If you’ve been reading the news or scrolling through social media, you’re probably encountering conversations about monkeypox. The World Health Organization (WHO) recently declared that monkeypox is a public health emergency of international concern. Unfortunately, there’s a LOT of misinformation going around about this disease, how it spreads and who can get it. Here are some answers to frequently asked questions about monkeypox.
What Is Monkeypox?
Monkeypox is part of the same family of viruses that causes smallpox. It was discovered in 1958 when outbreaks occurred in captive monkey colonies. That’s where the name “monkeypox” comes from. The initial source of disease remains unknown.
According to the Centers for Disease Control (CDC), the first human case of monkeypox was recorded in 1970. Monkeypox has been endemic in some Central and West African countries for decades, and there have been a few smaller outbreaks in Europe, Asia and North America due to human-to-human or animal-to-human transmission. The current monkeypox outbreak marks its largest international spread.
Monkeypox is rarely fatal, but the CDC reports that people with weakened immune systems, children under the age of eight, people with a history of eczema and people who are pregnant or breastfeeding may be more likely to become seriously ill or die from monkeypox. As of the writing of this article, the WHO reports that in 2022, there have been roughly 16,800 confirmed cases globally. Remember that these are only the confirmed cases — some experts believe that the numbers are much, much higher than that, because our testing capabilities are limited (more on that later).
What Are the Symptoms of Monkeypox?
According to the CDC, symptoms of monkeypox can include fever, headache, body aches, chills, swollen lymph nodes, exhaustion and, most notably, a rash. The rash might look like pimples or blisters that can appear anywhere on the body. Those pimples or blisters might also appear inside the mouth, vagina or anus. Some infected people only experience a rash, while others experience a rash along with other symptoms. Some patients report that the rash is extremely painful. Monkeypox symptoms typically last two to four weeks. The WHO reports that monkeypox can sometimes lead to other complications, such as bronchopneumonia, sepsis, encephalitis, eye infections that may cause vision loss and other secondary infections.
Is Monkeypox a Sexually Transmitted Infection?
No. In an interview with CNBC, WHO advisor Andy Seale explained, “Many diseases can be spread through sexual contact. You could get a cough or a cold through sexual contact, but it doesn’t mean that it’s a sexually transmitted disease.” According to the WHO, monkeypox is transmitted through close contact with an infected person. Sex is only one form of close contact.
How Is Monkeypox Transmitted Between Humans?
Monkeypox can be spread through kissing, coughing, sneezing, touching and sharing clothes or bedding. That’s because human-to-human transmission can result from contact with skin lesions on an infected person, contact with recently contaminated surfaces and contact with respiratory secretions. The WHO reports that transmission via respiratory particles “usually requires prolonged face-to-face contact, which puts health workers, household members and other close contacts of active cases at greater risk.” Some researchers have been noting that different potential transmission routes probably carry different levels risks. For example, having sex with someone who has monkeypox — which typically involves all-over skin-to-skin contact and prolonged contact with another person’s respiratory particles — carries more of a transmission risk than touching a contaminated surface.
Who Can Get Monkeypox?
Anyone can get monkeypox. Many cases in this current outbreak are occurring in men who have sex with men, which has led some people to believe that people of other genders and orientations are not at risk. This is not the case.
“The language used by the media reporting on monkeypox needs to be rooted in science, not stigma,” Gay Men’s Health Crisis (GMHC) said in a recent statement. “Rhetoric and click-bait headlines that state or imply that monkeypox is a ‘gay’ or ‘bisexual’ disease is dangerous because it misinforms the public about who is at risk and how the virus is spread.” The UN also put out a statement in May warning that racist and homophobic coverage of monkeypox reinforces stereotypes and increases stigma, which can undermine efforts to reign in the outbreak.
Again, anyone can get monkeypox. That said, it’s important to acknowledge the reality that right now, gay, bi and queer men are at a higher risk of contracting monkeypox than other people who live in areas where monkeypox is not currently endemic. It’s easy for a virus to spread in any tightly-knit community that engages in a lot of close contact, whether that close contact looks like having sex, dancing shirtless in a crowded gay bar, hosting gatherings with other community members or something else.
What Should I Do If I’ve Been Exposed to Monkeypox or If I Have Monkeypox Symptoms?
If you’ve been exposed to monkeypox, get a smallpox vaccine (either an MVA vaccine, which is also known as Jynneos in the US, or an ACAM2000 vaccine) as soon as possible if you can. According to the CDC, getting vaccinated within four days of exposure may prevent the onset of the disease. Getting vaccinated within four to fourteen days of exposure may not prevent you from contracting monkeypox, but it might ease symptoms. Talk to your healthcare provider about which vaccine would be best for you. ACAM2000 vaccines are not safe for people with compromised immune systems and certain health conditions. There is currently a shortage of MVA vaccines, so access is limited.
You may not experience symptoms right away if you’ve contracted the illness, since monkeypox has an incubation period of roughly one to two weeks before symptoms arise. According to the CDC, an infected person is not contagious during the incubation period. If you’re experiencing symptoms of monkeypox, immediately isolate from other people and pets, especially if you have lesions. Then contact a healthcare provider and ask to get tested.
Unfortunately, when it comes to testing, you might run into some roadblocks. Time reports that currently, swabbing a lesion is the only reliable way to test for monkeypox. If you do not have lesions, you might still have monkeypox, but you won’t be able to get tested until lesions develop. Additionally, testing sites and labs that read monkeypox tests are limited, so even if you do have lesions, you might not be able to get tested right away. On top of that, current tests can only detect orthopoxvirus, which is the family of viruses monkeypox belongs to. Any positive orthopoxvirus tests have to be sent to the CDC. Then the CDC has to confirm whether or not the orthopoxvirus is monkeypox. This process can take multiple days.
If you do have monkeypox and your symptoms don’t necessitate hospitalization, your healthcare provider will likely recommend that you rest and continue to isolate until all lesions have resolved in accordance with CDC guidelines.
How Is Monkeypox Treated?
Many cases of monkeypox resolve on their own, but some require treatment and/or hospitalization for severe symptoms or pain management. The US Food and Drug Administration has not approved any treatments specifically for monkeypox. The antiviral drug tecovirimat, or TPOXX, is being used to treat some high-risk patients and those who are experiencing severe symptoms, but many people are struggling to access the medication.
How Can I Protect Myself from Contracting Monkeypox in the First Place?
If you are in a high-risk group, get a smallpox vaccine if you can. Talk to a healthcare provider to determine which vaccine would be safest for you. Again, there is currently a vaccine shortage, so access is limited. Talk to a doctor or check with your local health department or LGBTQ+ center to find a vaccination site near you.
Whether you are vaccinated against smallpox or not, there are other ways you can reduce your risk. Avoid crowded spaces when possible. Limit your physical contact with others. Wash your hands after touching shared surfaces and before eating. Don’t share food or beverages with others. Avoid sharing clothes or bedding with others when you can. At one point, the CDC recommended wearing masks to reduce the risk of contracting monkeypox, but that advice was later removed from the CDC website because they felt the message was “confusing.” We know that monkeypox can spread through respiratory particles, so wearing a mask in public spaces, on public transportation and around those with suspected or confirmed monkeypox would probably provide some protection (and hey, we should all be doing this anyway to protect ourselves and our most vulnerable community members from COVID, right?). If you want to learn about some monkeypox risk reduction strategies that you can apply to your sex life, this POZ article offers some helpful suggestions.
Should We Be Worried?
Probably. This is the largest international spread of monkeypox. Testing is limited. Vaccines are limited. Contact tracing is limited. And in the US, based on the way our country has blundered other public health emergencies that disproportionately impact marginalized communities (HIV/AIDS, COVID-19), we could be in for a wild and terrible ride.
thanks for this, ro. definitely sobering, but your clear explainer is sorely lacking in the broader media landscape and is so appreciated.
Yeah, thank you! I just finnnally clicked an npr link about it yesterday, and while reputable, it wasn’t getting at what mattered most to me, and your article really does!
Thank you for this.
Really appreciate this clear and straightforward explainer – I didn’t even know that monkeypox was not an STI until I read this. Thanks Ro!
Thank you Ro! This pairs well with the Anti-Racism Daily newsletter for today:
Thank you for this informative article.
Thank you for this! I definitely did not know all the facts. Am I feeling very stressed now about having to get on a plane to go home tomorrow? Yes, but I was already because of Covid. What a world we live in…
thank you for this ro! i’ve been stressing about monkeypox since the first cases were reported in march/april and it’s been incredibly frustrating seeing disability activists and queer activists mobilizing and getting information out while government organizations sit on their asses and do nothing. there have been so many stories of people going to their doctors saying “i want to be tested for monkeypox” and the doctors saying “what is that?” or “i don’t think you need a test” and after several visits to several providers the person did indeed test pos for monkeypox
also vaccine availability! the smallpox vaccine exists, we don’t have to invent it wholesale like the covid vax, but somehow we aren’t to the point of manufacturing more yet? i know it’s more complicated than that but this feels very reminiscent of early aids epidemic- “it’s just this expendable group getting it so why bother to invest resources”
Thank you for this!! At this point I just really wanna know like…do I need to start bringing my own lysol wipes to use public restrooms? Before touching subway poles? Do I need to, like, bleach sheets if I have a guest come stay?
I feel like the total bungling of messaging around COVID, especially early on (it’ll be fine, it’ll be just like the flu, it’s not in our country yet and won’t spread here, etc…) is making me super paranoid that I need to be, like, 10x more cautious than the CDC is actually recommending :( which is hard on top of continuing COVID anxiety mostly keeping me inside the house anyway.
Oof, I hear ya! I wish I had the answers to these questions. And I absolutely agree that the messaging around COVID makes it hard to trust what the CDC is telling us right now. I totally get why you’re worried — I am, too.
If this helps, based on the studies I looked at when writing this article, it seems like different potential routes of transmission carry very different degrees of risk. To me, it seems like the most important thing we can all do right now to keep ourselves safe is to have open and honest communication about any symptoms we might be having (most importantly: any bumps or rashes) with the people we physically touch, whether those are friends, partners or coworkers. And those of us who are eligible to get the smallpox vaccine can do that, too! Hopefully, we’ll have more vaccine doses available in the near future.
is it too much of an oversimplification to say, for myself (not for other people!!!) that my covid precautions also cover monkey pox? like, if i don’t share airspace or skin or food outside my pod, which protects me from covid, that’s also covering the ways monkeypox spreads. . . obv nothing is 100%.
Glad to see this being discussed here! A couple of notes –
There’s been a lot of atypical presentation – cases that only have a single lesion, or don’t have the accompanying flu-like symptoms. Don’t brush off symptoms just because you don’t have a textbook pox rash.
MPX is very stable on surfaces, living for weeks (at least). Use alcohol or hypochlorous acid. Clothes can be disinfected with OxiClean or a quaternary laundry sanitizer.
It IS airborne, so wear a mask in any public spaces. But, hopefully, you were already doing that.
Do you have a source for that survival rate outside of the body? Cause generally virusses can’t survive for long outside of a host cell, since they can’t reproduce.
And a source for your other points would also be great :)