Monkeypox: Symptoms & How It Spreads

What is monkeypox?

Monkeypox is a virus that causes fever, body aches, fatigue, and headache. These symptoms are followed by a skin rash that can last for 2–3 weeks. Monkeypox can be passed from person to person, usually through close, skin-to-skin contact.

Most people who get monkeypox have a mild illness and recover on their own. But some higher risk groups of people, including those with compromised immune systems, may be prescribed antiviral medications.

The form of monkeypox that’s currently spreading is rarely deadly. But it is possible to develop serious complications of the virus, like severe scars, vision problems, or pneumonia.

Symptoms

The monkeypox virus first causes flu-like symptoms that last for about 5 days. They include:

• Fever
• Body aches
• Fatigue
• A throbbing or achy headache
• Sore throat, runny nose, cough
• Swollen and lymph nodes

It may be hard to tell whether these symptoms are caused by monkeypox or other viruses like the flu, COVID, or a common cold. But after a few days, a rash develops. It can appear anywhere on the body, including the mouth, genitals, anus, and rectum. You may just develop a few sores, but some people have many sores.

The rash looks like spots that:

• Are smaller than a pencil eraser
• Are flat at first, but later can become filled with clear fluid or pus
• Usually are painful

The main way the virus spreads is through contact with the rash or the fluid inside of the sores. Eventually the spots become crusty, and at that point you’re probably no longer contagious. Still, people should avoid touching monkeypox scabs.

When to worry about monkeypox

Symptoms of monkeypox can often be treated at home. But you should go to the ER if you develop the following signs of a serious or life-threatening complication:

• Severe chest pain
• Severe shortness of breath
• Vomiting many times or not able to keep fluids down
• Confusion
• Extremely severe headache
• Stiff neck
• New area of hot, red, or swollen skin

Causes

Monkeypox is caused by a virus. You can be exposed through close contact with an infected person or animal. The virus is usually spread by direct contact with the rash or an infected person’s saliva. Men who have sex with men have had a higher rate of infection during the current outbreak. But anyone can get monkeypox, regardless of their sexual orientation, since any close sexual or skin-to-skin contact with an infected person can spread the virus.

The virus also seems to spread by touching surfaces, objects, clothing, and bedding that someone with infectious monkeypox sores has touched. This virus does not seem to spread through the air or other body fluids, but scientists are still doing research to better understand how it spreads.

Preventative tips

You may have some protection from monkeypox if you had the smallpox vaccine when you were young. Doctors and scientists think it may be because smallpox and monkeypox viruses are very similar. However, smallpox was wiped out in the 1980s, so the vaccine isn’t commonly given anymore. As a result, most people today aren’t protected from monkeypox.

Effectiveness of Smallpox Vaccination Against Monkeypox

The smallpox vaccine has shown some effectiveness in protecting against monkeypox infection. According to the Centers for Disease Control and Prevention (CDC), data from Africa suggests the smallpox vaccine is at least 85% effective in preventing monkeypox. This is because monkeypox and smallpox are closely related viruses, both belonging to the orthopoxvirus family. However, the level of protection may vary, especially for those who received the smallpox vaccine many years ago as children. While older adults vaccinated against smallpox may still be susceptible to monkeypox infection, they are likely to experience milder symptoms if infected. It's important to note that routine smallpox vaccination in the United States ended in 1972, so many adults do not have this potential protection. For those at high risk of monkeypox exposure, getting vaccinated with newer vaccines specifically approved for monkeypox is still recommended.

There is a monkeypox vaccine available, but supplies are limited. You may be eligible for the vaccine if you’re at very high risk for catching monkeypox. This includes people who have had multiple sexual partners in the past 2 weeks and live in an area where there are active cases of monkeypox, some healthcare workers, and people who work in a laboratory that handles monkeypox. You may also get the vaccine if you believe you were exposed to the virus. Call your doctor or the local health department and ask if you’re eligible for the vaccine.

Other ways to reduce your likelihood of getting monkeypox include:

• Don’t have skin-to-skin contact or sex with anybody who feels sick, has a fever, or has a rash in any location. Keep in mind that you can catch monkeypox from an infected person before the rash appears.
• Avoid touching anything used by someone with monkeypox, including cups, utensils, bedding, towels, and clothing.
• Practice good hygiene. Wash your hands frequently, especially before eating or touching your face and after using the bathroom. When you’re not near a sink, use an alcohol-based hand sanitizer.
• If you’re planning to travel internationally, check for travel alerts. Avoid touching or holding wild animals, especially monkeys and rodents.