Mpox (Monkeypox) FAQ

Mpox symptoms usually appear within 3 weeks of exposure and can include:

• Fever

• Headache

• Muscle aches and backache

• Swollen lymph nodes

• Chills

• Exhaustion

• Respiratory symptoms, such as sore throat, nasal congestion or cough

• A pimple- or blister-like rash that may appear on the genitals (penis, testicles, labia and vagina) or the anus, but could also be on areas such as the hands, feet, chest, face or mouth. In cases of infection during anal sex, infected individuals may experience anal or rectal irritation.

Mpox can be spread from the time symptoms start until the rash has healed—meaning all scabs have fallen off and a fresh layer of skin has formed.

• People infected with mpox may get all or only some of the symptoms

• People who develop flu-like symptoms will usually develop a rash one to four days later

• Some people get the rash before other symptoms follow; others only have the rash

• The rash goes through different phases before healing; after forming, the rash turns into raised bumps which fill with fluid. The rash scabs over and, eventually, the scabs fall off

Most people recover in 2-4 weeks. The disease can be more serious in people who are pregnant, children or immunocompromised.

Learn more

Mpox can spread to anyone through close personal contact, such as:

• Direct contact with an infected rash, scab or body fluids

• Respiratory droplets during prolonged, face-to-face contact or during intimate physical contact such as kissing or sex

• Touching items that have been in contact with an infected rash or body fluids, such as clothing or bed sheets

• From a pregnant person to the fetus through the placenta

Close personal contact includes:

• Oral, anal and vaginal sex or touching the genitals (penis, testicles, labia or vagina) or anus or a person with mpox

• Hugging, massage, kissing

• Prolonged face-to-face contact

• Touching fabrics and objects during sex that were used by a person with mpox such as bedding, towels, fetish gear and sex toys that have not been disinfected

Scientists are still learning about:

• Whether the virus spreads when someone has no symptoms

• How often it’s spread through respiratory secretions

• When a person with mpox symptoms might be more likely to spread the virus through respiratory secretions

• If mpox can be spread through semen, vaginal fluids, urine or feces (poop)

Learn more

Anyone can become infected with mpox.

No, while mpox is spread through close, skin-to-skin contact, and commonly, when people engage in sex, it is not a sexually transmitted infection (STI). People who have had close contact without having sex can also transmit or become infected with mpox. Cases of mpox have spread among family members in the same household.

There are two strains of mpox virus. Infections identified during the current 2022 outbreak are the West African type.

West African Type

• Infections with the West African type of virus are rarely fatal, and more than 99% of people who get the West African type are likely to survive

• People with weakened immune systems, children under age 8, people who are pregnant or breastfeeding and people with a history of eczema may be more likely to get severely ill and die

• Symptoms can be very painful and may result in permanent scarring

Congo Basin Strain

The other type of mpox is the Congo Basin Strain.

• This strain is not associated with the 2022 outbreak.

• Has a fatality rate around 10%

According to the World Health Organization (WHO), current understanding of how long immunity lasts after mpox is limited and medical experts do not yet have a clear understanding of whether a past infection gives you immunity. People who have had mpox previously should still follow guidance for preventing infection.

Mpox is a zoonotic disease, which means it can be spread from animals to humans through scratches or bites or by preparing or consuming the meat of an infected animal.

Mpox can also be spread from humans to animals, although medical experts are still learning which animals can get mpox and the Centers for Disease Control and Prevention (CDC) do not believe that pets are at high risk. Learn how to prevent spreading the virus to animals.

Veterinary information can be found here.

While anyone can get mpox, there are people who are at higher risk for becoming infected. Even though cases internationally and nationally have mainly involved men who have sex with men, anyone who is sexually active with multiple partners or who has sex with someone else who has multiple sex partners may be at risk for exposure to mpox. See the previous question for more information about how it spreads.

People with weakened immune systems, such as people living with HIV, pregnant or breastfeeding people, children under age 8, and people with a history of eczema are more likely to get seriously ill or die.

Learn more about mpox and HIV

Luckily, mpox does not spread very easily and there are things that you can do to reduce your risk, including the following:

Sex

• Talk with any current sexual partners. It can be difficult to have these conversations, but it’s important for you to be on the same page as you discuss your tolerance for risk and to check in with each other about any recent illness and being aware of any new or unexplained rashes on your body or your partner’s body. If you or your partner are experiencing symptoms of mpox or know that you have mpox, the best thing you can do to protect yourself and others is to avoid sex of any kind (oral, anal or vaginal). Do not touch or kiss while sick and do not share towels, sex toys or toothbrushes. See a healthcare provider as soon as possible.

• If you or your partner believe you have (or might have) mpox and decide to have sex anyway, there are things you can do to limit risk—see this fact sheet for more information.

• If you are experiencing symptoms of mpox or think (or know) that you have mpox, avoid gatherings, especially if they involve close, personal, skin-to-skin contact.

Social Gatherings—Is it Safe to Go Out?

If you are planning to go to a social event, consider how much close, skin-to-skin contact is likely to occur at the event. According to the CDC, there is some indication that events where people participate in close, sustained skin-to-skin contact have resulted in cases of monkey pox.

• Festivals, events and concerts where everyone is fully clothed and unlikely to engage in skin-to-skin contact are safer (although activities like kissing can increase risk).

• A rave, party or club where there is minimal clothing and where there is direct, personal, skin-to-skin contact has some risk. Avoid any rash you see on other people and consider minimizing skin-to-skin contact.

• Events in enclosed spaces, such as back rooms, sex clubs, saunas or sex parties (private or public) where intimate and possibly anonymous sexual contact occurs with multiple partners may carry a higher risk for spreading mpox.

Consider having a conversation with your social groups too, particularly if you are planning to be in close personal contact. After more than two years of talking about health risks due to COVID-19, everyone is a little tired and burned out on the topic. But, as with COVID-19, being open about the degree of risk you’re willing to take can make it easier for everyone can enjoy their time together, with as little worry as possible.

Learn more about safer sex and social gatherings

If you have had close contact with someone who has confirmed mpox or is being tested for mpox, contact your healthcare provider.

You can spread mpox from when symptoms start until the rash is fully healed (takes two to four weeks). You can prevent spreading it to others by taking the following precautions:

• Stay home unless getting health care

• Separate yourself from people and animals (mammals) until the rash is gone—scabs have fallen off and skin has healed

• Only allow visitors or family and friends in your home as necessary

• Wear a well-fitting medical mask when at home with others

• Do not kiss, hug, cuddle, sleep or have sex with anyone

• Do not share bedding, towels, dishes or utensils

• Wash your own dishes and laundry

• Clean and disinfect commonly touched surfaces and items (including shared spaces such as bathrooms, toilets or showers)

• Have someone else care for pets or livestock

• Avoid using contact lenses—this helps prevent accidentally infecting your eyes

• Avoid shaving areas with rashes—this can cause the virus to spread to other parts of the body

• Do not use public transit such as planes, buses, taxis or ride shares

Testing is available in Washington state and there is no shortage of testing. Testing is conducted by the Washington State Public Health laboratories and certain clinical laboratories. Contact your doctor for testing.

You can spread mpox from when symptoms start until the rash is fully healed (takes two to four weeks). You can prevent spreading it to others by taking the following precautions:

• Separate yourself from people and animals (mammals)

• Do not kiss, hug, cuddle, sleep or have sex with anyone

• Do not share bedding, towels, dishes or utensils

• Wash your own dishes and laundry

• Have someone else care for pets or livestock

• Do not use public transit such as planes, buses, taxis or ride shares

There are no specific mpox infection treatments. However, because mpox and smallpox viruses are genetically similar, antiviral drugs developed for smallpox may be used to treat mpox virus infections. Patients who are more likely to get severely ill may be recommended an antiviral like tecovirimat (TPOXX), which is approved by the FDA for the treatment of smallpox.

Under specific circumstances, certain smallpox vaccines may be used for post-exposure prophylaxis in individuals at high risk of exposure. The United States maintains stockpiles of two vaccines, JYNNEOS™ and ACAM2000, that can prevent mpox in people who have been exposed to the virus. These vaccines may also be recommended for people who have had an exposure to someone who has mpox.

The JYNNEOS™ vaccine is available on a limited basis in Spokane County. Here are some things you should know about JYNNEOS™:

• It is the only vaccine that is FDA licensed vaccine in the United States that is approved for prevention of monkeypox—the vaccine received FDA approval on Sept. 4, 2019.

• It is also approved for the prevention of smallpox. The vaccine is approved for use in individuals 18 and older who are at risk for infection with smallpox or mpox.

• It is administered with two doses via a subcutaneous (under the skin) injection 28 days apart.

• JYNNEOS™ is a live, non-replicating vaccine that uses a Modified Vaccinia Ankara (MVA) virus that cannot replicate in the body.

• Because it’s non-replicating, it is safe to use in people who are immune compromised—and the risk of mpox vaccination outweighs the risk of receiving the vaccine in immune compromised people.

• JYNNEOS™ may be used in people younger than age 18 under the FDA’s Expanded Access Investigational New Drug (IND) mechanism.

A second vaccine, ACAM2000, is also available under the FDA’s Expanded Access IND mechanism; however, it is associated with higher risk of certain serious adverse reactions compared to JYNNEOS™.

Learn more

• Key Facts About Vaccines to Prevent Monkeypox Disease

• JYNNEOS™ Vaccine Information Statement

Side effects after JYNNEOS™ vaccination include pain, swelling, and redness where the shot is injected as well as fatigue, headache, and muscle pain.

The vaccines are currently in short supply in the United States, but efforts to produce more have ramped up.

In late July, SRHD received 320 doses of the JYNNEOS™ vaccine from the Washington State Department of Health’s (DOH) allotment of several hundred total. DOH requires each jurisdiction receiving vaccine to hold 25% of their allocation for neighboring jurisdictions or tribal partners. A larger supply of vaccine is expected to arrive in Washington in late August.

SRHD has prioritized high-risk individuals during this time of vaccine shortage based on the following criteria and is working with medical providers to identify and offer the vaccine to individuals who:

• Are high risk of a recent exposure to mpox, including members of the gay, bisexual, transgender, and gender non-conforming community and other communities of men who have sex with men and who have engaged in intimate, or skin-to-skin contact with others in the past 14 days in areas where mpox is spreading.

• Have had skin-to-skin contact with someone in a social network experiencing mpox activity, including men who have sex with men who meet partners through an online website, digital application ("app"), or social event, such as a bar or party.

• Have had recent mpox exposure are also eligible for post-exposure prophylaxis. These close contacts as identified through SRHD case investigations will be given direction on how to access mpox vaccine.

• Have specific medical histories that may affect the immune system or that indicates participation in high-risk activities.

No. At this time, it is not recommended that you receive the mpox vaccine.

The virus that causes COVID-19 (SARS-CoV-2) and the mpox virus are different. Mpox primarily spreads through close contact and does not spread through the air over longer distances like SARS-CoV-2. Short interactions that do not involve physical contact and interactions within a healthcare environment with appropriate PPE are generally considered low risk. In general, risk of getting mpox is considered low. If you think you may have mpox symptoms, contact a healthcare provider right away.