Monkeypox Frequently Asked Questions

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 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 the Democratic Republic of the Congo 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.

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.

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 a healthcare 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,

What are the symptoms of monkeypox?

Symptoms of monkeypox can include:

Fever Headache Muscle aches and backache Swollen lymph nodes Chills Exhaustion 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 a healthcare provider if you notice a new or unexplained rash or other monkeypox symptoms. Remind the healthcare provider that monkeypox is circulating. Avoid close contact (including intimate physical contact) with others until a healthcare provider examines you.

Avoid close contact with pets or other animals until a healthcare provider examines you. If you’re waiting for test results, follow the same precautions. If your test result is positive, stay isolated until your rash has healed, all scabs have fallen off, and a fresh layer of intact skin has formed.

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.

How can monkeypox be prevented?

People should take the following steps to prevent getting monkeypox:

Avoid close, skin- to- skin contact with people who have a rash that looks like monkeypox. Do not touch the rash or scabs of person with monkeypox. Do not kiss, hug, cuddle or have sex with someone with monkeypox. Do not share eating utensils or cups with a person with monkeypox. Do not handle or touch the bedding, towels, or clothing of a person with monkeypox. Wash your hands often with soap and water or use an alcohol-based hand sanitizer. In Central and West Africa, avoid contact with animals that can spread monkeypox virus, usually rodents and primates. Also, avoid sick or dead animals, as well as bedding or other materials they have touched. If you are sick with monkeypox

Isolate at home If you have an active rash or other symptoms, stay in a separate room or area away from people or pets you live with, when possible. CDC recommends vaccination for people who have been exposed to monkeypox and people who are at higher risk of being exposed to monkeypox.

What treatments are 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.

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.

The U.S. government has two stockpiled vaccines—JYNNEOS and ACAM2000—that can prevent monkeypox in people who are exposed to the virus. 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.

How and when are vaccines being distributed?

The Department of Health and Human Services (HHS) has been shipping doses of JYNNEOS vaccine to jurisdictions as part of an enhanced national vaccination strategy since late June. This strategy is intended to help limit the spread of monkeypox in communities where transmission is highest and with populations most at risk. HHS updates the number of vaccine doses distributed to jurisdictions each Wednesday.

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.

Where can you find out if you’re eligible for a vaccine?

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

If I am a man and have had multiple male sexual partners recently, does that automatically make me eligible for the vaccine?

No. Having multiple sexual partners is one factor for consideration in getting the vaccine, but there are others, such as whether you live in an area with ongoing spread of monkeypox or if one of your partners has recently been infected with monkeypox. If you think you have monkeypox or might be at risk for infection, contact a healthcare provider.

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.

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, healthcare providers might 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.

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

At this time, vaccination is recommended for people with exposures 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 healthcare 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

Could my pet get monkeypox?

Monkeypox is zoonotic, meaning it can spread between animals and people. However, CDC does not currently believe that monkeypox poses a high risk to pets. We are continuing to monitor the situation closely.

During the 2003 monkeypox outbreak in the United States, we did not see disease spread to domestic animals other than prairie dogs, and we do not have reason to believe that we will see that now. However, we still recommend that people with monkeypox avoid interacting with animals and find someone else to take care of their pets while they recover.