Monkeypox Frequently Asked Questions

What is monkeypox?

Monkeypox is a rare illness caused by the monkeypox virus. It may begin with flu-like symptoms and swelling of the lymph nodes, followed by a skin rash that turns into pus-filled blisters that take several weeks to heal. Sometimes rash is the first or only symptom. The virus is closely related to smallpox, which was officially eradicated in the United States by 1972, but the symptoms are generally less severe. Recently, cases of monkeypox occurring in Europe, Canada, and the United States have been making the news. After living through the devastating impact of COVID-19, concern is high surrounding the outbreak of another unfamiliar illness. It’s important to remember that monkeypox is not a new virus and is very unlikely to cause another pandemic, but has the potential to cause serious symptoms even if most cases are mild. Given that more cases of monkeypox are expected to arise in the coming months, it’s important to know what to look out for and how to react if you or a loved one may have been infected by the virus.

Where did the current cases of monkeypox come from?

Cases of monkeypox were first detected in the United Kingdom in early May. Since then more than 4000 cases have been diagnosed in more than 50 countries. In the United States, cases have been reported in at least 30 states, including Massachusetts, where the first case was reported on May 18.

What are the symptoms of monkeypox?

The typical symptoms include:

• Fever
• Chills
• Swollen lymph nodes
• A skin rash anywhere on the body
  • The rash can look like pimples or blisters on the face, the inside the mouth, and other parts of the body including hands, feet, chest, genitals or anus.
  • Sometimes the lesions are not visible, such as anal lesions, and pain is the main symptom.
  • Over the course of the next 2-3 weeks, these lesions scab over and heal.

Sometimes people get a rash first followed by other symptoms, while others will only experience a rash. The incubation period usually lasts 1-2 weeks, but symptoms of the illness can start anywhere from 5 days to 3 weeks after exposure. The virus lasts 2-4 weeks.

How does monkeypox spread?

Monkeypox is spread from person-to-person through physical contact. The kind of close contact or skin-to-skin contact that can transmit monkeypox includes:

• Direct contact with monkeypox rash, scabs or body fluids
• Sexual contact of any kind or touching the genitals or anus of a person with monkeypox
• Hugging, massaging, kissing
• Contact with objects such as clothing, bedding, sex toys, or towels
• Contact with surfaces used by someone with monkeypox
• Talking in close proximity to a person with monkeypox, although this mode of transmission is much less common

The contagious period for monkeypox begins with the development of the first symptom. It lasts until after all the lesions have crusted and fallen off and a fresh layer of healthy skin has formed underneath, which can take several weeks.

What is the treatment for monkeypox?

There are no treatments specifically for monkeypox as of right now. If a significant outbreak were to occur, we would be able to secure vaccines and medications to control it.

If you or a loved one has symptoms suggestive of a monkeypox infection, isolate in a private room to avoid infecting others and contact your healthcare provider. Be sure to rest well, eat well, and drink plenty of water to help the symptoms resolve and isolate from others until the end of the contagious period.

I've been at home recovering from monkeypox, but I've started to feel worse. Should I contact my healthcare provider again?

Call your primary care provider right away if you have any new symptoms suggestive of worsening monkeypox. The following are a special cause for concern:

• A new fever (100.4 °F /38 °C) or the return of a fever after it has disappeared for a few days
• A worsening rash
• Feeling more confused, lightheaded or have a stiff neck
• Worsening rectal pain or difficulty passing bowel movements
• Worsening throat pain or difficulty eating and drinking
• New or worsening cough, or other respiratory symptoms

How can someone with a monkeypox infection keep themselves and others safe?

Anyone with a monkeypox infection should keep their skin lesions covered and wear a well-fitting medical mask at home or after leaving the hospital or medical appointment. Avoid using public transportation and rideshare services such as Uber or Lyft. Regularly wash your hands, especially after touching any rashes, lesions, or scabs; and avoid touching your eyes or using contact lenses to prevent eye infections.

While recovering at home, the following measures will help prevent transmission of the virus:

• If possible, stay in a room by yourself or in separate area from other household members.
• Wear a well-fitting mask when within 6 feet of others at home, if close contact cannot be avoided.
• Avoid skin-to-skin contact and prolonged face-to-face contact.
• Avoid physical or close contact with pets in the home or other animals (specifically mammals).
• Do not share any items that have come into contact with your rashes, scabs, or secretions such as bedding, clothing, towels, sex toys, toothbrushes, kitchen dishes/utensils, food, or drinks.
• If possible, use a separate bathroom from others in your home. If this isn't possible, then wipe down all surfaces in the bathroom that you have touched with a household disinfectant.
• Wipe down all "high touch" surfaces such as doorknobs, faucets, light switches, cabinets, or countertops with disinfectant.
• Do not use or sit on materials that cannot be easily cleaned, such as upholstered furniture.
• Avoid shaving rash-covered areas of the body, as this can lead to the virus spreading.

Your doctor or a public health official will tell you when you can resume normal activities. Ask your care team about available resources if you need a ride home or a ride to a medical appointment.

What can partners, caregivers, or housemates do to protect themselves?

If you or someone you live with, have sex with, provide care to, or are in contact with someone who has monkeypox, the best way to protect yourself and others is to:

• Avoid sex of any kind.
• Do not kiss or touch each other's bodies while you are sick, especially any rash or open lesions.
• Do not share things like towels, fetish gear, sex toys, and toothbrushes.
• Wear a mask and gloves when you are close to them (within 6 feet) or touching their bedding, clothing, or linens.
• Wash your hands frequently with soap and water or use hand sanitizer.
• Practice physical distancing when possible.

If you or your partner have monkeypox and you do decide to have sex, the CDC recommends the following precautions, which may lower the chance of spreading the virus:

• Have virtual sex with no in-person contact.
• Masturbate together at a distance of at least 6 feet.
• Have sex with clothes on, or cover areas where there are rashes or sores, to avoid skin-to-skin contact.
• Avoid kissing.
• Wash your hands, fetish gear, sex toys, and any fabrics (bedding, towels, and clothing) after having sex.
• Limiting the number of partners you have will also help to avoid chances for monkeypox to spread.