What To Know About Monkeypox

Updated July 19, 2022.

Clinical Editors: Megan Dodson, PA-C and James Carter, III, MD

The U.S. has declared monkeypox a public health emergency, as cases continue to rise across the country. Here’s everything we know about the disease so far:

Monkeypox is a disease caused by a virus in the same family as smallpox. However, it’s usually much less severe. The disease was given its name after it was first detected among colonies of laboratory monkeys in 1958. The first human case was reported in 1970. Since then, monkeypox has been primarily found in Central and West Africa, with most cases occurring in the Democratic Republic of Congo and Nigeria.

Monkeypox is spread through close contact with an animal, human, or materials contaminated with the virus, such as clothing or bedding. The most common means of transmission for this current outbreak is skin-to-skin contact, and it can also be transmitted through respiratory droplets. Though monkeypox can be transmitted through close contact during sex, it is not a sexually transmitted disease.

Humans can also contract the virus from infected animals through a bite or scratch, or direct contact with their skin, blood, or feces.

While previous cases outside of Africa were linked to international travel or contact with an infected animal, many of the recent cases have been occurring among individuals with no history of travel to Africa. As a result, public health experts are continuing to monitor community transmission.

Within 7 to 14 days of exposure, infected individuals typically experience flu-like symptoms such as fever, headache, muscle aches, chills and exhaustion, along with swollen lymph nodes and back ache. Within 1 to 3 days of having a fever, people develop a rash. The rash may start on the face or in the genital area, and then may spread to other parts of the body, including the arms, legs, hands, and feet. This rash, which can appear as raised, pearly, fluid-filled blisters, goes through several stages over the course of 2 to 4 weeks, before the lesions crust over and the scabs fall off. An individual with monkeypox is no longer considered contagious once all the scabs have fallen off and new skin has formed.

If you have symptoms consistent with monkeypox, take the following steps:

1. Isolate immediately, since individuals with monkeypox are contagious from the time that symptoms appear until the scabs fall off and new skin forms. Visit the CDC website for detailed guidance on how to remain isolated at home and keep household members safe. If you have symptoms such as body aches, fatigue, fever, headache, or swollen lymph glands, isolate while you reach out to your healthcare provider. Your healthcare provider can help you with a plan to determine whether your symptoms are due to monkeypox or other causes.
2. Reach out to your healthcare provider or local health department. They can discuss with you how to take care of yourself while you’re sick, and arrange for testing.
3. Notify anyone you've been in close contact with since your symptoms started.

Currently, there are no treatments specifically approved for monkeypox. However, monkeypox and smallpox viruses are genetically similar, which means that antiviral drugs developed to protect against smallpox may be used to treat monkeypox virus infections for people who are hospitalized with severe disease or are at higher risk of severe illness. At this time, antiviral treatment is only available through consultation with and extensive documentation by the local health department and CDC. If you’re not sure if antiviral treatment is right for you, please reach out to your healthcare provider.

For those who are diagnosed with monkeypox and are not at high risk for severe illness though, there are a few ways to still manage symptoms without antiviral treatment. Here are a few steps you can take to feel better:

• Take pain relievers/fever reducers such as acetaminophen or ibuprofen
• Sitz baths may help lesions in the genital area feel better
• Calamine lotion for itching or painful sores
• Rest and fluids are also important to prevent dehydration.

If you’ve been exposed to a person or animal who is suspected of having or has been diagnosed with monkeypox, reach out to your healthcare provider or contact your local health department right away. In some scenarios, post-exposure vaccination against monkeypox may be considered up to 14 days after exposure. Close contacts may resume daily activities and are not required to quarantine. However, they are encouraged to monitor for symptoms for 21 days after the exposure and isolate immediately if symptoms develop.

The U.S. Department of Health and Human Services has announced a vaccination strategy that will aim to vaccinate those at-risk of monkeypox and prioritize vaccines for areas with the highest numbers of cases, though supply remains very limited. Many regions are limiting vaccines to individuals who have been exposed, while some are able to vaccinate a larger population.

Check with your local health department for more information about vaccine availability and who is eligible.

Although the news of this outbreak may be alarming, public health experts have said that monkeypox is not likely to pose the same threat or have the same impact as COVID-19. While monkeypox can be transmitted between humans, it does not spread easily from person to person. Human transmission of monkeypox requires prolonged close contact, so it’s not thought to be as contagious or infectious as COVID-19. Additionally, most cases of monkeypox that have occurred in the U.S. have been mild and resolved on their own in a few weeks.