Monkeypox

What is monkeypox?

Monkeypox is a contagious rash illness caused by the monkeypox virus. The virus is in the same family of viruses as the virus that causes smallpox. Monkeypox causes milder illness than smallpox, but some symptoms can be severe. The monkeypox virus can spread from animals to people and from person to person.

In 2022, a monkeypox outbreak began. There are cases in many countries or areas where this infection is not usually found, including in the U.S. and in Virginia.

Who is at risk for monkeypox?

The risk to the general public is considered low at this time. 

Anyone can get and spread monkeypox; however, it is spread by close contact with an infected person.  Close contact includes touching skin lesions, bodily fluids, or clothing or linens that have been in contact with an infected person. Spread can also occur during prolonged, face-to-face contact.

Monkeypox can spread from person to person through: 

  • Sexual or intimate contact (including oral, anal, and vaginal sex)  
  • Hugging, kissing, cuddling, and massage
  • Sharing a bed, sharing a towel, or sharing clothes that have not been washed 

The highest risk activity at present is sex with multiple or anonymous partners. Avoiding these activities greatly reduces your risk of catching or spreading monkeypox.

Monkeypox does not spread from person to person through: 

  • Walking by someone who is infected 
  • Casual conversation with someone infected 

The Centers for Disease Control and Prevention has more information about prevention for people who are sexually active, who are at higher risk of exposure.

If you are at risk for contracting monkeypox, visit VDH's prevention and vaccination website to read more about the vaccines available, who is eligible for the vaccine, and other prevention tips.

What are the symptoms of monkeypox?

Monkeypox symptoms usually start within 3 weeks of exposure to the virus. For many people, the illness starts with flu-like symptoms that begin a few days before the rash appears. Initial symptoms can include: 

  • Fever or chills
  • Headache 
  • Muscle aches and backache
  • Tiredness
  • Swollen lymph nodes

For some people, this rash may be their only symptom. The rash can look like pimples or blisters. It often begins on the genitals or perianal area, or in and around the mouth. In these situations, the monkeypox rash could be confused with a more common sexually transmitted infection (STI). The rash might develop on just one part of the body or can appear on many parts of the body. These lesions might be painful.

Rash lesions go through different stages, shown in the photographs below, before healing. The illness typically lasts 2-4 weeks. People with certain conditions may be more likely to develop severe illness. These include people with weakened immune systems, children under 8 years of age, people with a history of eczema, and people who are pregnant or breastfeeding.

Lesions from monkeypox virus

Photo credit: UK Health Security Agency

For additional images and more detailed clinical information about monkeypox, please visit the CDC's website on clinical recognition.

I may have monkeypox. What should I do?

Isolate Yourself

If you have symptoms, you should separate yourself from other people and pets, cover your lesions, and contact your healthcare provider. If you do not have a provider, you can contact a public health clinic. Please call ahead before going to a healthcare facility and let them know that you are concerned about monkeypox.  You may be asked screening questions before you are scheduled for testing. You can use these resources to find a public health clinic: 

If you cannot completely separate yourself from others, you should wear a well-fitting face mask and cover areas where rash or sores are present. CDC has other recommendations for people who have monkeypox and are isolating at home.

Get Screened for Testing

If you have symptoms of monkeypox, contact your healthcare provider immediately for testing, especially if it is possible you were in a setting or situation within the last month where monkeypox is known to spread.

Explore Treatment Options

Not everyone who has symptoms of monkeypox is recommended to take treatments.  Certain antivirals, such as tecovirimat (TPOXX), may be recommended for people who are more likely to get severely ill, like patients with weakened immune systems.

There are no specific treatments for monkeypox virus infections. However, monkeypox and smallpox viruses are similar. This means that treatments developed to protect against smallpox may be used to treat monkeypox virus infections.

A clinical trial evaluating the antiviral tecovirimat, also known as TPOXX, is now enrolling adults and children with monkeypox infection in the United States. Interested volunteers can visit the ACTG website (clinical trial A5418) for more information.  

Treating Symptoms at Home

The following list provides ways to take care of yourself and help reduce symptoms using medicines and remedies that do not require a prescription. Ask your provider or pharmacist for assistance choosing over-the-counter medicines. Read and closely follow any instructions on the medicine box and package insert, including about dose, frequency of use, who should not take or use the medicine, and allergies.

  • Stay hydrated by drinking plenty of water and other fluids, especially if you have diarrhea.
  • Keep rash and sores clean and dry when not showering or bathing to prevent the sores from becoming infected.
  • To relieve pain and itching from rash and sores:
    • Medicines such as ibuprofen (such as Advil and Motrin), naproxen (such as Aleve) and acetaminophen (such as Tylenol) can help reduce pain, swelling, and fever. It is important to keep to the recommended dosage and interval per medicine.
    • Antihistamines (such as Benadryl), calamine lotion, petroleum jelly, and cooling lotions (such as menthol and camphor lotions) can provide temporary itch relief.
    • Warm oatmeal baths or sitz bath can reduce itching and pain.
    • Dibucaine ointment, often used for hemorrhoids, or lidocaine gel may also provide temporary relief. These are for external use only.
    • Take docusate (such as Colace), a stool softener, to reduce pain when you go to the bathroom.
  • If you have mouth sores:
    • Rinse your mouth with clean salt water at least four times per day to keep mouth sores clean; a mouthwash with no alcohol (such as Listerine Zero Alcohol) can also be used.
    • Suck on ice chips or ice pops and drink water to stay hydrated.
    • Consider using patches (such as Dentemp Canker Cover) that cover the sores and benzocaine gels to reduce mouth pain, especially to help you eat and drink.

If you have symptoms of monkeypox, you should talk to your healthcare provider, even if you don’t think you have had contact with someone who has monkeypox. Healthcare providers may not have these treatments on site, but they can work with VDH to provide them to patients. VDH is working with healthcare providers to make sure they have information about monkeypox treatment.

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

If you have symptoms of monkeypox, you should talk to your healthcare provider, even if you don’t think you have had contact with someone who has monkeypox. VDH is working with healthcare providers to make sure they have information about monkeypox treatment.

Last updated: September 27, 2022

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