Monkeypox FAQs

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Monkeypox | Symptoms | Spread | Prevention | Treatment | Vaccination | HIV

Monkeypox basics

• What is monkeypox?

  Monkeypox is a rare disease caused by infection with the monkeypox virus. Monkeypox virus is part of the same family of viruses as variola virus, the virus that causes smallpox. Monkeypox symptoms are similar to smallpox symptoms, but milder, and monkeypox is rarely fatal. Monkeypox is not related to chickenpox.

  Monkeypox was discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research. Despite being named "monkeypox", the source of the disease remains unknown. However, African rodents and non-human primates (like monkeys) might harbor the virus and infect people.

  The first human case of monkeypox was recorded in 1970. Prior to the 2022 outbreak, monkeypox had been reported in people in several central and western African countries. Previously, almost all monkeypox cases in people outside of Africa were linked to international travel to countries where the disease commonly occurs or through imported animals. These cases occurred on multiple continents.

• When should someone get tested for monkeypox?

  People who think they have monkeypox or have had close personal contact with someone who has monkeypox should visit their ARC provider to help them decide if they need to be tested for monkeypox. If they decide that you should be tested, they will work with you to collect the specimens and send them to a laboratory for testing.

  To make an appointment at ARC, call the clinic nearest you or make an appointment online.

• Are there different types of monkeypox?

  There are two types (or clades) of monkeypox virus: West African and Congo Basin. Infections in the current outbreak are from the West African type.

• Is monkeypox deadly?

  Infections with the type of monkeypox virus identified in this outbreak — the West African type — are rarely fatal. Over 99% of people who get this form of the disease are likely to survive. However, people with weakened immune systems, children under 8 years of age, people with a history of eczema, and people who are pregnant or breastfeeding may be more likely to get seriously ill or die.

  Although the West African type is rarely fatal, symptoms can be extremely painful, and people might have permanent scarring resulting from the rash.

  The Congo Basin type of monkeypox virus has a fatality rate around 10%.

• Am I at risk of getting monkeypox?

  At this time, the risk of monkeypox in the United States is believed to be low. Monkeypox does not spread easily between people; however, anyone in close contact with a person with monkeypox can get it and should take steps to protect themselves. People who do not have monkeypox symptoms cannot spread the virus to others.

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Symptoms of monkeypox

• What are the symptoms of monkeypox?

  Symptoms of monkeypox can include:

  • Fever
  • Headache
  • Muscle aches and backache
  • Swollen lymph nodes
  • Chills
  • Exhaustion
  • Respiratory symptoms (e.g. sore throat, nasal congestion, or cough)
  • A rash that can look like pimples or blisters that appears on the face, inside the mouth, and on other parts of the body, like the hands, feet, chest, genitals, or anus.
  • The rash goes through different stages before healing completely. The illness typically lasts 2-4 weeks.

  Sometimes, people get a rash first, followed by other symptoms. Others only experience a rash.

  Symptoms usually appear one to two weeks after infection.

• What should I do if I have symptoms?

  • See your ARC provider if you notice a new or unexplained rash or other monkeypox symptoms.
  • Avoid close contact (including intimate physical contact) with others until your ARC provider examines you.
  • Avoid close contact with pets or other animals until your ARC provider examines you.
  • If you're waiting for test results, follow the same precautions.
  • If your test result is positive, stay isolated and observe other prevention practices until your rash has healed, all scabs have fallen off, and a fresh layer of intact skin has formed.
  • Remain isolated if you have a fever or respiratory symptoms, including sore throat, nasal congestion, or cough. Only go out to see your ARC provider or for an emergency and avoid public transportation.
  • If you need to leave isolation, you should cover the rash and wear a well-fitting mask.

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Spread of monkeypox

• How does monkeypox spread?

  Monkeypox spreads in different ways. The virus can spread from person-to-person through direct contact with the infectious rash, scabs, or body fluids. It also can be spread by respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact, such as kissing, cuddling, or sex. In addition, pregnant people can spread the virus to their fetus through the placenta.

  Touching items (such as clothing or linens) that previously touched the infectious rash or body fluids is another way monkeypox spreads. It's also possible for people to get monkeypox from infected animals, either by being scratched or bitten by the animal or by eating meat or using products from an infected animal.

  People who do not have monkeypox symptoms cannot spread the virus to others.

  Monkeypox can spread from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. The illness typically lasts 2-4 weeks.

• Can I get monkeypox from having sex?

  Even though it is not considered a sexually transmitted infection, monkeypox can spread during intimate physical contact between people. This contact can happen when you have sex, including:

  • Oral, anal, and vaginal sex, or touching the genitals or anus of a person with monkeypox
  • Hugging, massaging, kissing, or talking closely
  • Touching fabrics, shared surfaces, and objects, such as bedding, towels, and sex toys, that were used by a person with monkeypox

  Anyone can get monkeypox if they have close personal contact with someone who has symptoms of monkeypox.

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Prevention of monkeypox

• How can monkeypox be prevented?

  Following the recommended prevention steps and getting vaccinated if you were exposed to monkeypox or are at higher risk of being exposed to monkeypox can help protect you and your community.

  View the CDC monkeypox prevention guide to learn more.

• Should people be concerned about going to crowded events?

  People can get monkeypox if they have close, skin-to-skin contact with someone who has monkeypox. Early indications are that events with activities in which people engage in close, sustained skin-to-skin contact have resulted in cases of monkeypox. If you plan to attend an event, consider how much close, personal, skin-to-skin contact is likely to occur there.

  Learn more about social gatherings and monkeypox.

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Treatment available for monkeypox

• What treatments are available for monkeypox?

  There are no treatments specifically for monkeypox virus infections. However, because of genetic similarities in the viruses, antiviral drugs used to treat smallpox may be used to treat monkeypox infections.

  Antivirals, such as tecovirimat (TPOXX), may be recommended for people who are more likely to get severely ill, like patients with weakened immune systems.

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Vaccinations for monkeypox

• Is there a vaccine to prevent monkeypox?

  Because monkeypox and smallpox viruses are genetically similar, vaccines developed to protect against smallpox viruses may be used to prevent monkeypox infections.

  Vaccines may be recommended for people who have had or may have contact with someone who has monkeypox, or for healthcare and public health workers who may be exposed to the virus.

  There are 2 vaccines that can be used for monkeypox prevention – Jynneos and ACAM2000. Neither is specifically a monkeypox vaccine but given their efficacy against smallpox, they are expected to provide protection. Jynneos is the only one that is officially approved.

  • Jynneos is a live non-replicating vaccine that is approved for use age 18 and over
  • ACAM2000 is a live replicating vaccine and it should not be used in patients with HIV, immune compromise, or pregnancy

• Who should get vaccinated?

  CDC recommends vaccination for people who have been in close contact with people who have monkeypox. Currently, this outbreak is largely affecting gay, bisexual, or other men who have sex with men. People who may be eligible for vaccination include:

  • People who have been identified by public health officials as a contact of someone with monkeypox
  • People who may have been exposed to monkeypox, such as:
    • People who are aware that one of their sexual partners in the past 2 weeks has been diagnosed with monkeypox
    • People who had multiple sexual partners in the past 2 weeks in an area with known monkeypox cases

  Talk to your health care provider if you think you have been exposed to monkeypox or are at high risk for exposure.

  Learn more about the symptoms of monkeypox.

• Where can you find out if you're eligible for the vaccine?

  If you think you may be eligible for vaccination, contact your local health department. They can help you determine if you should get vaccinated.

  Indications for vaccination:

  • Post-exposure prophylaxis: within 4 days of exposure to a confirmed or suspected case, vaccination can prevent infection. From 4-14 days of exposure, vaccination can reduce severity of infection.
  • Pre-exposure prophylaxis for certain high risk groups:
    • People identified by public health as being a contact of a confirmed case of monkeypox
    • People who are aware that one of their sexual partners was diagnosed with monkeypox in the last 2 weeks
    • People with multiple sexual partners in an area known to have monkeypox
    • Certain lab workers that perform testing or handle cultures for monkeypox AND are not able to follow the unvaccinated lab worker protocol
    • Some designated healthcare workers that deal with a lot of monkeypox patients – for now, that does not include us

• Should everyone who is sexually active get vaccinated?

  No, CDC does not recommend widespread vaccination against monkeypox at this time. During this outbreak, people who are sexually active are not considered to be at risk for monkeypox unless their sexual partners have monkeypox or they have had multiple sexual partners within the past 14 days in areas where monkeypox cases have been reported.

  If you want to reduce the risk of monkeypox, you should not

  • have close, skin-to-skin contact with someone with the monkeypox rash.
  • touch the rash or scabs of someone with monkeypox.
  • kiss, hug, cuddle, or have sex with someone who has monkeypox.
  • handle or touch the bedding, towels, or clothing of a person with monkeypox.
  • share eating utensils or cups with someone who has monkeypox.

  Learn more about preventing monkeypox and find out where monkeypox cases have been reported in the United States. You can also contact your state health department to learn more about monkeypox cases in your area.

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Monkeypox and HIV

• Are people with HIV more likely to get monkeypox?

  CDC doesn't know if having HIV increases the likelihood of getting monkeypox. Monkeypox can spread to anyone through prolonged, close, personal, often skin-to-skin contact, as well as through contact with objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with monkeypox, or contact with respiratory secretions, through kissing and other face-to-face contact.

• Are people with HIV more likely to have more severe illness if they get monkeypox?

  CDC continues to monitor monkeypox among people with HIV. During the current monkeypox outbreak, there does not appear to be more severe monkeypox illness in people who have HIV and are virally suppressed (having less than 200 copies of HIV per milliliter of blood). In fact, the World Health Organization (WHO) monkeypox guidance states, “People living with HIV on antiretroviral therapy with suppressed viral load are not considered to be immunosuppressed.” However, people with HIV who are not virally suppressed may be at increased risk for severe illness and death from monkeypox.

• What treatment is recommended for people with HIV who get monkeypox?

  Currently there is no treatment approved specifically for monkeypox. However, medicine (antivirals) developed for use in patients with smallpox may help treat people with monkeypox.

  At this time, CDC doesn't have enough data to know whether people who have HIV and are virally suppressed might benefit from taking medicine if they get monkeypox.

  Because patients with a weakened immune system may have more severe monkeypox illness, your ARC provider may consider using antiviral medicines (e.g., tecovirimat) or Vaccinia Immune Globulin for these patients. This could include people newly diagnosed with HIV or people with HIV who are not virally suppressed. See: Treatment Information for Healthcare Professionals.

• Is a vaccine recommended and are vaccines safe for people with HIV?

  At this time, vaccination is recommended for people with exposure to a probable or confirmed case with monkeypox, for example people who have had close physical contact with someone diagnosed with monkeypox. Vaccination may also be offered to people who had a presumed exposure, such as men who have sex with men who have had multiple sexual partners during the past 14 days in a jurisdiction with known monkeypox activity.

  There are currently two licensed vaccines in the United States to prevent smallpox – JYNNEOS and ACAM2000. These smallpox vaccines may provide protection against monkeypox because smallpox and monkeypox are very similar viruses. Only JYNNEOS is FDA approved for the prevention of monkeypox in people 18 and older.

  The JYNNEOS vaccine has been studied in people with HIV who are virally suppressed, and they do not have more frequent or severe side effects from the vaccine than people who did not have HIV. The JYNNEOS vaccine seems to be well tolerated, with the most common side effects being injection site pain, redness, swelling and itching. Some recipients also reported muscle pain, headache, fatigue, nausea, and chills. More data are needed to know if this vaccine is tolerated by people newly diagnosed with HIV or by people with HIV who are not virally suppressed. Clinicians should weigh the benefits of vaccination with the unknown risk of an adverse event for a person if their HIV is not virally suppressed.

  ACAM2000 has been shown to have more frequent and severe side effects, especially for people with weakened immune systems or who are pregnant, have a heart condition, or skin conditions like eczema, psoriasis, or dermatitis. ACAM2000 is not recommended for people with HIV, even if they are virally suppressed, due to this increased risk of severe side effects.

   

• Will monkeypox treatment or vaccines interact with HIV medications?

  Data is limited, but most HIV treatment can be safely given with monkeypox treatment and smallpox vaccines. People with HIV should inform their ARC provider of all their medications to help determine if any interactions exist.

• Does monkeypox affect how well pre-exposure prophylaxis (PrEP) works for HIV prevention?

  No, HIV pre-exposure prophylaxis (PrEP) is still effective and should be continued as prescribed.

   

• What can people with HIV do to protect themselves from monkeypox?

  People with HIV should follow the same recommendations as everyone else to protect themselves from monkeypox.

  • Avoid direct contact with rashes, sores, or scabs on a person with monkeypox, including during intimate contact such as sex. We believe this is currently the most common way that monkeypox is spreading in the U.S.
  • Avoid contact with objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with monkeypox.
  • Avoid contact with respiratory secretions, through kissing and other face-to-face contact from a person with monkeypox.

  For more information, including guidance around sex visit Monkeypox Facts for People Who are Sexually Active | Monkeypox | Poxvirus | CDC

   

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