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RALEIGH — Two cases of mpox were reported to the North Carolina Department of Health and Human Services over the past six weeks, the first cases in North Carolina residents since April 2023. In addition to the two cases, mpox virus was recently detected in one out of 12 wastewater sites where monitoring is being conducted. These cases and wastewater detections were all in different counties, suggesting increased spread of mpox in North Carolina.

“If you are at higher risk for mpox and haven’t yet gotten the vaccine, now is a good time to do so,” said Dr. Zack Moore, State Epidemiologist. “Numbers of cases have been low recently thanks to vaccinations and engagement of partners in the LGBTQ+ community, but this is a reminder that mpox is still with us.”

NCDHHS is working closely with local health departments and community partners to provide education about mpox, encourage testing and improve vaccine access and uptake for individuals at higher risk. These efforts to enhance communication, education and outreach include the Mpox Equity Report, the Mpox Communications Toolkit and the Take Pride Now campaign.

Mpox typically begins with flu-like symptoms including fever, chills, headache, muscle aches, swollen lymph nodes and exhaustion followed a few days later by a rash that may be located on hands, feet, chest, face or mouth or near the genitals or perianal area. In some recent cases, the rash has appeared before or at the same time as the flu-like symptoms. Mpox can be spread from the time symptoms start until all sores have healed and a fresh layer of skin has formed — this can take several weeks. Symptoms can be more severe for people who are immunocompromised, such as in individuals living with HIV.

The disease is spread person to person through direct skin-to-skin contact, having contact with an infectious rash, through body fluids or through respiratory secretions. Such contact often occurs during prolonged, face-to-face contact or during intimate physical contact, such as kissing, cuddling or sex. While anyone can get mpox, in the current outbreak, most cases have been in men who have sex with men and more than half of the cases in North Carolina have been in people living with HIV.

If you think you have mpox or have had close personal contact with someone who has mpox, visit a health care provider or contact your local health department to help you decide if you need to be tested for mpox. You should also talk with your doctor about getting tested for other sexually transmitted infections including HIV and syphilis, both of which are on the rise in

North Carolina. Learn more information about mpox testing and STD testing online.

NCDHHS and the Centers for Disease Control and Prevention recommend five steps to prevent mpox infection:

• Get vaccinated. Vaccines, including the JYNNEOS vaccine, are free and available, regardless of immigration status. Vaccination can protect against mpox infection or reduce disease severity if infection does occur. NCDHHS recommends vaccination for —
  • Anyone who has or may have multiple or anonymous sex partners; or
  • Anyone whose sex partners are eligible per the criteria above; or
  • People who know or suspect they have been exposed to mpox in the last 14 days or
  • Anyone else who considers themselves to be at risk for mpox through sex or other intimate contact.
• Use the mpox vaccine locator to find nearby healthcare locations in your area that provide mpox vaccinations.
• Take steps to lower your risk during sex or at social gatherings, like using a condom correctly every time you have sex.
• Avoid close contact with people who have a rash that looks like mpox.
• Avoid contact with objects and materials a person with mpox has used.
• Wash your hands often.

Information about mpox cases and vaccinations in North Carolina is updated monthly and displayed on NCDHHS’ mpox website.