These decisions come after monkeypox cases started spreading rapidly around the world earlier this year. Previously, the virus—a relative of smallpox—had been endemic to certain countries in West and Central Africa. (It was initially discovered by lab researchers in Denmark in 1958.) The disease can be contracted by anyone of any age, gender, sexuality, race, or ethnicity, says Michelle Forcier, MD, MPH, staff clinician at LGBTQ+ telehealth startup FOLX, and professor of pediatrics and assistant dean of admissions for the Alpert School of Medicine at Brown University. (That said, the vast majority of reported cases are among men who have sex with men, per WHO data.)
- Michelle Forcier, MD, MPH, Michelle Forcier, MD, MPH, is a professor of pediatrics and assistant dean of admissions at The Warren Alpert Medical School of Brown University. She specializes in sexual health care and is also a staff clinician at FOLX Health.
Many misconceptions and myths about monkeypox have been swirling as the outbreak continues to grow in size. For example, people wrongly assume that because the majority of reported cases are currently among men who have sex with men, the disease is sexually transmitted—even though that’s not the case, says David C. Harvey, executive director of the National Coalition of STD Directors.
So what is the truth about monkeypox and how it spreads—and how can you protect yourself from it? Experts are still learning about this particular variant of the virus, so information may evolve over the coming weeks and months. But here’s what we know now about how to prevent monkeypox and keep it from spreading in your circles.
How does monkeypox spread—and what does it look like?
There are a few ways that monkeypox can spread from person to person—some of which scientists are still figuring out. But in general, "monkeypox is predominantly spread among humans from close skin-to-skin contact—such as persons living closely together in the same household, sharing a bedroom, cuddling, or having sex," says Dr. Forcier. The disease can cause a rash or scabs, and touching those can allow the virus to spread. Hugging, kissing, massage, and extended face-to-face time all count as close contact, per the Centers for Disease Control and Prevention (CDC). Pregnant people infected with monkeypox can transmit it to their fetus, or to their babies through post-delivery skin-to-skin contact.
The virus can also be spread via fomites, aka linens, bath towels, and clothing used or worn by a person infected with monkeypox. Same goes with eating utensils used by someone with monkeypox, since the virus can spread through saliva. As a zoonotic disease—meaning it is spread from animals to humans—the monkeypox virus can also proliferate through contact with an infected animal's body fluids, according to the WHO.
There are still some unknowns on how monkeypox is transmitted—particularly this new strain, which is spreading more rapidly and widely than older iterations of the virus. For example, while experts state that a person is infectious at the onset of symptoms, scientists don't know at present if it can be spread by asymptomatic people. It's also unclear whether it can be spread through semen or vaginal fluids, per the CDC and WHO.
As for how monkeypox manifests, this virus presents a range of symptoms that differ between individuals. According to the CDC, monkeypox can cause a fever, headache, swollen lymph nodes, and a painful, blistering rash on the genitals, hands, feet, face, or chest. In more serious cases, a person can get rashes or lesions around or on their eyes. But it can take a long time for symptoms to show up after you’re infected. "The incubation period of monkeypox infection is typically five to 13 days, but can range from four to 21 days,” says Dr. Forcier. It also can take a while to recover, she says. "Over time—now estimating as much as four weeks post original exposure—the rash crusts over, and the scabs fall off. This part usually happens seven to 14 days after the rash starts.”
How to protect yourself and others from monkeypox
The monkeypox virus is spreading rapidly in the U.S., and yet the federal- and state-led efforts to contain it remain slow. (Just today, two officials from the CDC and the Federal Emergency Management Agency were named to head a response to the virus.) As such, individuals are unfortunately still on their own when it comes to protecting themselves from the disease. And again, we're still figuring out if it can spread through additional means, which will influence mitigation strategies. But here's what is known about how to prevent monkeypox and keep it from spreading.
1. Wash your hands regularly and avoid touching your eyes or mouth
This should come as no surprise to us given the past two-plus years of dealing with COVID-19. Since monkeypox is spread through close skin contact (you know, touch!) with an infected person, wash your hands often with soap and water before and after eating, before touching your face, and after every time you use the bathroom. An alcohol-based hand sanitizer can work in a pinch, too.
2. Avoid people currently infected with monkeypox
Maintaining physical distance and avoiding contact with persons exposed to or known to have monkeypox seems to help reduce your risk of getting the virus, says Dr. Forcier. If someone in your household gets monkeypox, they should self-isolate, wear a mask, and wear clothing that covers their rash, she says. If you have to be around them—say bringing them food or washing their linens—the UN recommends wearing a mask and gloves (and disposing of them after every use). Clean and disinfect their living area and items they’ve used with warm water and detergent.
3. Be mindful of the potential risk of certain public and private gatherings
The CDC recommends considering how much close, personal contact you’ll get at certain events. Festivals and concerts where folks are fully clothed, for example, are likely safer from a monkeypox standpoint than going to a party or club where people are wearing less clothes and/or pressed up against each other for extended periods of time.
4. Isolate yourself if you start having symptoms
If you think you’ve been exposed to monkeypox—say, you were at a party and find out later a person you hung out with had monkeypox—you should monitor for symptoms for 21 days after that exposure. You can go about your daily activities, but if symptoms develop (like an unexplained rash), you should immediately self-isolate and contact the health department for further guidance, Dr. Forcier says.
5. Check in with your sexual partner(s)
"If you are someone in a social group that is seeing increased monkeypox infection and activity, check in with sexual partners about exposure or symptoms,” says Dr. Forcier. Remember, while monkeypox is not a sexually-transmitted infection, it can be transmitted through close skin-to-skin contact…which, you know, is a hallmark of sex. “If there is an exposure or symptoms, holding off on sex for the time being not just stops the spread of Monkeypox, but helps you avoid being infected too," she says. The same goes for asking about other infectious symptoms, be it monkeypox, COVID-19, or the common cold. And if you or a partner gets monkeypox, the WHO recommends that you use condoms consistently during any sexual activity for 12 weeks after recovering.
6. Get vaccinated for the disease if you are eligible and in an area of distribution
There are two vaccines that can be used to prevent monkeypox. The CDC recommends people who are at increased risk of monkeypox (including public health workers and close contacts of someone with monkeypox) should get vaccinated. Currently, Dr. Forcier says that the vaccine is being locally distributed in places like New York, San Francisco, and Chicago, but broader bigger picture vaccination plans have yet to be identified or laid out by the CDC. Contact your local health department for information on the vaccine as well as who specifically is eligible in your state or city.
7. Talk about it with your personal networks
Making sure community and social groups know about monkeypox can also help reduce its spread. While local health departments are responsible for these education efforts, you can help by talking to friends, posting signs with information at public places like the library, the gym, and bars or clubs, or sharing accurate information on social media.
Efforts to decrease stigma or shame about any sort of illness and infection are important so that people can show an interest in learning more, ask important questions, and get care early if they need it, adds Dr. Forcier. "Viruses do not care about who you are, what you do, who you love. Viruses tend to be opportunistic and spread wherever and whenever they can,” says Dr. Forcier—and monkeypox is no exception. The best way to prevent MPX is to have open and honest communication with people who are close to you. Ask questions, check in on family members or sexual partners' health, and if there is an exposure or risk of infection for any virus, then act in ways that reduce your own risk and the risk of spread to others.
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