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How To Prevent Monkeypox: Answers on Risk, Vaccines, and More

Posted on September 12, 2022

Article written and medically reviewed by
Manuel Penton, M.D.

You may have heard that both the World Health Organization (WHO) and the White House have declared monkeypox a public health emergency. What can you, as an individual, do to prevent monkeypox from spreading to yourself and your community?

Anyone, including children, can be infected with monkeypox when exposed. The ongoing outbreak is a public health issue everyone should be concerned about. Currently, communities most affected include gay, bisexual, and other men or transgender people who have sex with men. Black and Latino people in some areas may have higher rates of monkeypox as well.

We all desire to feel knowledgeable, aware, and empowered to act on facts, not fear, when it comes to our health care. At myHIVteam, we want to give you the facts about monkeypox so you can make the best decisions for yourself and the people around you.

What Is Monkeypox?

Monkeypox is an infectious disease caused by a virus with the same name. The virus is related to the smallpox virus, but the disease is much less severe and rarely causes death. Despite a similar disease name, the monkeypox virus is not related to varicella, the virus that causes chickenpox.

What Does a Monkeypox Rash Look Like?

Warning: This article contains images that could be
disturbing to some readers.

A rash is the most distinct symptom of monkeypox. It can start as small raised lesions (like pimples) and evolve into blisters or lesions that are filled with fluid or pus.

This is a monkeypox lesion from early in the course of illness. The rash changes appearance over time. (CC BY-NC-ND 3.0 NZ/DermNet)

These lesions eventually crust over and dry up. After scabs form, they usually fall off, leaving normal skin behind. Sometimes, there can be scarring. A person with monkeypox can have anywhere from a few to a few thousand lesions as a part of their rash.

Monkeypox bumps can progress to blister-like lesions filled with pus or fluid. The lesions often have a depressed area in the center, and they can connect with other nearby bumps to form larger lesions. (CC BY-NC-ND 3.0 NZ/DermNet)

The monkeypox rash can appear in different colors, depending on skin tone. The color of the rash may change as it progresses. (CC BY-NC-ND 3.0 NZ/DermNet)

Some people with monkeypox have rashes that spread down from the face to the chest and back.(CC BY-NC-ND 3.0 NZ/DermNet)

This current outbreak of monkeypox has presented differently than cases in the past. Before 2022, most monkeypox rashes began on the face and spread to the extremities and sometimes the trunk of the body. Now, many cases include lesions on the penis, testicles, anus, labia, and the surrounding areas. The lesions can also appear in body cavities (called mucous membranes), like the inside of the mouth, vagina, or anus.

Monkeypox rashes can develop on and around the genitals. (CC BY-NC-ND 3.0 NZ/DermNet)

The face is another common place for monkeypox lesions, including inside and around the mouth.(CC BY-NC-ND 3.0 NZ/DermNet)

What About Other Symptoms?

Not everyone experiences the same monkeypox symptoms. Some people don’t have any symptoms besides a rash. Other people experience a few of the following symptoms either before or after the rash appears:

  • Fatigue
  • Headache
  • Fever and chills
  • Swollen lymph nodes
  • Sore throat
  • Cough
  • Muscle aches
  • Back pain
  • Nasal congestion

Swollen lymph nodes, which are common in monkeypox, are not caused by many other, similar rashes. Be sure to mention whether your lymph nodes are swollen when talking to your doctor, as it may give them a clue that you have monkeypox.

How Does Monkeypox Spread?

In the past, humans typically acquired monkeypox when they were touched or bitten by animals (often rodents or monkeys) with the disease or ate undercooked animals that were infected.

In the current outbreak, monkeypox is spreading mostly through skin-to-skin contact with the rash of other humans who have monkeypox. The virus can also be spread from human to human through respiratory secretions, including sneezing, coughing, or being face-to-face with a person who is infected. Less commonly, monkeypox can be spread through surfaces alone — including through materials involved in sex if a person who has monkeypox used them. The Centers for Disease Control and Prevention (CDC) warns that “bedding, towels, fetish gear, and sex toys” that have not been disinfected can spread monkeypox.

Monkeypox is not a sexually transmitted infection (STI) in the traditional sense that is used to describe infections like syphilis or chlamydia. However, because having sex with another person can involve a lot of skin-to-skin and face-to-face contact, sexual experiences have been the main way monkeypox has been spreading lately. This includes the following types of sex and other intimate encounters:

  • Oral sex
  • Vaginal sex
  • Anal sex
  • Kissing
  • Massages
  • Cuddling or hugging
  • Any touching of the vagina, penis, labia, testicles, or anus

Keep in mind, the type of contact that can spread monkeypox does not have to be sexual or intimate in nature.

Who Is at Risk of Getting Monkeypox?

Anyone of any age, race, gender, or sexual identity can be infected with monkeypox. So it’s important for everyone to understand the basic facts about this illness during the outbreak.

Data collected by the CDC shows the communities most affected right now include gay, bisexual, and other men or transgender people who have sex with men. Infection rates among Latino and Black people may be higher in some areas as well. Health care workers who might come in contact with people who are infected may also be at higher risk. Public health resources, like testing and vaccines, may be appropriately distributed with highest priority to the groups of people who are currently at the greatest risk of catching the disease.

Even if you do not fit into any of those categories, you should be aware that any situation where you may have close bodily contact with strangers (like parties, dances, or music festivals) may put you at higher risk for getting infected with monkeypox. The communities most affected by monkeypox may change in the future.

How Is Monkeypox Diagnosed?

The preferred way to diagnose monkeypox is for a health care worker to swab any suspicious skin lesions and then run that swab through a polymerase chain reaction (PCR) test to look for monkeypox genetic material (DNA). Monkeypox may also be diagnosed through growing the virus in a culture or through another genetic test called “next generation sequencing.” Sometimes a blood test showing antibodies against monkeypox can help make the diagnosis, but a blood test is not required to confirm monkeypox.

Depending on the medical resources available in your area, it might be difficult to confirm if you have monkeypox through proper testing. The CDC and other medical organizations have developed definitions to help doctors understand what cases are most likely to be monkeypox even without access to testing.

Suspected Cases

Understanding what doctors view as a “suspected case” of monkeypox may help you decide if you or someone you know should isolate, seek testing, or get vaccinated. Suspected cases are people who have a new rash that looks like monkeypox and have experienced any of the following in the 21 days before the rash started:

  • Encounters with anyone who has likely or confirmed monkeypox or who also has a rash that looks like monkeypox
  • Close social, sexual, or intimate experiences with people in groups known to be currently affected by monkeypox, like men who have sex with men
  • Travel to another country where monkeypox has been diagnosed
  • Contact with any animal or animal product from a species known to harbor monkeypox

As the monkeypox rash changes over time, it can be easy to confuse it with other skin conditions like eczema, psoriasis, or even insect bites. If you’re unsure about the cause of your rash, it’s best to ask your doctor to evaluate it in person, if possible.

What Should You Do if You Get Monkeypox?

If you think you might have the rash or other symptoms of monkeypox, contact a medical provider or your regular doctor. The CDC recommends you remind your doctor that monkeypox is currently present in the U.S. Not all doctors will be equally familiar with the outbreak.

Until you’re able to be evaluated and see your test results, it’s important to isolate to prevent physical contact with other people and animals. Try your best to only leave your home to seek medical care. Wear a face mask, cover up your rash to prevent accidental spread, and don’t take public transportation.

If your health care provider confirms you have monkeypox through testing, or if testing is unavailable but the provider thinks monkeypox is likely, you’ll want to discuss with them how to best manage both your rash and your pain until the illness resolves.

Manage Your Rash

The first rule of managing your rash is, don’t scratch or touch it. Popping or lancing the lesions will not allow them to heal any quicker and may cause more harm. Touching or scratching your rash may result in the following:

  • A transfer of the rash to other people or other parts of your body
  • Possible long-lasting scars
  • Secondary bacterial infections

You especially should not touch your anus, mouth, eyes, vagina, or nose after touching your rash to avoid potentially painful lesions in those areas. Be sure to wash your hands with soap and water if you do mistakenly touch the rash.

Do not shave any areas affected by the rash to prevent the lesions from worsening or multiplying. You can use bandages found at a pharmacy or gauze from the doctor’s office to cover the lesions and help prevent spreading. Try disposable or reusable gloves to cover lesions on your hands.

Manage Your Pain

Monkeypox can be extremely painful, depending on where the lesions appear. Make sure your doctor addresses any pain you have when they diagnose you. Make a plan with them for what to do if your pain increases in the coming days or weeks. Most doctors will have you start with over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Motrin or Advil). However, if your pain worsens and becomes severe, don’t hesitate to call the doctor’s office again to let them know you need more help.

Besides prescription pain-relief pills, your doctor may recommend some topical treatments to manage the pain at the site of the lesions. These treatments may include soothing lotions, oatmeal baths, and lidocaine or benzocaine gels to dull the pain. Sitz baths may help with controlling the pain from lesions in and around the genitals.

Stay Isolated

Once diagnosed with monkeypox, the best way to keep it from spreading is to stay in isolation. Avoid kissing, touching, and sexual contact with other people while you feel sick or have the rash. Also don’t share objects used for hygeine or sex, like toothbrushes or sex toys.

Continue isolation until all of the scabs or dried skin from the lesions falls off.

How Can You Protect Yourself and Prevent Monkeypox from Spreading?

The CDC offers three basic tips for protecting yourself from monkeypox:

  1. If someone has a rash that looks like monkeypox, do not touch them.
  2. While someone has monkeypox, avoid sharing any tools, utensils, or household items with them.
  3. Use hand sanitizer or wash your hands frequently.

If you notice you or a partner have a rash of any kind, avoid any sex or skin-to-skin contact until a medical provider can evaluate you for monkeypox. This is a great way to prevent possible infection and spread.

If you had a recent exposure to monkeypox or are in a group of people that is currently at high risk, getting vaccinated is also one of the best ways to avoid the disease. If you have confirmed or probable monkeypox, staying isolated until your lesions are completely healed will help prevent you from spreading the virus to other people in the community.

Besides vaccination and isolation, you can take other steps to protect yourself and the people around you. The CDC has a list of ways to experience activities like parties and sex while lowering your risk of monkeypox. Some tips include:

  • Use condoms and gloves during sexual contact to help reduce exposure to monkeypox lesions.
  • Try virtual sex or masturbation with your partner in the same room but without touching the other person.
  • Wear as many clothes as possible when having sex. This can include latex and leather, as long as these pieces are disinfected before encountering another partner.
  • Spend as little time kissing or face-to-face as possible, since saliva and heavy breathing can spread the monkeypox virus.
  • Consider waiting to have sex in-person until two weeks after your second dose of the vaccine for monkeypox, when your immune system is best able to protect you from the virus.
  • Choose to attend parties, concerts, and music festivals where most people are fully clothed to avoid skin-to-skin contact with strangers.

How Long is Monkeypox Contagious?

Monkeypox is contagious from the beginning of the symptoms (including any flu-like symptoms) until new skin takes the place of the crusted-over lesions of the rash.

Is There a Treatment or Cure for Monkeypox?

There is no specific cure for monkeypox. The disease is “self-limited,” which means it generally goes away on its own eventually, even with no treatment.

Currently, treatment for most people with monkeypox is centered around relieving symptoms, like pain, or addressing complications, like bacterial infections that may arise after the viral rash.

There are a few people, such as those with weakened immune systems, who might need treatment to fight the virus itself. In these cases, doctors may prescribe antiviral medications, although these aren’t specifically proven to treat monkeypox.

How Long Does Monkeypox Last?

The symptoms of monkeypox, including the rash, can last around two to four weeks.

After being exposed and infected, it can take between five and 21 days for the first symptoms to appear. This period of time between getting infected and the start of symptoms is called the incubation period.

Should You Get a Monkeypox Vaccine?

Generally, the CDC recommends the monkeypox vaccine for individuals who are more likely to get monkeypox or who have already been exposed to it. Monkeypox vaccination can help prevent the disease both before someone is exposed to the virus and in the first 14 days after exposure.

The U.S. Food and Drug Administration (FDA) has approved a two-dose vaccine for smallpox and monkeypox called Jynneos. While there is no data available on the vaccine’s effectiveness during the current outbreak, previous studies showed that Jynneos prevented monkeypox in 85 percent of people who got the two-dose course. There are no studies showing how effective the vaccine is after just one dose.

The following people should seek monkeypox vaccination:

  • Anyone who was exposed to someone with monkeypox through sex or other close contact anytime in the past 14 days
  • Anyone who may encounter the monkeypox virus at work, including laboratory workers involved with testing, certain health workers, and sex workers
  • Anyone with multiple sexual partners in an area with known monkeypox cases and who had sex in the last 14 days
  • Anyone told by a public health official that they are a contact of a person with monkeypox

If you fall into the above categories, the CDC recommends contacting your local health department to find out how to get vaccinated.

The most common side effects from the Jynneos vaccine are:

  • Itching and redness of the skin where the vaccine was given
  • Chills
  • Muscle aches
  • Headaches
  • Feeling tired
  • Feeling nauseous

The monkeypox vaccine is in short supply right now, but that supply is increasing. Your city, county, tribal, or state health department may have a shot available for you now even if they didn’t earlier in the outbreak.

Talk With Others Who Understand

On myHIVteam, the social network for people with HIV, more than 35,000 people come together to ask questions, give advice, and share their stories with others who understand life with HIV.

Have you had monkeypox or gotten vaccinated? What questions do you still have about monkeypox? Share your experience or thoughts in the comments below, or start a conversation by posting on your Activities page.

Manuel Penton, M.D. is a medical editor at MyHealthTeam. Learn more about him here.
All updates must be accompanied by text or a picture.

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