Monkeypox

Monkeypox (MPX) is an illness caused by infection with the MPX virus. MPX typically causes a painful rash, fever, head and muscle aches, and exhaustion.

Up until recently, human cases of MPX were rare and mostly limited to parts of Africa. A case of human MPX was recorded in the United Kingdom in May 2022. Since then, the virus has spread to several countries, including the United States.

MPX is a painful condition with a long recovery period (generally two to four weeks). People at greater risk of becoming severely ill include:

• Children under 8 years old
• People with eczema
• People with compromised immune systems

The MPX virus is related to the virus that causes smallpox. The two have similar symptoms, but symptoms of MPX are milder than those of smallpox.

MPX is not related to chickenpox. Having had chickenpox does not give you natural immunity to MPX.

The most recognizable symptom of MPX is a rash on the face, inside of the mouth, chest, and other parts of the body. People infected through intimate contact may develop a rash on their genitals or anus. The rash usually starts out as flat, red bumps that look like pimples and are often painful. The bumps turn into blisters that eventually turn into scabs and fall off.

MPX symptoms usually appear a week or two after infection and may include:

• Painful rash that turns into blisters that eventually scab over
• Fever
• Headache
• Chills
• Sore throat, cough, congestion
• Swollen lymph nodes in the armpits, neck, or groin
• Muscle aches
• Back pain
• Lack of energy

MPX is contagious from the time the first symptoms appear until the rash has fully healed and new skin has formed. This usually takes two to four weeks.

MPX spreads through close contact with an infected person. Possible ways to get infected include:

• Direct contact with the rash, scabs, or body fluids of an infected person
• Touching a surface or object touched or used by a person with MPX
• Sharing clothing, bedding, towels, or other fabrics
• Hugging, massaging, or kissing
• Intimate contact
• From mother to child during pregnancy

Infection through face-to-face contact — for example, having a conversation in a closed space — is uncommon.

To diagnose MPX, a health care provider will take a swab from the rash and send it to a laboratory to be tested for MPX. They may also take a blood sample to test it for signs of the virus.

Because it has been so rare until recently, there are no medications specifically approved for MPX. However, there is an antiviral drug used to treat smallpox that may prevent serious illness from MPX. There are also vaccines that can be used to prevent MPX, even if given within four days after exposure.

If you or your child have been exposed to MPX, talk to your health care provider as soon as possible about possible treatments or a vaccine.

Most people recover from MPX without treatment in two to four weeks. If you, your child, or another family member has MPX, you should be closely followed by a clinician. Since MPX is a virus, antibacterial drugs are not an effective treatment.

Based on similarities between smallpox and MPX, vaccines developed for smallpox are being used for the prevention of MPX in people who are 18 and older. Because supplies of this vaccine are limited, only people at highest risk of MPX infection are currently eligible to receive it.

If someone in your household has MPX, the Centers for Disease Control and Prevention recommends isolating at home until all symptoms have gone away. To isolate, the infected person should:

• Stay in a separate room, away from family members and pets, if possible
• Wear a mask when in indoors in the same room with household members
• Not share a bed, towels, or clothing with others
• Not share plates, cups, or silverware with others
• Wash plates, cups, and silverware in a dishwasher or with soap and warm water
• Use a separate bathroom if possible
• If sharing a bathroom, the infected person should wash all surfaces with a disinfectant after each use
• Use disposable gloves when cleaning the rash or changing bandages
• Cover couches, chairs, and other shared seating with covers that can be easily laundered

The best way to protect yourself and your family from MPX is to limit exposure to an infected person.

• Avoid skin-to-skin contact with a person infected with MPX and anyone who has a rash that could be MPX.
• Do not share eating utensils with someone who has MPX.
• Do not touch or share bedding, towels, or clothes with someone infected with MPX.
• Wash your hands often and well with soap and water, particularly before you eat or touch your face.