Mpox (formerly known as monkeypox) is a disease caused by a virus in the same family as the smallpox virus. In the ongoing global outbreak, most cases have been linked to sexual contact between men, but anyone in close contact with an infected person can get mpox.
Keystone Infectious Disease’s Medical Director, Dr. Raghavendra Tirupathi, and medical students studying under him, Navyatha Annareddy, Nayanika Tummala and Jugalkishor Chauhan, share what you should know about mpox in today’s Take Care article.
What is mpox?
Mpox is a virus that can cause a painful, itchy rash and flu-like symptoms. Although mpox can cause a rash that goes through several stages before healing, it is unrelated to chickenpox. The virus is most often found in men who have sex with other men, but the virus can be spread to anyone through various types of non-sexual contact as well. It can even spread between animals and people, with small rodents, monkeys and other mammals in Central and West Africa known to carry it.
Two types of the mpox virus exist: clade I and clade II. Clade II, which is less severe, is causing the current outbreak in many countries, including the U.S., while clade I has not been reported in the U.S. Clade II continues to spread at low levels, mainly through intimate contact. The good news is that over 99% of people who get clade II mpox recover. It’s essential to know that even if you don’t fall into a high-risk group, you should still be aware of the symptoms and take precautions to avoid close contact with those who may have mpox.
How does it spread?
Mpox spreads mainly through direct skin-to-skin contact, kissing or sexual activity with an infected person, or through their blood or other bodily fluids. Although rare, it can also spread through respiratory droplets, so prolonged face-to-face contact with someone with mpox may spread the virus. Coming into contact with contaminated surfaces, like bedding or clothing an infected person uses, can lead to transmission as well. In some areas, people can get mpox from handling infected animals or eating undercooked meat.
It’s important to note that mpox is not easily spread through the air like COVID-19. It’s also not transmitted through water in pools or hot tubs when properly chlorinated.
Who’s at risk?
While anyone can contract mpox through close contact, some groups are at a higher risk of severe illness, including those with weakened immune systems (like individuals with HIV/AIDS), children under 1-year-old, people with a history of eczema and those who are pregnant. Taking extra precautions is essential for these groups.
Additionally, people living with or caring for someone with mpox, including household members or intimate partners, and healthcare workers handling bodily fluids or sores are at a higher risk of contracting the virus. In endemic areas, children are particularly vulnerable to severe illness.
Children are susceptible to more severe rashes and fever from mpox. The virus in younger populations can lead to more serious complications due to their developing immune systems. Early intervention and diagnosis are crucial in preventing complications in children.
What are the symptoms?
The initial symptoms of mpox typically include fever, chills, headache, muscle aches, fatigue and swollen lymph nodes, which can occur in the neck, armpits or groin. These early signs can appear before any rash develops.
A rash usually appears one to three days after the fever starts, initially forming on the face and then spreading to other areas such as the hands, feet, chest, mouth and near the genitals, including the penis, testicles, labia, vagina and anus. The incubation period for mpox is between three to 17 days, during which an infected person may feel fine and show no symptoms.
How is it prevented?
To protect yourself and your family from mpox, avoid close skin-to-skin contact with anyone showing rashes or blisters. Do not share personal items like clothing, towels or bedding, and practice regular handwashing with soap or alcohol-based sanitizer.
If someone in your household is infected, ensure they are insulated in a separate room and limit direct contact. Clean frequently-touched surfaces and wash contaminated laundry separately. Avoid kissing, hugging, cuddling or sexual activities with infected individuals, as these increase transmission risk. A vaccine is also available, which is crucial for high-risk people, such as close contacts or travelers to outbreak areas. Consult your healthcare provider about vaccination options.
How is it diagnosed?
Diagnosis is performed by swabbing the rash, and results are typically ready in two to four days. These tests are accessible through health departments and commercial labs. If you develop a new or unexplained rash or symptoms after possible mpox exposure, visit a healthcare provider for evaluation. Testing is typically recommended only if you have a rash that resembles mpox. During your visit, wear a mask and avoid close contact with others until evaluated.
How is it treated?
For most people, the main treatments for mpox focus on supportive care and pain management. It’s important to seek help early, especially for pain from rashes, blisters or sores. Individuals with weakened immune systems or other health issues may need extra care, as mpox can lead to severe problems such as eye infections or skin issues that affect daily life. A drug called tecovirimat can treat severe cases using specific protocols. Additionally, children and teenagers exposed to mpox may be eligible for preventive treatments including vaccines or special medications, to help protect them.
Who should get vaccinated?
Vaccines are crucial for preventing mpox by preparing your body to fight the virus if you’re exposed.
The JYNNEOS Vaccine protects against both mpox and smallpox, and is a two-dose vaccine given four weeks apart. Full protection is achieved two weeks after the second dose.
If you are traveling to areas with high rates of mpox transmission, start your vaccination at least 6 weeks before traveling. If you miss your second dose, get it as soon as possible to complete the series.
The vaccine is especially recommended for individuals at higher risk, including men who are gay, bisexual or have sex with men, transgender individuals with multiple partners or recent STIs, and anyone in close contact with someone diagnosed with mpox — ideally vaccinated within four days of exposure. Vaccination within 14 days can still help reduce illness severity.
What are the side effects?
Most people tolerate the JYNNEOS vaccine well. Common side effects include pain, redness or itching at the injection site, and symptoms such as fever, fatigue or muscle aches. These symptoms are usually mild and how that your body is building protection.
Vaccination is a vital step in safeguarding individual health and community wellbeing for those who have recently been exposed or belong to high-risk groups. For guidance on whether the mpox vaccine is appropriate for you, contact your local health department or healthcare provider.
Common concerns and misconceptions about vaccination
Some people believe they must get vaccinated even after recovering from mpox. If you’ve already had mpox, your body has developed immunity, and reinfection is rare and typically milder.
Many people think they are fully protected after just one dose of the JYNNEOS vaccine. However, to achieve the best protection, completing both doses as recommended is important. There is a misconception that a booster dose is required after the two initial doses. Current guidelines only recommend the two-dose series; no extra booster is necessary.
While men who have sex with men and transgender individuals are at higher risk, anyone who has had close contact with someone infected or is otherwise exposed to mpox should consider getting vaccinated, regardless of their gender identity.
It’s important to understand that even after vaccination, taking precautions like avoiding close skin-to-skin contact with someone with mpox is still crucial to minimize the risk of spreading the virus.
Key takeaways on mpox
Mpox (formerly monkeypox) is a viral disease related to smallpox, causing flu-like symptoms and a rash. It primarily spreads through close skin-to-skin contact, bodily fluids and contaminated surfaces. It is not easily transmitted through the air or water. Avoid close contact with infected individuals, maintain good hygiene and consider vaccination if you are high risk.
Early signs include fever, chills, headache and swollen lymph nodes, followed by a rash that develops one to three days later. Consult a healthcare provider if you develop a rash or symptoms after possible exposure to mpox. Supportive care is key, and severe cases may need antiviral treatment. Early intervention is essential, especially for children.
The JYNNEOS vaccine requires two doses for full protection and is recommended for high-risk individuals.
This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.
