hMPXV (Monkeypox)

What is Monkey Pox?

It is in the same group of viruses, but this isn't smallpox! hMPXV is much harder to catch, and it is not as severe. There are two strains of this virus, and the main one that's circulating now causes milder disease. Most people are recovering at home without any special treatment.

Is hMPXV a sexually transmitted disease?

The virus spreads through close, prolonged, skin-to-skin contact, not sex specifically. Though risk of infection is not high, anyone who has close, prolonged, skin-to-skin contact with someone ill with monkeypox could possibly catch it. Most but not all infections have been among gay, bisexual, and other men who have sex with men who have traveled to countries with hMPXV cases or who have had contact with someone else with hMPXV.

How is it spread?

It can be transmitted person-to-person. This can happen through prolonged, close contact, either skin to skin, contact with fluid from hMPXV lesions, or possibly from large respiratory droplets. Most infections in the current outbreak appear to be due to skin-to-skin contact.  An ill person who coughs or sneezes on someone else could possibly spread the infection. However, most transmission in the current outbreak appears to be from prolonged, skin-to-skin contact. People at increased risk include sexual partners of an ill person, or family members and health care workers caring for someone ill with monkeypox.

Remember: skin-to-skin is NOT only genital area contact–the rash can be on hands and other parts of the body, so things like holding hands with someone who has the rash on their hands can transmit it. Contact with used towels, sheets, clothing or surfaces that other may have used or touched. 

What are the symptoms?

Symptoms usually begin within seven to 14 days, with a range of five to 21 days. Illness typically starts with fever, headache, and muscle aches. This is followed in one to three days by a rash, often on the face, spreading to the limbs. The rash starts with flat patches that then form large, firm bumps, which then fill with fluid or pus. These then scab and fall off, usually over two to four weeks.

Check your body regularly, such as before or after bathing, if you believe you are at-risk for hMPXV infection. Sores can be itchy or incredibly painful, and can be flat or raised, fluid-filled (like little blisters or large pimples) or not.  Classic sores have an indent in the middle, but not everyone will develop a classic rash. If the sores you have are in your throat or rectum, they may cause significant pain but not be visible. 

Rash or sores

Everyone with monkeypox gets a rash or sores (pox)(link is external). The rash can look similar to other things like acne, bug bites, or some sexually transmitted diseases. The rash may be hard to see. It can be painful or itchy and occur anywhere on the body including:

• Face
• Hands
  
• Genital area
• Mouth
  
• Anus
  
• Rectum

The rash starts as raised bumps that then fill with fluid (clear to cloudy), turn into open sores, then scab over and disappear. This process usually takes 2-4 weeks.

Flu-like symptoms

Some people also get flu-like symptoms before the rash appears, such as: 

• Fever
• Swollen lymph nodes 
• Chills
  
• Headache
• Muscle aches
  
• Fatigue
  

People with monkepox (hMPXV) may experience all or some of these symptoms. Rash that looks like pimples or blisters on or near your genitals (penis, testicles, labia, and vagina) or anus (butthole). Flue-like symptoms including fever, chills, achiness, and sore throat. If you are feeling sick and notice new rashes, talk to a health care provider (or call 211). Cover lesions and let them know you suspect monkeypox.

Preventing monkeypox

Monkeypox most often spreads from person to person through close contact, including direct contact with a rash, sores, or scabs from a person infected with the virus. To prevent the spread of the virus:

• Avoid skin-to-skin contact such as through sex or other intimate contact if you or your partner have new rash or sores, fever, swollen lymph nodes or otherwise suspect you may have been exposed to the virus. Condoms do not prevent the spread of the virus (but do prevent spread of other infections).
• Wear gloves when handling materials such as bedding that have been used by someone with the virus.
• Wash hands thoroughly if you have contact with someone with hMPXV.
• If you get symptoms, stay home until you can connect with a health care provider.

If you believe you have monkeypox

• Contact your health care provider about testing.
• If you do not have a health care provider, call 211.
• Quarantine until your results come back negative.
• Stay at home except to seek medical care.
  
• If you live with others, wear a mask in common spaces.
• Use a separate bathroom if possible and if not, clean it frequently with a germicidal wipe, and prevent others from touching your bedding, towels, clothes, etc.
• You are welcome to spend time in your yard, running, gardening, walking dogs, etc., alone, but please do not spend time in outdoor or indoor spaces with others until your doctor has indicated that you are not infectious.

Ask a health care provider about testing if you develop a new rash, bumps, or sores, especially if:

• You know you have been in close contact with anyone with a known or likely hMPXV infection.
  
• You have had close skin-to-skin contact with someone in a social network known to be experiencing the spread of hMPXV, such as men who have sex with men who meet partners through websites, apps or social events such as at clubs or parties.
• You have traveled in the last month to other areas where cases have been found.

Most people recover on their own in 2-4 weeks without treatment. Your healthcare provider can help you manage your symptoms, and may recommend antiviral treatments depending on your health and the severity of symptoms.