August 18, 2022
The Los Angeles County Department of Public Health (LAC DPH) has provided an updated guidelines on expedited testing for persons experiencing homelessness (PEH) and alternative JYNNEOS dosing in regards to the monkeypox virus.
Help control the spread of monkeypox by testing for PEH
The following actions were adapted from the LAC DPH Health Update: Monkeypox Updates Including Expedited Testing for PEH and Alternative JYNNEOS Dosing, published on August 12, 2022. Please view the update in full for additional details and information, including contact information for clinical consultations or to request approval for monkeypox testing.
Test the rash of any patient with suspected monkeypox.
This includes any patient with a new characteristic rash and patients with risk factors for monkeypox and a new rash. The rash associated with monkeypox can be confused with other rashes encountered in clinical practice including herpes, syphilis, and varicella and co-infections have been reported.
Submit specimens for monkeypox testing through commercial labs with the exception of specimens from PEH.
If you suspect monkeypox in a person experiencing homelessness, submit specimens to the LAC DPH Public Health Laboratory to expedite test results and decisions on PEH placement needs. Providers who do not have access to commercial orthopoxvirus testing may submit samples from suspect cases to the LAC DPH PHL. Consultation and approval is required before submitting specimens for testing at the LAC DPH PHL.
Instruct patients with suspected monkeypox to isolate immediately pending test results.
If an alternative diagnosis is made, isolation can be discontinued. Patients with confirmed monkeypox should continue to isolate in accordance with LAC DPH monkeypox isolation instructions.
Report all Los Angeles County residents with orthopoxvirus-positive and/or presumptive positive test results if using a commercial lab.
See the Reporting section of the Healthcare Provider Monkeypox Hub for information on secure online reporting and other options. It is not necessary to report results of tests processed by LAC DPH PHL.
Authorized emergency use of JYNNEOS
To make the limited supplies of JYNNEOS vaccine available to more people, the FDA authorized JYNNEOS to be administered as:
- An injection volume of 0.1mL intradermally as a 2-dose series to individuals 18 years of age and older at high risk of monkeypox infection who do not have a history of keloid formation.
- An injection volume of 0.5mL subcutaneously as a two-dose series to individuals under the age of 18 who are at high risk of monkeypox infection. This regimen is also available for individuals ages 18 and over who have a history of keloid formation.
Refer to the Monkeypox Vaccine Provider website for further guidance and training.
For information on monkeypox vaccination, including eligibility and how to refer patients for vaccination, see Monkeypox Vaccination and Post Exposure Prophylaxis.