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Monkeypox: What to Know

Medically Reviewed by Melinda Ratini, DO, MS on May 25, 2022

What Is Monkeypox?

Monkeypox is a viral disease from the same family as smallpox, though its symptoms usually aren't as serious. Scientists have known about it since 1958, when it was found in lab monkeys used for research. Monkeypox is most common in Central and West Africa. But in May 2022, health officials began reporting an outbreak of the virus in several regions outside Africa.

As of late May 2022, The World Health Organization (WHO) had confirmed around 100 cases across several countries in Europe, along with Australia and Canada. The CDC had confirmed one case in the U.S.

Monkeypox is a zoonotic virus, which means it spreads from animals to humans. In addition to monkeys, it's been found in other primates and certain rodents in Africa. But people can transmit it to each other, too. The first known human infection was in 1970 in the Democratic Republic of Congo.

How Is Monkeypox Transmitted?

While monkeypox is less contagious than smallpox, it's similarly spread from person to person through close contact. Someone who's infected with it can pass it to you through:

  • Respiratory droplets that you breathe in
  • Contact with body fluids like blood or semen
  • Contact with monkeypox lesions on their skin (including inside their nose and mouth)
  • Things that have touched infected body fluids, like bedding or clothing (This happens less often.)

Infected animals can pass on the virus if they bite or scratch you. You can also get it from eating uncooked contaminated meat.

The virus can get into your body through a break in the skin (which you might not even be aware of) or through your mouth, nose, or eyes. You can breathe it in, but you’d probably have to be in close contact for a fairly long time. That’s because most droplets don’t travel very far.

Monkeypox isn't technically considered a sexually transmitted infection (STI), since you can get it from other forms of contact. But people infected with monkeypox can pass it on during sex. WHO officials say most of the May 2022 cases were sexually transmitted, especially among men who have sex with men.

Symptoms of Monkeypox

It typically takes between 1 and 2 weeks after exposure to get sick from the monkeypox virus, but it could take as long as 3 weeks. Symptoms include:

One to 3 days after your fever starts, a rash shows up. It typically starts on your face before spreading to other parts of the body. The rash is more common on the hands, feet, arms, and legs. It also tends to follow a particular pattern: Flat, round lesions (macules) grow into slightly raised bumps (papules), then into bumps filled with clear fluid (vesicles). These then change into bumps with yellowish fluid (pustules) that crust over and fall off.

You can spread monkeypox to others starting a day before the rash shows up. You're contagious for up to 21 days after your first symptoms, or until your lesions have scabbed over and you don't have any other symptoms.

How Serious Is Monkeypox?

The illness typically runs its course in 2 to 4 weeks. It can be quite serious, especially in children who were exposed to a lot of the virus or in people with other health conditions or weak immune systems.

In some cases, thousands of lesions grow together and cause the loss of large sections of skin at once. Death is rare, but possible. In Africa, monkeypox leads to death in up to 1 of every 10 people who get it. But many people in this region live in areas without adequate medical care. Children are most at risk for serious illness and death.

Possible serious complications from monkeypox include secondary infections like:

Exposed to Monkeypox: What to Do

If you think you've been in contact with monkeypox, call your doctor for instructions. Look out for symptoms for 21 days after your first exposure. You should:

  • Check your temperate twice a day.
  • If you have chills and swollen lymph nodes but no fever or rash, isolate yourself at home for 24 hours.
  • If you get a fever and/or rash, self-isolate right away and contact your local health department.
  • If chills and swollen lymph nodes don't go away, call your doctor.

If you have no symptoms, you can go about your daily routine as usual. But don’t donate blood, cells, tissue, breast milk, semen, or organs while you’re monitoring for symptoms.

Diagnosis

Your doctor will look at your lesions and ask you in detail about your symptoms, such as when you likely came into contact with the virus. They’ll try to rule out similar conditions like:

A laboratory test can tell whether you have monkeypox.

Monkeypox Treatment

There's no specific treatment for monkeypox. Your doctor will likely help keep you comfortable and try to ward off serious complications with rest, plenty of fluids, and over-the-counter meds.

To control an outbreak, doctors could turn to antivirals and vaccinia gamma globulin (made from the blood of people recently vaccinated against smallpox) as well as the smallpox vaccine.

If you’ve had a recent smallpox vaccine (in the last 3-5 years), you have some protection against monkeypox. Studies show that the smallpox vaccine is 85% effective at preventing monkeypox.

The U.S. currently has two vaccines to prevent smallpox: ACAM2000 and JYNNEOS (Imvamune, Imvanex). In 2019, the FDA also approved JYNNEOS to prevent monkeypox.

The two vaccines contain live virus. ACAM2000 is given by pricking the skin. A small lesion may form, and the virus can grow on it. (This causes the telltale scar of a smallpox vaccine.) Before it heals, the virus could spread to other parts of body or to other people. If you get this vaccine, take care not to spread the virus while the lesion heals.

You get JYNNEOS in two shots taken 4 weeks apart. With this vaccine, there’s no risk of spreading the virus.

While it’s best to get a vaccine before you're exposed to monkeypox, getting it afterward may still help prevent the disease or make it less serious. The CDC recommends getting the vaccine within 4 days after exposure to monkeypox. But even if you get it as long as 14 days after exposure, it could still reduce your monkeypox symptoms.

If you’ve been exposed to monkeypox and haven’t had a smallpox vaccine in the last 3 years, experts recommend getting revaccinated as soon as possible.

You could have minor reactions from the smallpox or monkeypox vaccine, such as:

Prevention

To avoid catching monkeypox:

  • Stay away from animals that might have the virus, especially dead animals in areas where monkeypox is common.
  • Stay away from bedding and other materials that have touched a sick animal.
  • Separate infected persons or animals from others at risk for infection.
  • If you have to be close to an animal or person with the virus, wash your hands with soap and water often.
  • Use protective gear like masks, safety goggles or glasses, and gloves if you can’t avoid contact.

Show Sources

Photo Credit: Science Source

SOURCES:

CDC: “Personal Protective Equipment,” “Monkeypox,” “CDC and Texas Confirm Monkeypox In U.S. Traveler,” “Monkeypox and Smallpox Vaccine Guidance,” “2022 United States Monkeypox Case.”

Harvard Health: " Monkeypox: An unfamiliar virus spreading fast – sound familiar?”

ISU College of Veterinary Medicine Center for Food Security and Public Health: “Monkeypox.”

New York State Department of Health: “The Smallpox Vaccine – What You Need to Know.”

World Health Organization: “Multi-Country Monkeypox Outbreak in Non-Endemic Countries,” “Monkeypox.”

KidsHealth: "Monkeypox."

New Jersey Department of Agriculture: "Monkeypox."

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