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Division of Communicable Disease Control

Monkeypox (MPX)

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Questions and Answers

The California Department of Public Health will update recommendations and information as the situation continues to evolve.

Topics: Basics | Symptom & Spread | Prevention Treatment | Vaccination | JYNNEOS Vaccine | More Information



What is MPX?140What is MPX?<p><span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">Monkeypox (MPX) is a rare disease caused by infection with the MPX virus, which is related to the smallpox virus. While less severe and much less contagious than smallpox, MPX can be a serious illness. It spreads from infected humans, animals, and materials contaminated with the virus but primarily through close, personal, skin-to-skin contact with people who have MPX symptoms, such as rash and sores.</span><br></p>
Is MPX a new disease?141Is MPX a new disease?<p>MPX is not a new disease. MPX was first discovered in 1958 in monkeys, hence the name monkeypox’. However, monkeys are not the main reservoir (species that carries/spread a pathogen without becoming sick by it) for this disease and it’s unknown exactly where MPX comes from, though it’s most likely some types of rodents. The first human case of MPX was recorded in 1970 in the Democratic Republic of Congo. MPX is endemic (regularly found) in west and central African countries.<br></p>
Should I be worried about MPX?142Should I be worried about MPX?<p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">There is a recent increase in reported cases where MPX is not commonly seen, like Europe and the United States, including California. While it's good to stay alert about any emerging public health outbreaks, <span style="box-sizing:border-box;font-weight:700;">the current risk to the general public of getting MPX is low.</span></p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">MPX is a known illness that spreads through very close contact compared to other infectious diseases like COVID-19 that are primarily spread though very small particles in the air. MPX is also thought to be most contagious when symptoms like rash and sores are present, making it easier for infected individuals to know when to stay away from others to prevent further spread.<br></p>
Is MPX related to COVID-19?143Is MPX related to COVID-19?<p>​<span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">No, MPX is a completely different disease, is not related to COVID-19, and spreads differently. People are generally contagious when they have a rash or other symptoms, and MPX spread takes place through prolonged direct, close contact. This is different from COVID-19, which spreads easily through the air.</span><br></p>
Does the MPX virus have variants?144Does the MPX virus have variants?<p>​<span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">All viruses change and evolve over time. However, the MPX virus is a DNA virus which mutates slower than coronaviruses, which are RNA viruses (the virus that causes COVID-19 is a coronavirus).  There are two known families or “clades” of MPX virus. The clade recently identified in Europe and in the United States is the West African clade, which tends to cause less severe disease.</span><br></p>
Who can get MPX?145Who can get MPX?<p>​<span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">Anyone can get MPX after having close physical contact with someone who has the infection, especially if coming into direct contact with the rash and sores, bodily fluids. However, the current risk to the general public is low. Though not exclusively, most recent cases include gay, bisexual, trans, and other men who have sex with men, as well as household contacts.</span><br></p>
How serious is MPX?146How serious is MPX?<p><span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;">MPX is usually </span><span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;">a mild disease with symptoms lasting from 2 to 4 weeks. Certain groups of people may be at higher risk for severe disease. These groups 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.</span></p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">Infections with the strain of MPX virus identified in this outbreak—the West African strain—are rarely fatal. Over 99% of people who get this form of the disease are likely to survive. Despite this, symptoms can be extremely painful, and people might have infections or permanent scarring resulting from rashes and sores.<br></p>



How is MPX transmitted?147How is MPX transmitted?<p>​</p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">MPX can be spread by:</p><ul style="box-sizing:border-box;margin-top:0px;margin-bottom:10px;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;"><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Direct skin-to-skin contact with the sores or scabs of people with MPX</p></li><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Direct contact with body fluids of people with MPX, such as drainage from skin sores or saliva that was in contact with mouth sores</p></li><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Contact with the respiratory secretions of people with MPX, such as saliva, during prolonged, face-to-face contact or during intimate physical contact, such as kissing, cuddling, or sex</p></li><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Touching items (such as bedding towels, clothing, cups and utensils) that previously touched the sores or body fluids of people with MPX<br style="box-sizing:border-box;"></p></li></ul><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">To date, there has been no evidence that MPX is spread by:</p><ul style="box-sizing:border-box;margin-top:0px;margin-bottom:10px;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;"><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Attending an outdoor event with fully clothed people</p></li><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Trying on clothes or shoes at the store</p></li><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Traveling in an airport, on a plane or on other public transit</p></li><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Swimming in a pool or body of water</p></li><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Going to a public setting (grocery store, restaurant, workplace, restroom)</p></li></ul><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">If you have MPX symptoms, avoid crowded settings and close contact, including sexual or intimate contact, until you see your health care provider.</p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">For more information about isolation recommendations, please refer to the <a href="" style="box-sizing:border-box;color:#0071bc;background-color:transparent;outline:none;">CDPH MPX Home Isolation Guidance for the General Public.</a><br style="box-sizing:border-box;"></p><h4 class="ms-rteElement-H4B" style="box-sizing:border-box;margin-top:10px;margin-bottom:10px;font-weight:700;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">Scientists are still learning if MPX can be spread through:</h4><ul style="box-sizing:border-box;margin-top:0px;margin-bottom:10px;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;"><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Semen or vaginal fluids</p></li><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Contact with people who have no symptoms (we think people with symptoms are most likely to spread it, but some people may have very mild illness and not know they are infected).<br></p></li></ul><p><br></p>
What are the signs and symptoms of MPX?148What are the signs and symptoms of MPX?<p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">MPX often starts with symptoms like those of the flu, with fever, low energy, swollen lymph nodes, and general body aches. Within 1 to 3 days (sometimes longer) after the appearance of fever, the person can develop a rash or sores. The sores will go through several stages, including scabs, before healing. They can look like pimples or blisters and may be painful and itchy.</p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">The rash or sores may be located on or near the genitals (penis, testicles, labia, and vagina) or anus (butt) but could also be on other areas like the hands, feet, chest, and face. They may also be limited to one part of the body.</p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">People with MPX may experience all or only a few of these symptoms. Most people with MPX will get the rash or sores. Sometimes the sores can be in places that are difficult for someone to see.  Some people have reported developing the rash or sores before (or without) the flu-like symptoms.<br></p>
When is MPX contagious?149When is MPX contagious?<p>​<span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">MPX symptoms usually start within 2 weeks (but can be up to 3 weeks) after exposure to the virus. People are thought to be contagious until all sores have fully healed and a fresh layer of skin has formed. This can take several weeks. Researchers are still trying to understand if the virus can spread from someone who has no symptoms.</span><br></p>
Could my pet get MPX?150Could my pet get MPX?<p><span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;">Infected an</span><span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;">imals (mammals) can spread MPX to people, and people who are infected can spread MPX to animals through close contact, including petting, cuddling, hugging, kissing, licking, sharing sleeping areas, and sharing food.</span></p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">People with MPX should avoid contact with animals, including pets, <a href="" style="box-sizing:border-box;color:#0071bc;background-color:transparent;outline:none;">domestic animals, and wildlife</a> to prevent spreading the virus. People with MPX should ask another household member or outside friend/family member to care for pets until the person with MPX is fully recovered.<br></p>
What should I do if I've been exposed to MPX?151What should I do if I've been exposed to MPX?<p>​<span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">Contact a health care provider or your </span><a href="" style="box-sizing:border-box;color:#0071bc;background-color:#ffffff;outline:none;font-family:"source sans pro", sans-serif;font-size:18px;">local health department</a><span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;"> as soon as possible and let them know you have been exposed to MPX. Health care providers and local health departments may recommend a vaccine to help prevent infection or decrease the seriousness of the illness. You also may be asked to monitor for any new symptoms for 21 days after the exposure.</span><br></p>
What should I do if I have symptoms of MPX?152What should I do if I have symptoms of MPX?<p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">Contact a health care provider as soon as possible and let them know you have symptoms so they can test for MPX and provide treatment as needed.<br style="box-sizing:border-box;"></p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">People who have MPX symptoms should ideally isolate away from others until their symptoms have gone away completely and until all sores have healed and a fresh layer of skin has formed.  If needing to be around others, people with MPX should completely cover sores and wear a well-fitting mask.</p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">Standard laundry detergents are appropriate for washing clothes or linens (e.g., bedding and towels) used by someone with MPX.</p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">For more information about isolation and guidance on how to take care while presenting symptoms, please refer to the CDPH <a href="" style="box-sizing:border-box;color:#0071bc;background-color:transparent;outline:none;">MPX Home Isolation Guidance for the General Public</a>.<br></p>
Is MPX a sexually transmitted infection (STI)?153Is MPX a sexually transmitted infection (STI)?<p>​<span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;">Sex is just</span><span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;"> one of the ways that the virus can spread. MPX primarily spreads from skin-to-skin contact, especially close or intimate physical contact such as sex or touching rashes. MPX can also spread contact with contaminated materials like utensils, cups, bedding, towels, clothing or sex toys. </span></p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">Scientists are investigating whether the virus could be spread by exposure to semen or vaginal fluids, but this has not been previously known to be how the virus spreads.</p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">MPX may look like sexually transmitted infections (STIs) that cause a rash on the genitals and anus, including herpes and syphilis. MPX may also cause rectal pain, which is a symptom of proctitis (inflammation of the rectum) and can be seen in other STIs as well. It's always important to talk to a health care provider as soon as you notice unusual rashes or sores or have rectal pain.<br></p>



How is MPX prevented? 154How is MPX prevented? <p>​<span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;">There </span><span style="background-color:#ffffff;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;">are number of ways to prevent the spread of MPX, including:</span></p><ul style="box-sizing:border-box;margin-top:0px;margin-bottom:10px;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;"><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Talking to your sexual partner/s about any recent illness and being aware of new or unexplained sores or rashes on your body or your partner's body, including on the genitals and anus</p></li><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Avoiding close contact, including hugging, kissing, cuddling and sexual activity with people with symptoms like sores or rashes</p></li><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Not sharing materials (e.g., utensils, cups, clothing, towels, bedding) with someone who has symptoms</p></li><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Washing your hands often with soap and water or using an alcohol-based hand sanitizer</p></li><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Using appropriate <a href="" style="box-sizing:border-box;color:#0071bc;background-color:transparent;outline:none;">personal protective equipment (PPE)</a> (like a mask, gown and gloves) when caring for people with symptoms</p></li><li style="box-sizing:border-box;"><p style="box-sizing:border-box;">Avoiding contact with infected animals <br></p></li></ul>



What treatments are available for MPX?158What treatments are available for MPX?<p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">Most infections are mild and will heal without any treatment. Antiviral drugs developed to protect against smallpox, such as tecovirimat (TPOXX), may be used to treat MPX. This treatment may be recommended for people who are more likely to get severely ill, for people who are experiencing severe disease, or those who have rash and sores in areas that are at risk for severe complications, such as eyes or genitals.<br style="box-sizing:border-box;"></p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">People who may be at risk for more severe illness include those with a weakened immune system, children (particularly those less than 8 years), those who are pregnant or breastfeeding, and those with a history of certain skin diseases like eczema.</p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">It is important to talk to your health care provider if you have symptoms of MPX and are experiencing pain or irritation due to the rash or sores. Your provider may be able to also offer treatments that are not specific to MPX, but may help to reduce your symptoms, like prescribed mouth rinses, stool softeners for those with rectal pain, or topical gels or creams.<br></p>


JYNNEOS Vaccine for Monkeypox Exposure



What is CDPH doing about mpx?159What is CDPH doing about mpx?<p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">CDPH has activated our public health response coordination center and is closely monitoring MPX transmission in the U.S. and California to ensure rapid identification of cases. CDPH is working with local health officials and CDC to ensure appropriate care and response, including outreach and communications, laboratory testing, contact tracing, obtaining vaccine to support local vaccination efforts for people who may have been exposed and making antiviral treatment more widely available in California.</p><p style="box-sizing:border-box;color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">Additionally, CDPH is promoting awareness amongst health care providers and the public about appropriate testing and infection control when patients with suspected MPX disease are cared for in healthcare settings. CDPH is working to help health care providers and the public become familiar with the symptoms and appearance of MPX.<br></p>
Where can I find more information?160Where can I find more information?<p>​<span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;">Visit our </span><a href="" style="box-sizing:border-box;color:#0071bc;background-color:#ffffff;outline:none;font-family:"source sans pro", sans-serif;font-size:18px;">Community Resources</a><span style="color:#202020;font-family:"source sans pro", sans-serif;font-size:18px;background-color:#ffffff;"> page for more information.</span><br></p>

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