Monkeypox Information

“If you have any Monkeypox (MPV) symptoms, and especially if you have a rash, it is best to avoid prolonged physical contact with anyone until you are well.” IF YOU ARE SICK, STAY IN!

Am I at risk for Monkeypox (MPV)? Who should get vaccinated?

September 12, 2022: Outer Cape Health Services offers 2nd dose appointments and 1st dose based on eligibility; clinics are Thursdays and Fridays from 9 am - 3 pm through the end of September. Call 508.905.2888  to make an appointment.

Barnstable County operates a Community Health Helpline: call 774-330-3001 and leave a detailed message to receive a call from a public health nurse to assist with monkeypox (MPV) infection related questions.

August 8, 2022:  The Department of Public Health is prioritizing first dose MPV vaccines for as many people as possible. This approach is intended to provide the broadest possible protection against the spread of MPV. Second dose appointments that are already scheduled will be honored and not cancelled; no new second dose appointments will be scheduled until additional vaccine is available. In the United States, there is a very limited supply of JYNNEOS and it is solely distributed by the Centers for Disease Control and Prevention (CDC). Massachusetts has received several allocations of vaccine from the CDC since July 5th but additional vaccine is not expected by the federal government until Fall 2022. People who get vaccinated should continue to protect themselves from infection by avoiding close, skin-to-skin contact, including intimate contact, with someone who has MPV.

August 4, 2022: White House declares monkeypox a public health emergency,  the Centers for Disease Control and Prevention (CDC) says the declaration will provide resources and increase access to care. 

August 2, 2022: Click here for Outer Cape Health Services MPV Resources webpage, including vaccine clinic information, and here for additional vaccine locations.

  • To date, OCHS has administered more than 1800 first doses of MPX vaccine and is working with DPH to plan for second dose appointments.
  • First dose appointments in the next week or so will be scheduled for second doses into September.

July 23, 2022: World Health Organization convened to assess health implications of the evolution of the multi-country monkeypox (MPV) outbreak. Transmission is occurring in many countries that had not previously reported cases of MPV, and the highest numbers of cases are currently reported from countries in Europe, and America. The majority of currently reported MPV cases are in males, and most occur among males who identified themselves as gay, bisexual and other men who have sex with men (MSM), in urban areas, and are clustered in social and sexual networks. Early reports of children affected include a few with no known epidemiological link to other cases.

In the United States, cases of MPV are widely distributed across the country, although most cases are concentrated in three large cities. While a few cases have occurred in children and a pregnant woman, 99% are related to male-to-male sexual contact. Click here for the WHO Director-General's statement. 

" short, we have an outbreak that has spread around the world rapidly, through new modes of transmission, about which we understand too little, and which meets the criteria in the International Health Regulations. For all of these reasons, I have decided that the global MPV outbreak represents a public health emergency of international concern."

Click here for isolation guidance for individuals with MPV.

July 6, 2022: Click here for MA DPH vaccine announcement. Here is the CDC guidance for who is eligible

  • Known contacts of MPV cases identified by public health via case investigation, contact tracing, and risk exposure assessments (this may include sexual partners, household contacts, and healthcare workers)
  • Presumed contacts who meet the following criteria:
  • Know that a sexual partner in the past 14 days was diagnosed with monkeypox; or
  • Had multiple sexual partners in the past 14 days in a jurisdiction with known monkeypox.

MA DPH criteria for who is eligible: lives in or works in Massachusetts. Call the Outer Cape Health Services number 508.905.2888 for an appointment or go directly to the Provincetown Health Center at 49 Harry Kemp Way by foot, bike or car to schedule a vaccination appointment. 

Click here for MPV U.S. map and case count per state. MA DPH is the lead  for case investigations and conducting contact tracing for any positive cases at this time, providing isolation instructions. The state is not identifying individuals or their town or county locations.

UPDATE June 29, 2022: The Biden-Harris Administration is building a comprehensive strategy to combat MPV and announced plans for expanding access to vaccinations for high-risk individuals. The plan includes:

  • Scaling and delivering vaccines directly to high-risk communities
  • Making testing easier - the CDC started shipping tests to commercial labs, expanding testing capacity and convenience.
  • Activating community leaders, health care providers, and stakeholders in high-risk communities

The Administration is communicating with health care providers, public health officials, elected leaders, and members of the LGBTQI+ community on a daily basis to raise awareness of the outbreak and increase access to vaccines, testing, and treatments.

Here is the recording of 6/28/22 Provincetown MPV Prevention Public Awareness Forum  with MA Department of Public Health representatives! Due to an increasing number of MPV cases nationally and state-wide, Provincetown initiated a multi-agency effort to educate the public about the risk factors, symptoms, and MPV transmission. The town has been working with local healthcare providers, the legislative delegation, Barnstable County, and state officials to identify and promote best practices for MPV awareness and prevention amongst Cape Cod residents, local businesses, and visitors. Although MPV case numbers among  the general population remain low, officials believe early awareness and proactive public outreach are integral to inhibiting a potential spread of the virus. Click here for FAQs.

While the virus does not spread easily between people, people can spread the infection once they develop symptoms. Transmission occurs through direct contact with body fluids and MPV sores, by touching items that have been contaminated with fluids or sores (clothing, bedding, etc.), or less commonly, through respiratory droplets following prolonged face-to-face contact. In many of the recent cases, the locations of the rash lesions suggest transmission during sexual contact. 

Click here for World Health Organization (WHO) advice for MSM with answers to common questions about MPV

Click here for Barnstable County Department of Health & Environment information for Cape Cod residents, visitors, businesses, and health care practitioners.

Click here for information from Outer Cape Health Services. Call 508.487.9395 if you are feeling ill with symptoms that need to be evaluated. At this time, testing is only available through the DPH state lab. Local urgent care clinical evaluation is necessary for sample collection authorization in consultation with the state epidemiological program. Click here for regional urgent care facilities.

Examples where MPV can spread and where it does not:

  • MPV can spread through:
    • Direct skin-skin contact with rash lesions. Sexual/intimate contact, including kissing while a person is infected.
    • Living in a house and sharing a bed with someone. Sharing towels or unwashed clothing.
    • Respiratory secretions through face-to-face interactions (the type that mainly happen when living with someone or caring for someone who has monkeypox).
  • MPV does not spread through:
    • Casual conversations. Walking by someone with MPV in a grocery store. Touching items like doorknobs.

Other things you can consider to help reduce the risk from MPV include:

  • Avoid large gatherings like raves and dance parties where you may have lots of close body contact with others.
  • Ask any partner, especially new partners whose health status and recent travel history you are not familiar with, if they have any symptoms of MPV.
  • Stay informed by reading information available on the DPH and CDC websites.

Click here for safer sex guidance,  here for social gathering and more sex information and here for CDC situation summary.

Click here for information provided by the AIDS Support Group of Cape Cod.

Click here for cleaning information.

Click here for business flyer to post MPV information.

MA DPH announced an additional case of monkeypox in an adult male (6/14/22). The case is currently isolating to prevent spread to others. Current data from CDC indicates that there have been 65 cases of monkeypox virus this year in US residents. There have been no deaths in the US or globally related to this outbreak and patients generally recover fully in 2-4 weeks. Although many of the early cases were associated with international travel, recent cases are not. Gay and bisexual men and other men who have sex with men make up a large proportion of the cases identified to date. However, the risk is not limited to the LGBT community, and anyone who has been in close contact with someone who has monkeypox is at risk. On May 18, the Massachusetts Department of Public Health (MDPH) reported that a Massachusetts resident tested positive for monkeypox after returning to the U.S. from Canada. Since early May, global public health authorities have been reporting multiple clusters of monkeypox in several countries that do not typically report monkeypox. In most instances, these cases did not have the traditional risk factor, which is recent travel to an endemic country in West or Central Africa. Some recent case clusters have been identified in men who report sex with men (MSM).  MDPH is urging healthcare providers to be alert for patients who have rash illnesses consistent with monkeypox.Clinicians are asked to be alert to the possibility of monkeypox virus infection in individuals who have rash illnesses consistent with monkeypox. Early symptoms of monkeypox can include fever, headache, sore throat, and swollen lymph nodes, but rash may be the first symptom. Rash lesions start flat, become raised, fill with clear fluid (vesicles), and then become pustules (filled with pus). A person with monkeypox can have many lesions or may have only a few. More complete information about how to recognize monkeypox is available here


Monkeypox is a rare but potentially serious viral illness that typically begins with flu-like illness (fever, chills, malaise, headache, muscle aches) and swelling of the lymph nodes and progresses to a rash on the face and body. Most infections last 2-to-4 weeks. In parts of Central and West Africa where monkeypox occurs, people can be exposed through bites or scratches from rodents and small mammals, preparing wild game, or having contact with an infected animal or possibly animal products. The virus does not spread easily between people; transmission can occur through direct contact with body fluids and monkeypox sores, or indirect contact with fomites (items that have been contaminated with the virus (clothing, bedding, etc.), or through large respiratory droplets following prolonged face-to-face contact.

Symptoms of monkeypox involve a characteristic rash. The rash is typically preceded by fever/chills, swollen lymph nodes, and other non-specific symptoms such as malaise, headache, and muscle aches following an average incubation period of up to 21 days (typically 6-16 days). Some recent cases have begun with characteristic lesions in the genital/perianal region, and in the absence of fever. For this reason, cases may be confused with more commonly seen infections (e.g., syphilis, chancroid, herpes, and varicella zoster). 

Monkeypox lesions typically progress through specific stages before scabbing and falling off. The rash appearance of monkeypox is very similar to that of smallpox, appearing first on the face or genital area, and spreading to other parts of the body and may include lesions on the palms and soles. The illness is usually mild and most of those infected will recover within a few weeks without treatment. Initial laboratory testing for monkeypox is performed using real-time polymerase chain reaction (PCR) assay on lesion material.

May 25, 2022 Provincetown Health Department Statement:

There are currently no known or suspected cases in Provincetown. Transmission from person to person is by direct contact (touch) with body fluids, fluid from the pox vesicles, or bedding contaminated with the fluids. Respiratory transmission is also possible but through large droplets that fall quickly and therefore requires prolonged close contact (usually hours face to face) with someone who has the vesicles in the throat or respiratory tract.

Symptoms of Monkeypox: Monkeypox begins with symptoms similar to other pox viruses. The main difference between smallpox and monkeypox symptoms is that monkeypox causes swollen lymph nodes (lymphadenopathy) while smallpox does not. The incubation period (time from infection to symptoms) for monkeypox is usually 7−14 days but can range from 5−21 days.

The illness begins with fever, headache, muscle aches, backache, swollen lymph nodes, chills, exhaustion. Within 1 to 3 days after the appearance of fever (sometimes longer), the patient develops a rash, often beginning on the face, then spreading to other parts of the body.

What people should do:

People who may have symptoms of monkeypox should contact their healthcare provider. This includes anyone who:

1.    traveled to central or west African countries, parts of Europe where monkeypox cases have been reported, or other areas with confirmed cases of monkeypox during the month before their symptoms began, or

2.    reports close or intimate contact with a confirmed monkeypox case or person with suspected monkeypox symptoms.

What We are Doing:

The Provincetown Department of Health takes seriously any potential threat to the public’s health. We are communicating and coordinating with our local health care clinic, Outer Cape Health Care, the Barnstable County Health Department, and the Massachusetts Department of Public Health, as well as following and disseminating advisories from the US CDC.

We are communicating with licensed businesses whose staff or guests may be impacted by monkeypox, sharing signs and symptoms, and recommending cleaning protocols that can help to prevent the spread of monkeypox, should it appear in Provincetown.

Vaccination is not currently recommended for the general public. We have inquired about the possibility of accessing and distributing a vaccine through our health care network should it become recommended and remain vigilant about signs and symptoms that could indicate cases of monkeypox in Provincetown.

We have sent notice to licensed businesses whose staff or guests may be impacted by monkeypox, to share signs and symptoms, and recommend cleaning protocols that can help to prevent the spread of monkeypox, should it appear in Provincetown.

The CDC recommends:

  •  Hand hygiene (i.e., hand washing with soap and water or use of an alcohol-based hand rub) should be performed by infected persons and household contacts after touching lesion material, clothing, linens, or environmental surfaces that may have had contact with lesion material.
  • Laundry (e.g., bedding, towels, clothing) may be washed in a standard washing machine with warm water and detergent; bleach may be added but is not necessary.
  • Care should be used when handling soiled laundry to avoid direct contact with contaminated material.
  • Soiled laundry should not be shaken or otherwise handled in a manner that may disperse infectious particles.
  • Dishes and other eating utensils should not be shared. It is not necessary for the infected person to use separate utensils if properly washed. Soiled dishes and eating utensils should be washed in a dishwasher or by hand with warm water and soap.
  • Contaminated surfaces should be cleaned and disinfected. Standard household cleaning/disinfectants may be used in accordance with the manufacturer’s instructions.