It’s been almost a year since Oregon reported its first case of mpox (monkeypox). That number has since risen to 279, including two pediatric cases (under age 18). But new cases have been trickling in slowly, and the initial fears shared by health experts about potential spread and illness have shifted to cautious optimism.

“We feel pretty good about the progress we made over the past year in terms of preparedness,” said Dr. Tim Menza, OHA senior health advisor and OHA’s Office of Recovery and Resilience. “Due to the work of the queer and transgender community, local public health partners and health care providers throughout Oregon, the mpox outbreak has been relatively contained in Oregon. We now have the necessary tools to prevent a resurgence.”

Those tools include an ample supply of mpox vaccines, which wasn’t the case a year ago.

The Jynneos vaccine against mpox is available to anyone who wants it, of any age, for free. It is administered in two doses, received at least 28 days apart. If someone received only one dose a year ago, for example, they can still get the second dose now, without restarting the series.

The Malheur County Health Department has Mpox vaccine available. Call our clinic at 541-889-7279 to schedule an appointment.

“At this point, we encourage anyone who wants to be vaccinated against mpox to get vaccinated,” Menza said. “We also have better access to testing and treatment, stronger community partnerships for outreach, education and vaccine events, as well as very good data on mpox cases to guide Oregon’s outbreak response.”

Mpox causes often painful skin lesions that usually heal in two to four weeks without medical treatment, and it spreads primarily through prolonged and close skin-to-skin contact. While mpox most often spreads during sexual contact, sex is not required for mpox to spread. Out of more than 30,000 cases in the United States since the outbreak began, 42 people have died. The majority of deaths have occurred among people living with advanced or untreated HIV or other immunocompromising conditions. In Oregon, five people have been hospitalized with mpox to date, and none has died.

Globally, the World Health Organization has just declared the mpox outbreak no longer a global health emergency, recommending a shift to a “robust, proactive and sustainable mpox response and control program,” versus the emergency status.

In the U.S., the Centers for Disease Control and Prevention (CDC) has not declared the mpox outbreak over, but things have slowed down dramatically.

Here in Oregon, the rate of new mpox cases peaked in August 2022 at about 10 per week. Now, the state has diagnosed five new cases in the past three months. The question is: do these sporadic new cases represent on-going, steady, low-level virus transmission that’s here to stay, or do they signal a possible future end to all mpox transmission?

Unfortunately, we’re not yet able to answer that question.

Menza is paying close attention to mpox resurgences happening in other places, specifically new clusters of cases in Chicago, France and South Korea.

“Those outbreaks raise our level of concern,” Menza said. “Moving toward summer travel and Pride events across Oregon and the U.S. over the next several months, we could see a similar situation with increased cases in Oregon.”

If you’re planning to travel this summer, especially to places reporting recent clusters of new cases, Menza advises the best way to protect yourself and prevent a resurgence back home in Oregon is to get vaccinated.

Lifting of COVID-19 vaccine requirement for education, health care workers among other changes taking effect in coming weeks

In alignment with the federal COVID-19 public health emergency ending May 11, state health officials today announced the lifting of health-protective measures that helped reduce COVID-19 infections, hospitalizations and deaths, and expanded access to services during the pandemic.

The changes affect a wide range of programs and services. Some changes are effective May 11, and others will take effect in the coming weeks. Other changes put in place during the COVID-19 emergency will continue after the end of the federal emergency.

“These changes are an acknowledgement of the progress we’ve made over the last three-plus years,” said Dean Sidelinger, M.D., M.S.Ed., health officer and state epidemiologist at OHA. “However, we know COVID-19 will remain a part of our lives for years to come, so we need to continue taking steps that prevent its spread, such as staying up to date with vaccinations. My thoughts go out to those sick with COVID-19, mourning a loved one, or still suffering with symptoms following their acute infection.”

Highlights of the changes resulting from the ending of the federal public health emergency are as follows:

Vaccination requirements

Effective Thursday (May 11), workers in health care settings will no longer be required to be vaccinated against COVID-19 under state rules, OHA announced today. A similar vaccination requirement for teachers and school staff in private and public education settings will lift June 17, the end of the last week of school, to support consistency in student instruction through this school year.

Exposure, isolation guidance

A five-day period of isolation for those infected with COVID-19 also will no longer be recommended for the general population, including people in K-12 education settings. Oregon public health officials believe widespread population immunity due to vaccination and repeated infections means many COVID-19 infections are now likely asymptomatic or mildly symptomatic, and the five-day isolation period is doing little to reduce transmission.

Instead, officials say, the recommendation for the general population will be to stay home until fever free for 24 hours and symptoms are improving; avoid contact with individuals at increased risk for severe disease, including older adults and those with underlying medical conditions; and consider masking for 10 days.

School testing

Diagnostic testing resources for students and staff with symptoms or exposure to COVID-19 in schools will remain available through July 31, 2024. iHealth self-tests will remain available for K-12 schools to request and distribute to their school communities until current stock is depleted. Weekly opt-in “screening” testing for K-12 students and staff without COVID-19 symptoms will end July 31 as funding for the effort wraps up.

The endings of the vaccination, isolation and some testing measures are among a spate of impending changes over the coming weeks as Oregon, and the nation, continue the long, careful transition out of the pandemic. A number of “flexibilities” put in place during the pandemic will remain in effect.

The following are among the COVID-era activities and requirements that will continue after May 11:

• An extension of a 90-day “reasonable opportunity period” for non-citizens to verify citizenship or immigration status to 180 days so they can enroll in Oregon Health Plan (OHP).
• A requirement that OHP providers, including coordinated care organizations, continue to cover COVID-19 vaccinations and treatment without cost sharing, and that commercial health insurers cover vaccinations without cost sharing. In Oregon, vaccinations are covered no matter where someone gets a shot. Oregonians should contact their health care provider about where they can get vaccinated.
• A requirement that Oregon health care providers be reimbursed for language interpreter services (spoken or signed) provided during an office visit.
• A requirement that OHP providers offer access to telehealth services.
• In addition, state officials are currently implementing previously announced changes in access to Medicaid coverage and other human services programs administered by the state and federal governments.

The following are among many other changes taking effect May 11:

COVID-19 reporting

• A change in how OHA monitors COVID-19. Epidemiologists will transition to a more sustainable and effective model that focuses on measures that indicate transmission, and continue monitoring for severe outcomes, including hospitalizations and death. Case data, which is based on individual laboratory test reporting and is heavily biased, will be retired. The changes align with CDC recommendations and mirror how influenza is monitored.
• A change in how OHA reports COVID-19 data. Epidemiologists will streamline data reporting to a smaller number of dashboards updated weekly. Data visualizations will include graphs showing statewide percent positivity, wastewater levels and trends, distribution of variants, hospitalization rates and capacity, death counts, emergency department visit and vaccination trends. Dashboards with case counts and county data will be archived.

Health coverage, supports

• The end of extended health coverage, services and supports for people with disabilities and older adults, and extra food benefits that were provided during federal emergency. Continuous coverage for Medicaid also is ending. Oregon began a “redetermination” process April 1 to help people renew their OHP membership and other Medicaid benefits, and stay on the plan, and is encouraging members to keep mailing addresses, phone numbers and email addresses current to ensure they receive information about their benefits in the coming months. More information about the renewals process and options for updating contact information is at oregon.gov/oha/phe. Those with questions can reach out to the ONE Customer Service Center at 800-699-9075 (TTY 711) from 7 a.m. to 6 p.m., Pacific Time, Monday through Friday.

Almost all of us will have HPV at some point and while for most of us it isn’t harmful, HPV is linked to several kinds of cancer. There is a vaccine that can prevent HPV infection and prevent most HPV related cancers. The Malheur County Health Department has the HPV vaccine and has many appointment times available throughout the week for immunizations. HPV vaccine is recommended for routine vaccination at age 11 or 12 years. (Vaccination can be started at age 9.)  CDC’s Advisory Committee on Immunization Practices (ACIP) also recommends vaccination for everyone through age 26 years if not adequately vaccinated when younger.

The International HPV Awareness Campaign is a key initiative of the International Papillomavirus Society (IPVS) which aims to increase public awareness of the virus as part of their mission to improve understanding of HPV and the importance of prevention, screening, diagnosis and treatment of papillomavirus-related diseases.

Educating ourselves and others about HPV and cancer is the first step to reducing our risk. Find out more about the public information resources available to help spread the word. Below are answers to frequently asked questions about HPV.

What is HPV?

HPV means “human papillomavirus”. It’s a very common virus. 8 out of 10 men and women will get it at some point. Lots of people have never heard of it, but HPVs are a very big family of viruses.

There are around 200 types of HPV. Some types of HPV are transmitted by sexual contact and infect the skin cells of the genital region and the mouth and throat. Most cause no harm. But some HPVs cause warts and some can cause cancers. Both men and women get cancer from HPV, and rates are accelerating fastest in men. These cancers include cervical cancer and cancer of the penis, anus, vagina, vulva, and throat.

How can I avoid getting HPV?

HPV is a common virus and avoiding it can be difficult. About 8 out of 10 sexually active people get at least one genital HPV infection at some point in their lives! But there are a few things you can do to reduce the risk:

1. The best way to prevent HPV is to be vaccinated at the recommended age. Get vaccinated to prevent HPV infection if you are eligible for the vaccine, or if your health care provider thinks you might benefit from it. Vaccination can prevent 90% of cervical and anal cancers and most other cancers caused by HPV. The vaccine is most effective if given before you have any sexual contact. Talk to your healthcare provider or call our office at 541-889-7279 to schedule an appointment.
2. Use condoms whenever you can. Consistent condom use can reduce (but not eliminate) the risk of getting HPV. This is because HPV is passed on by skin-to-skin contact. Condoms only partially protect the skin of the genital region. The more consistent the use of condoms, the higher the amount of protection. Condom use 100% of the time reduces the risk of spreading HPV by about 70%. Less consistent use means less protection.
3. The fewer sexual partners you or your partner have, the lower your risk of getting HPV.

I’ve had the HPV vaccine – do I still need to be screened?

The vaccine reduces your risk of HPV-related cancers by about 90%. But even if you have had the HPV vaccine, you still need to have cervical screening. This is because the vaccine will not protect you against HPV types that you may have acquired before being vaccinated. In addition, you might still get infected after vaccination with the rarer HPV types that can cause cancer but which are not covered by the vaccine.

I’m a boy – do I need to know about HPV?

Yes—you are at risk for HPV and the cancers that it causes. HPV can cause genital warts as well as cancers of the anus, penis and mouth/throat in men. You can also spread HPV to your sexual partners. All of the currently available vaccines prevent infection with HPV types that cause most HPV-related cancers, and some vaccines also protect against the types that cause genital warts. The most important step you can take to prevent HPV is to get vaccinated before you have sex.

We CAN eliminate HPV and create one less worry for our world. Learn more here.