County of Marin Health and Human Services


Marin County Public Health is actively monitoring a multi-country monkeypox outbreak in non-endemic countries, including the United States. In response to a U.S. Centers for Disease Control and Prevention (CDC) Health Alert, Marin County Public Health is partnering with the California Department of Public Health (CDPH) and local healthcare providers to enhance surveillance activities. 

The risk to the general public is low, but you should seek medical care immediately if you develop a new, unexplained skin rash (lesions on any part of the body), with or without fever and chills. Current available evidence suggests that those who are most at risk are those who have had close physical contact with someone with monkeypox, while they are symptomatic. 

Learn more at Centers for Disease Control and Prevention (CDC).

Status Update

As of June 23, 2022, there are 3504 confirmed cases of monkeypox globally, including the United States and other non-endemic countries (incl., U.K., Spain, Portugal, Canada, Germany, France). As of June 23, 2022 there are 173 confirmed cases of monkeypox in the U.S. There are 48 confirmed cases in California. No associated deaths have been reported to date.  On June 6, CDC issued a travel advisory to practice enhanced precautions (Level 2).  On June 14, CDC issued updated case-finding guidance for clinicians. On June 23, CDPH issued updated information for California healthcare providers in the evaluation and management of suspected monkeypox cases.



Monkeypox is a rare but potentially serious viral illness that typically begins with flu-like illness and swelling of the lymph nodes and progresses to a rash on the face and body. Most infections last 2-to-4 weeks. The virus does not spread easily between people; transmission can occur through contact with body fluids, sores, items that have been contaminated with fluids or sores (clothing, bedding, etc.), or through respiratory droplets following prolonged face-to-face contact.

Monkeypox: A review of the history and emergence in the Western hemisphere

Clinical presentations of confirmed cases to date

Suspected cases may present with early flu-like symptoms and progress to lesions that may begin on one site on the body and spread to other parts. Illness could be clinically confused with a sexually transmitted infection like syphilis or herpes, or with varicella zoster virus. Thus far in the U.S. outbreak, all patients diagnosed with monkeypox in the United States have experienced a rash or exanthem. Although the characteristic firm, deep-seated, well-circumscribed and sometimes umbilicated rash has been observed, the rash has often begun in mucosal areas (e.g., genital, perianal, oral mucosa) and in some patients, the lesions have been scattered or localized to a specific body site rather than diffuse and have not involved the face or extremities.

The Centers for Disease Control and Prevention (CDC) issues updated public information here. For more about this virus, visit

Traveler's Health

Alert - Level 2 | Practice Enhanced Precautions

As the COVID-19 situation around the world changes, CDC is monitoring COVID-19 risk in each country and making travel recommendations. If you are considering international travel, see CDC’s COVID-19 Travel Recommendations by Destination.

More information at


Page last reviewed: June 24, 2022