suggestions for Patients with Monkeypox (Mpox)

If you’re making a sitz bath in your tub:

Fill the bathtub with about 2 to 3 inches of warm water
Sit in the tub, making sure your private area is covered
Afterward, gently pat the area dry using a soft towel. You can also dry off by using a hair dryer on a cool or low, warm setting.

Medical supply stores and pharmacies also sell small plastic tubs or basins that fit over a toilet seat that can be used for a sitz bath.