Mpox: What you need to know

 In mid-May 2022, the first cases of mpox were found in the United States and some western European countries. The U.S. declared mpox a national health emergency in early Aug. 2022 as cases peaked. Since then, cases of mpox have decreased significantly, but the virus continues to spread. Read on to learn more about the virus and how to protect yourself.

What is mpox?

Mpox is a rare disease caused by the mpox virus. It is a viral disease that can spread from animals to humans and between people. Mpox is in the same family of viruses that cause smallpox but is unrelated to chickenpox. Symptoms are similar but usually milder than smallpox and rarely fatal. The virus, discovered in 1958, was initially named Monkeypox because it was first seen in monkeys kept for research. The first human case of mpox was recorded in 1970. Since then, small outbreaks have been limited to hundreds of cases in 11 Central and West African countries.

According to the Centers for Disease Control and Prevention (CDC), people with mpox get a rash on or near their genitals or anus. They could be on other areas like the hands, feet, chest or mouth. Initially, the rash will look like pimples or blisters and may be painful or itchy. It will go through several stages, including scabbing, before healing.

In addition to the rash, other symptoms can include:

• Fever
• Chills
• Swollen lymph nodes
• Exhaustion
• Muscle aches and backache
• Headache
• Respiratory symptoms (sore throat, stuffy nose or cough)

People may experience all or only a few symptoms.

Mpox symptoms usually start within three weeks of exposure to the virus. If someone has flu-like symptoms, they will usually develop a rash one to four days later, and others may get a rash first before flu-like symptoms appear. Mpox can be spread from when symptoms start until the rash has healed, all scabs have fallen off, and a fresh layer of skin has formed.

In most cases, the symptoms of mpox go away on their own within a few weeks. Still, in some individuals, they can lead to medical complications and even death. Newborns, children and people with underlying immune deficiencies may be at risk of more severe symptoms and death from mpox.

How is mpox spread?

Anyone can get mpox, but some people are at a higher risk. Transmission of mpox requires close, continuous interaction with a symptomatic individual. Brief interactions that do not involve physical contact are low risk.

The mpox virus spreads to anyone through close, personal, often skin-to-skin contact, including:

• Direct contact with mpox rash and scabs from a person with mpox, as well as with their saliva, respiratory secretions (snot and mucus), and the areas around the anus, rectum or vagina.

Direct contact can happen during intimate contact, including:

• Oral, anal or vaginal sex or touching the genitals (penis, testicles, labia and vagina) or anus of a person with mpox
• Hugging, massage and kissing
• Prolonged face-to-face contact

Although mpox is not a sexually transmitted infection, data suggest that men who have sex with men are most cases in the current mpox outbreak. Despite this, anyone who has been in close, personal contact with someone who has mpox is at risk.

Mpox can also be transmitted from mother to fetus via the placenta or through close contact during and after birth. Humans can get also mpox from contact with infected animals (including monkeys, squirrels, rats and mice) or their environments through an animal bite, scratch, bodily fluids, feces or consuming undercooked meat. The first case of human-to-dog transmission was recently reported in France, thus leading scientists to believe the virus can spread to or from other household pets. 

Tips for preventing the spread

The CDC recommends the following measures the public can take to prevent infection with mpox:

• Avoid close, skin-to-skin contact with people who have a rash that looks like mpox — this might include skin with what appears to be a rash, pimples, blisters or scabs.
• Avoid contact with objects and materials that a person with mpox has used.
• Practice good hand hygiene: wash your hands with soap and water or use an alcohol-based hand sanitizer.
• Get vaccinated.

While mpox is not a sexually transmitted disease, anyone who is sexually active with multiple partners or whose partner has sex with multiple partners is at higher risk. Practicing safer sex and temporarily reducing or avoiding behaviors that increase the risk of mpox through sexual exposure will help slow the spread of mpox.

If you have only flu-like symptoms, there is no way to test for mpox. But if you notice red lesions, you should see your primary care physician or visit an urgent care center for a mpox test. Call the provider ahead of time and inform them that you would like to come in; doing so will help your provider’s office take steps to keep their staff safe.

If you develop symptoms, isolate yourself at home and avoid close contact with others. Even though exposure to mpox through casual contact with shared household items may be low, it is considered best not to share a bathroom, bed, or other household objects with anyone before they can be cleaned and disinfected. Wear a high-quality mask if you come in contact with others. You should also isolate yourself from any household pets and avoid activities with pets, including petting, cuddling, hugging and sharing sleeping areas.

What treatments are available?

No specific treatment is currently approved for mpox. If you get sick, treatment usually includes symptom management. Since mpox and smallpox viruses are genetically similar, antiviral drugs and vaccines developed to protect against smallpox may be used to prevent and treat mpox virus infections. Antiviral medications may be recommended for people more likely to get severely ill.

The CDC recommends vaccination for people exposed to mpox and people who may be more likely to get mpox. This list includes:

• People whom public health officials have identified as a contact of someone with mpox.

• People who are aware that one of their close contacts in the past two weeks has been diagnosed with mpox; or

• People who have had multiple sexual partners in the past two weeks in an area with known mpox.

• People with high-risk occupational exposure, e.g., health care or lab workers.

The preferred vaccine to protect against mpox is JYNNEOS, an Food and Drug Administration-approved two-dose regimen administered 28 days apart. It takes 14 days after getting the second dose of JYNNEOS for its immune protection to reach its maximum.

Due to a limited supply of vaccines, local public health departments initially prioritized the vaccine for those at the highest risk. As cases have declined, vaccine availability has increased but varies by community.  For more information on availability and vaccination eligibility, please visit your state’s public health website or contact your local public health department:

• Alaska Department of Public Health
• Oregon Health Authority 
• Washington State Department of Health

The mpox vaccine is free, and providers must give you the vaccine regardless of your ability to pay the administration fee. The providers may bill a program or insurance plan that covers the mpox vaccine administration fee.

For more information, please visit the CDC mpox website.