Monkeypox spreads between people primarily through direct contact with infectious sores, scabs, or body fluids. It also can be spread by respiratory secretions during prolonged, face-to-face contact. Monkeypox can spread during intimate contact between people, including during sex, as well as activities like kissing, cuddling, or touching parts of the body with monkeypox sores. At this time, it is not known if monkeypox can spread through semen or vaginal fluids.

Anyone who has had close, prolonged contact with someone who is infected with Monkeypox or who have touched contaminated objects/materials (clothing, bedding, towels, eating utensil and dishes) are at risk of becoming infected.

Symptoms may be similar to smallpox but less severe. Factors such as age, type of exposure, compromised immune system, and previous immunity from smallpox vaccination can impact severity of symptoms. Most people experience mild illness and recover on their own after a few weeks. However, in some situations people may become very sick.

Symptom onset can take place anywhere from 5 to 21 days (commonly 7-14 days) after being exposed to the monkeypox virus. Symptoms occur in 2 stages and typically last from 2 to 4 weeks.

In stage 1, symptoms may include:

• fever
• chills
• swollen lymph nodes
• headache
• muscle pain
• joint pain
• back pain
• exhaustion

In stage 2 of the illness:

A rash develops – usually within 1 to 3 days (sometimes longer) after the fever starts. The rash often starts on the face or extremities however it can affect other parts of the body, such as the hands, feet, mouth, and genitals. The rash usually lasts between 14 and 28 days and changes through different stages before finally forming a scab which later falls off.

Monkeypox is diagnosed based on a combination of factors, such as:

• signs and symptoms
• laboratory testing
• risk factors such as
  • exposure to a case
  • travel history

A diagnosis must be made by a healthcare provider. Swabs of affected tissues or sores should be taken.

Treatment involves supportive symptom management, including adequate nutrition and fluid intake. There is currently no specific treatment for Monkeypox. In most cases, the disease is mild and self-limiting. In more severe cases, anti-viral medication used to treat smallpox may be prescribed. Previous vaccination for smallpox can provide some protection from infection with Monkeypox or help reduce the severity of symptoms. In some cases, the vaccine for smallpox may be administered to close contacts for post-exposure prophylaxis.

Anyone who develops symptoms of Monkeypox should be assessed by a health care provider as soon as possible.