Monkeypox is a viral infection in which a person develops fever, fatigue, muscle aches, and a rash that may include the entire body. Most cases resolve within 2 to 4 weeks.
This rare disease was found mainly in central and western African countries. Cases without international travel or contact with imported animals have been recently reported indicating spread of this infection.
Monkeypox was first detected in Denmark in 1958 in a colony of monkeys used for research. This is how it came to be called “monkeypox.” The first human case occurred in 1970 in the Democratic Republic of the Congo (DRC).
Since May 2022, cases of monkeypox have been reported in countries where monkeypox does not normally occur. These include countries in Europe, North and South America, the Middle East, and Australia.
Monkeypox is caused by Orthopoxvirus. It is similar to the virus that causes smallpox, but is much less severe. The virus is transmitted when a person comes into close contact with an infected animal, human, or material contaminated with the virus.
Monkeypox can be transmitted from animal to human when a person:
- Comes in contact with an infected animal
- Gets bitten or scratched by an infected animal
- Handles or consumes bushmeat
People with monkeypox can spread the virus to animals, such as pets and livestock.
Monkeypox can be transmitted from human to human through close contact, such as:
- Direct skin-to-skin contact with body fluids, sores, rash, or scabs from an infected person
- Touching objects, clothing, linens, or surfaces used by a person with monkeypox
- Exposure to large respiratory droplets
Monkeypox can be transmitted from human to human during intimate contact, including:
- Oral, anal, and vaginal sex
- Touching the genitals or anus of an infected person
- Hugging, kissing, cuddling, and massaging
- Face-to-face contact
- Touching fabrics or objects during sex that were used by a person with monkeypox such as bedding, towels, and sex toys
A pregnant person can spread the virus to their fetus through the placenta.
Symptoms usually appear in 1 to 3 weeks after exposure.
A rash appears that can be found on or near the genitals and can appear on all parts of the body. The rash starts as flat spots that become raised bumps, which fill with fluid, then pus. The bumps may be painful. Soon they crust over and form itchy scabs that fall off and heal over.
Flu-like symptoms include:
You may experience all or just some of the symptoms.
- You may have flu-like symptoms followed by the rash in 1 to 4 days
- You may get the rash first, then the flu-like symptoms
- Or you may just have the rash
Monkeypox lasts about 2 to 4 weeks. You are no longer contagious only after:
- All symptoms are gone
- Scabs have healed completely
- New skin has formed
Exams and Tests
Your health care provider can diagnose monkeypox by looking at the rash and asking questions about your medical history.
Your provider may take specimens from your skin lesions and send them for testing. A PCR test (polymerase chain reaction test) can confirm the diagnosis.
Currently, there is no specific treatment for the monkeypox virus. In most people, symptoms usually go on their own in 2 to 4 weeks.
Certain people may be at risk for more severe disease and may need to be hospitalized and given supportive care:
- People with severe symptoms
- People whose immune system is not working well
- People who are pregnant or breastfeeding
- Children younger than 8 years old
Antivirals used for smallpox may be helpful in treating monkeypox in people who are more likely to get severely ill.
Home care for monkeypox can help prevent the spread and keep you more comfortable.
- Do not pop or scratch the lesions and do not shave the area. Avoid touching the rash, as you can spread it to other parts of the body.
- Cover lesions with bandages or gauze to help prevent spreading the virus.
- Try over-the-counter (OTC) topical products such as benzocaine/lidocaine for pain and calamine lotion or petroleum jelly for itching.
- OTC oral antihistamines may also help with itching.
- An oatmeal bath may help with itching. Using a sitz bath or sitting in shallow water in the tub can help with lesions on the genitals. Epsom salt, vinegar, or baking soda can be added to the water to help soothe the area.
- Keep the area dry and clean (except when washing).
- Wash your hands often with soap and water or sanitizer, especially after touching the rash.
- For a rash on your hands, wear comfortable gloves when touching surfaces or objects in shared spaces.
- Wear a well-fitting face mask around other people until all of your symptoms are gone and your skin is healed.
- OTC pain relievers such as ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) can help relieve pain. Your health care provider may prescribe something stronger, if needed.
In most people, symptoms go away within 2 to 4 weeks. Rarely, severe cases may lead to death.
When to Contact a Medical Professional
Contact your provider if you:
- Think you may have been exposed to monkeypox
- Develop symptoms of monkeypox
- Have an unexplained rash
If you have monkeypox, you should call your provider if:
The Centers for Disease Control and Prevention recommends vaccination for people at risk for monkeypox:
- People who have had contact with someone with monkeypox
- People with multiple sexual partners in an area where monkeypox is spreading
- People in jobs that may expose them to the virus such as those who work in health care, public health, or clinical or research laboratory workers
If you have monkeypox, remember that you can still spread the virus until skin lesions heal completely and all symptoms are gone. To help prevent infecting others:
- Stay away from other people until you heal completely (isolate at home).
- If you live with other people, stay in one room away from others.
- Disinfect commonly used surfaces after each use, such as in the bathroom or kitchen.
- Cover all shared furniture with sheets or blankets.
- Wear a well-fitting mask when around other people and pets in your household
- Do not share items you have touched with others.
- Avoid contact with pets and other animals.
The CDC has more information on disinfecting your home to protect others.
Centers for Disease Control and Prevention website. Monkeypox: clinical recognition. www.cdc.gov/poxvirus/monkeypox/clinicians/clinical-recognition.html. Updated August 5, 2022. Accessed August 16, 2022.
Centers for Disease Control and Prevention website. Monkeypox: how it spreads. www.cdc.gov/poxvirus/monkeypox/transmission.html. Updated July 29, 2022. Accessed August 16, 2022.
Centers for Disease Control and Prevention website. Monkeypox: preventing spread to others spreads. www.cdc.gov/poxvirus/monkeypox/if-sick/preventing-spread.html. Updated August 11, 2022. Accessed August 16, 2022.
Centers for Disease Control and Prevention website. Monkeypox: signs and symptoms. www.cdc.gov/poxvirus/monkeypox/symptoms.html. Updated August 5, 2021. Accessed August 16, 2022.
Centers for Disease Control and Prevention website. Monkeypox: treatment. www.cdc.gov/poxvirus/monkeypox/treatment.html. Updated August 10, 2022. Accessed August 16, 2022.
Centers for Disease Control and Prevention website. Monkeypox: vaccines. www.cdc.gov/poxvirus/monkeypox/vaccines.html. Updated August 5, 2022. Accessed August 16, 2022.
Centers for Disease Control and Prevention website. Monkeypox: what to do if you are sick. www.cdc.gov/poxvirus/monkeypox/if-sick/what-to-do.html. Updated August 11, 2022. Accessed August 16, 2022.
Review Date 6/21/2022
Updated by: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 08/19/2022.