What is mpox?
Mpox, formerly called monkeypox, is a rare viral disease caused by infection with the mpox virus, an orthopoxvirus in the same family as smallpox. Mpox was first identified in animals in 1958 and in humans in 1970.  From May 2022 to January 2024, the United States has reported 32,063 cases and 58 deaths. There have been 95,912 cases worldwide through May 2024.

What are the symptoms of mpox?

Typically appearing 3-21 days after exposure:

• Fever, chills, exhaustion, headache, muscle and backaches
• Sore throat, nasal congestion and cough
• Swollen lymph nodes

Typically appearing 5-21 days after exposure:

• A rash may appear near the penis and testicles or the labia, vagina, or the anus, but can also appear on the hands, feet, chest, or face. For some, a rash may be the only symptom.
• The rash goes through several stages, including scabs, before healing
• It can initially look like pimples or blisters and may be painful or itchy
• Do not scratch or pick at the rash

The mpox rash is very contagious. Clothing, towels and bedding that have touched the rash are also infectious. Caregivers should wear surgical masks, gowns and gloves when caring for or handling the clothing or bedding of a person with mpox.

What should I do if I develop symptoms?

• See a healthcare provider if you notice a new or unexplained rash or other symptoms
• Avoid close contact, including intimate physical contact, until examined by a healthcare provider
• If you are waiting for test results, avoid close contact, including intimate physical contact, until you receive a negative result
• If your test is positive, stay isolated until your rash is fully healed, all scabs have fallen off, and a fresh layer of intact skin has formed

How does mpox spread from person-to-person?

• Direct contact with infectious rashes, scabs
• Direct contact with body fluids such as saliva or upper respiratory secretions (snot, mucus)
• Direct contact with fluids or lesions around the anus, rectum, or vagina
• Pregnant people can spread the virus to their unborn baby through shared blood

When is mpox contagious?

From up to 4 days before rashes appear until the rash has fully healed and a fresh layer of skin has formed, which is usually 2-4 weeks after symptoms start.

What should I do if I think I was exposed to someone with mpox?

Contact your doctor for advice, testing and medical care. If possible, isolate yourself (one room, one bed, one bathroom) and avoid close contact with others.  If you do not have a private space to isolate, both you and your household members should wear surgical masks. People who do not live in your household should not visit while you are isolating.

Monitor your health for 21 days after your last exposure by taking your temperature with a thermometer twice a day (morning and night) to check for fever. Notify your provider immediately if symptoms develop and be prepared to isolate yourself.

People with known exposure to a confirmed case and who have not developed symptoms may be vaccinated with Jynneos vaccine within 4 days of exposure to reduce the risk of developing disease. When vaccinated, it is still recommended to continue monitoring for symptoms for 21 days after exposure and refraining from any activity that risks exposure to others.

If I am exposed, do I have to avoid any activities?
If you have been exposed but have no symptoms, you can continue routine daily activities such as work or school. However, you should not donate blood, cells, tissue, breast milk, semen, or organs during your 21-day monitoring period.

What will happen if I am diagnosed with mpox?
If you are tested and diagnosed with mpox, you will be required to isolate at home until all of your rash lesions have healed, the scabs have fallen off and a fresh layer of skin has formed.

While you are isolating, you should not leave your home unless it is required for medical care.

Can people die from mpox?
Those with weakened immune systems, children under 8 years of age, people with a history of eczema, and people who are pregnant or breastfeeding may be more likely to become seriously ill or die. Though rarely fatal, Clade II mpox symptoms can be extremely painful with the potential for permanent scarring.

Is there treatment for mpox?
There are no treatments specifically for mpox virus infections at this time. Mpox and smallpox viruses are similar, so antiviral drugs developed to protect against smallpox may prevent and treat mpox virus infections. Antivirals, such as Tecovirimat (TPOXX), may be recommended for people who are more likely to get severely ill, like children or patients with weakened immune systems.

How can I prevent mpox?

• If you are at-risk for mpox exposure, you should get vaccinated
• Avoid skin-to-skin contact with people who have a rash that looks like mpox
• Do not touch anyone else’s rash or scabs
• Talk openly with partners about symptoms before sexual or intimate contact
• Do not kiss, hug, cuddle, or have sex with someone with mpox
• Do not share food, drinks, or eating utensils with someone with mpox
• Do not handle or touch the bedding, towels, or clothing of someone with mpox
• Wash your hands often with soap and water or use an alcohol-based hand sanitizer

What is the vaccine for mpox?

JYNNEOS, which requires two doses given 4 weeks apart. JYNNEOS reaches its full level of protection 14 days after the second dose is given.

JYNNEOS can be given:

• Intra-dermally (between the layers of the skin) preferably on the inner forearm
• Subcutaneously (under the skin) in the upper arm above the elbow.

Should I get vaccinated for mpox?

The vaccine should be given within four days from the date of exposure to prevent onset of the disease. If given between 4-14 days after the date of exposure, vaccination may reduce the severity of symptoms but not prevent the disease.

The CDC recommends vaccination for mpox if:

• You had known or suspected exposure to someone with mpox within the past four days to prevent disease or between 4 and 14 days to lessen the severity of the illness
• You had a sex partner in the past 2 weeks who was diagnosed with mpox
• ​You are a gay, bisexual, or other man who has sex with men or a transgender, non-binary, or gender-diverse person who in the past 6 months has had any of the following:
  • ​​A new diagnosis of one or more sexually transmitted infections such as chlamydia, gonorrhea, or syphilis
  • ​More than one sex partner
• You have had any of the following in the past 6 months:
  • ​Sex at commercial sex venues, like a sex club or bathhouse
  • Sex related to a large event or in a geographic area (city or county) where mpox virus transmission is occurring
  • ​​Sex in exchange for money or other items
• You have a sex partner with any of the risks listed above
• You anticipate experiencing any of these scenarios
• You have HIV or other causes of immune suppression and have had recent or anticipate future risk of mpox exposure from any of these scenarios
• You work in settings where you may be exposed to mpox (medical or laboratory setting)

QUICK FACTS

Having had chickenpox offers NO protection against mpox

• If you are exposed to mpox, neither previous infection or vaccination against chickenpox will prevent mpox from developing. Prior vaccination for smallpox has limited protection that decreases over time

Children can get mpox

• Children tend to have worse symptoms than teenagers and adults
• Mpox can pass to unborn or newborn babies through pregnancy, during birth or during early physical contact
• Treatment with Tecovirimat (TPOXX), an antiviral treatment for orthopoxes, may be prescribed for children

Second infections have been documented

• Although previous mpox infection may give you some immunity against future infection, the level and duration of protection from future infection is not known
• Even if you had mpox before, preventing exposure is critical if you are at risk

There is no self-test kit

• If you think you might have mpox, contact your primary care provider immediately

Mpox is not specifically a sexually-transmitted infection

• Mpox spreads from one person to another through close physical contact such as massage, caregiving, bathing, handling clothing or bedding and sexual contact
• Semen and vaginal fluid have not been identified as infectious fluid, but direct skin-to-skin contact with lesions can spread the virus whether that contact is sexual or not
• Other bodily fluids, notably saliva and respiratory fluids, as well as the fluid discharge from the rash, are known to be infectious
• Men, particularly Black and Latinx MSM, gay and bisexual men, have comprised the majority of cases. Black and Latinx MSM, gay and bisexual men have been overrepresented in case counts and underrepresented in vaccination statistics, both locally and nationally

Gender and sexual orientation do not define someone as being at-risk. Anyone exposed to infectious fluids can get mpox.