Mpox is a rare disease caused by infection with the monkeypox virus. Monkeypox virus is part of the same family of viruses as variola virus, the virus that causes smallpox. Mpox symptoms are similar to smallpox symptoms, but milder, and mpox is rarely fatal. Mpox is not related to chickenpox.

Mpox was discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research. Despite being named “monkeypox,” the source of the disease remains unknown. However, African rodents and non-human primates (like monkeys) might harbor the virus and infect people.

The first human case of mpox was recorded in 1970. Prior to the 2022 outbreak, mpox had been reported in people in several central and western African countries. Previously, almost all mpox cases in people outside of Africa were linked to international travel to countries where the disease commonly occurs or through imported animals. These cases occurred on multiple continents.

There are two types of monkeypox virus: Clade I and Clade II. Infections in the current outbreak are from Clade II, or more specifically, Clade IIb.

Infections with Clade IIb are rarely fatal. Over 99% of people who get this form of the disease are likely to survive. However, people with severely weakened immune systems, children under 1 year of age, people with a history of eczema, and people who are pregnant or breastfeeding may be more likely to get seriously ill or die.

The Clade I type of monkeypox virus has a fatality rate around 10%.

The monkeypox virus (mpxv) is part of the Orthopoxvirus genus, which also includes variola virus (the cause of smallpox), vaccinia virus, and cowpox virus. It causes mpox disease, formerly known as monkeypox disease. Although mpox is similar to smallpox, it is much less deadly. Initial symptoms of mpox include: fever, headache and body aches, fatigue, and swollen lymph nodes, followed by a rash of lesions on the skin. Human-to-human transmission of mpxv occurs through direct contact with body fluids, lesions, prolonged face-to-face contact, including sexual contact, and indirect contact with contaminated clothing or bedding. 

The virus was first discovered in 1958 in two outbreaks of a pox-like disease among colonies of research monkeys. The first human case of mpox was recorded in 1970 in the Democratic Republic of the Congo (DRC). The disease is endemic in central and western Africa.

2022 Outbreak

In 2022, an outbreak of cases began occurring in multiple countries where mpox had not normally occurred, including the United States. Gay, bisexual, and other men who have sex with men comprise a high number cases; however, anyone who has been in close contact with someone who has mpox is at risk for infection.

Mpxv virus variants are referred to as clades: Clade I (formerly known as the Congo Basin or Central African clade) and Clade II (formerly known as the West African clade). Clade II is further divided into subclades: Clade IIa and Clade IIb. According to the World Health Organization, cases identified as part of the ongoing global outbreak are largely caused by Clade IIb. Clade I is responsible for infections in the DRC and is estimated to cause more severe disease and higher mortality than Clades IIa and IIb.

(Ortho: from Greek orthos, “straight”)

The genus Orthopoxvirus contains a number of species that can infect animals and humans. The most well known member of the genus is variola virus, the causative agent of smallpox. Other notable members include vaccinia virus which is used in the current smallpox vaccine; cowpox virus, first introduced by Edward Jenner in the late 18th Century as the material of the first vaccine; and monkeypox virus.

Orthopoxviruses

• Camelpox virus
• Cowpox virus
• Ectromelia virus
• Horsepox virus
• Monkeypox virus
• Raccoonpox virus
• Skunkpox virus
• Taterapox virus
• Uasin Gishu virus
• Vaccinia virus (smallpox vaccine)
• Variola (smallpox) virus
• Volepox virus

What is mpox?

Mpox is a rare disease.

• If you get mpox, you may have fever, chills, sore muscles, headache, or tiredness and then get a rash.
  • Sometimes, you may get a rash first, followed by other symptoms.
  • You might only get a rash without having the other symptoms. The rash may look like pimples or blisters.
  • The rash is usually on the face, inside the mouth, and on other parts of your body like your hands, chest, and genitals.
• Even though you should get better in 2-4 weeks, you should see a healthcare provider as soon as you get symptoms that could be from mpox.
• If you have a weakened immune system (from HIV, cancer, an organ transplant, or other reason), are pregnant, or have other skin problems like eczema, you may become more severely ill from mpox.

How do you get mpox?

Mpox does not spread easily between people.

• You can get mpox from close, skin-to-skin contact with a person who has a rash or scabs from mpox.
  • For example, this can include during hugging, cuddling, a massage, or close contact sports.
• It also includes contact with spit droplets during close conversation and kissing.
• It can also spread through sexual contact including touching the genitals, and oral, anal, or vaginal sex.
• You can also get mpox from contact with objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with mpox.

What can I do to protect myself?

The best way to protect yourself from mpox is to avoid skin-to-skin contact with anyone who has a rash that looks like mpox.

• If you know that a friend or family member has been diagnosed with mpox:
  • Try to avoid contact with them if possible.
  • If you must be within 6 feet of them, you should wear a respirator or well-fitting mask and they must wear a well-fitting mask.
  • Do not share silverware or cups.
  • Do not touch their sheets, blankets, towels, or clothing. If you do touch any of these things, you should wash your hands with soap and water or use an alcohol-based hand sanitizer.
• If you are sexually active:
  • Talk to your partner about any recent illnesses.
  • Be aware of any new or unexplained rashes on your body or your partner’s body, including the genitals and butt.
  • If you or your partner have recently been sick, currently have symptoms of mpox, or have a new or unexplained rash, do not kiss, cuddle, hug, touch each other’s genitals, or have oral, vaginal, or anal sex.

What should I do if I think I have mpox?

If you have a new or unexplained rash or other symptoms of mpox, see a healthcare provider or your school health clinic. You can also visit a public health clinic. A public health clinic can be a good option if you don’t have a regular doctor or insurance. Let the doctor or nurse know you are worried about mpox.

If you think you have mpox, cover all parts of the rash with clothing, gloves, or bandages, and wear a mask. Remember to:

• Avoid touching anyone until you have been to the doctor.
• If your test result is positive, follow your healthcare provider’s recommendations.
• Wash your hands often and try not to touch your eyes. If you wear contact lenses, wear glasses instead, if possible, to avoid infecting your eyes.
• Stay in a space away from others until your rash has healed, all scabs have fallen off, and a fresh layer of intact skin has formed. This may mean wearing a mask around others in the place you live and cleaning and disinfecting frequently.
• You should try to avoid contact with pets and with people who are more likely to get very sick, like children under 8 years old, people who are pregnant, and people who have weakened immune systems or certain skin conditions.

If I have questions, who can answer them?

If you have questions and feel comfortable, talk to a parent or other trusted adult.

It’s important to talk honestly with a healthcare provider about any concerns you may have about mpox, especially if you know you spent time with someone who had mpox. You can request time alone with a healthcare provider at your next visit to discuss your concerns in private.

Protect Yourself and Others

At this time, data suggest that gay, bisexual, and other men who have sex with men make up the majority of cases in the current mpox outbreak. However, anyone, regardless of sexual orientation or gender identity, who has been in close, personal contact with someone who has mpox is at risk.

Following the recommended prevention steps and getting vaccinated if you were exposed to mpox or are at higher risk of being exposed to mpox can help protect you and your community.

Mpox Prevention Steps

These five steps can help you protect yourself from getting mpox:

STEP 1

Avoid close, skin-to-skin contact with people who have a rash that looks like mpox.

Examples of Mpox Rashes. Photo credit: UK Health Security Agency

This might include skin with what appears to be a rash, pimples, blisters, or scabs.

• The rash might appear on the genitals (penis, testicles, labia, vagina) or anus and could be on other areas like the hands, feet, chest, face, or mouth. Do not touch the rash or scabs of a person with mpox.
• Do not kiss, hug, cuddle, or have sex with someone with mpox.

STEP 2

Avoid contact with objects and materials that a person with mpox has used.

• Do not share eating utensils or cups with a person with mpox.
• Do not handle or touch the bedding, towels, or clothing of a person with mpox.

STEP 3

Wash your hands often.

• Wash your hands often with soap and water, or use an alcohol-based hand sanitizer, especially before eating or touching your face and after you use the bathroom.
• Handwashing is one of the best ways to protect you, your family, and your friends from getting sick.

STEP 4

Get vaccinated!

• The JYNNEOS vaccine is approved for prevention of smallpox and mpox. It is the primary vaccine being used in the U.S. during this outbreak.
• Use the Mpox Vaccine Locator to find nearby healthcare locations in your area that provide mpox vaccinations.

STEP 5

If you are in Central or West Africa, avoid contact with animals that can spread monkeypox virus, usually rodents and primates.

Also, avoid sick or dead animals, as well as bedding or other materials they may have touched. 

What You Need to Know

• The U.S. national monkeypox vaccine strategy was announced on June 28, 2022. Multiple federal agencies, including the Administration for Strategic Preparedness and Response (ASPR), U.S. Food and Drug Administration (FDA), National Institutes of Health (NIH), and Centers for Disease Control and Prevention (CDC) are coordinating to implement this enhanced vaccination strategy.
• This document provides interim guidance regarding use of JYNNEOS and ACAM2000 vaccines during the mpox outbreak that began in the United States on May 17, 2022. This interim guidance is in addition to standard guidance and recommendations for use of these vaccines from CDC’s Advisory Committee on Immunization Practices (ACIP).
• Two vaccines may be used for the prevention of mpox disease:
  • JYNNEOS vaccine is approved for the prevention of mpox and smallpox. During the current outbreak, JYNNEOS is the main vaccine being used in the United States.
  • ACAM2000 vaccine is approved for immunization against smallpox and made available for use against mpox under an Expanded Access Investigational New Drug (EA-IND) protocol.
• The standard regimen for JYNNEOS involves a subcutaneous (Subcut) route of administration with an injection volume of 0.5mL. In the context of the current national Public Health Emergency (PHE), an alternative regimen involving intradermal (ID) administration with an injection volume of 0.1mL may be used under an Emergency Use Authorization (EUA).
• People may be vaccinated after exposure to monkeypox virus to help prevent mpox disease (i.e., post-exposure prophylaxis).
• People who are at higher potential for exposure to monkeypox virus may be offered vaccination to help prevent mpox disease (i.e., pre-exposure prophylaxis).
• No data are currently available on the clinical efficacy or effectiveness of JYNNEOS or ACAM2000 for mpox disease.  Limited data on performance of JYNNEOS vaccine in the current outbreak are becoming available. Across 32 U.S. jurisdictions, among males aged 18–49 years eligible for JYNNEOS vaccination, mpox incidence was 14 times as high among unvaccinated males compared with those who had received a first vaccine dose ≥14 days earlier

• Because there are limitations in our knowledge about the effectiveness of these vaccines in the current outbreak, people who are vaccinated should continue to take steps to protect themselves from infection by avoiding close, skin-to-skin contact, including intimate contact, with someone who has mpox.

• In the United States, there is a large supply of ACAM2000, but this vaccine has more known side effects and contraindications.

Current data suggest that about 40% of people diagnosed with mpox in the United States also had HIV (human immunodeficiency virus). CDC doesn’t know if having HIV increases the likelihood of getting sick with mpox if exposed to the virus. However, we do know that people with severe immunocompromise (like advanced HIV) are at increased risk of severe mpox, or even death, if they become infected.

If you have HIV, you should follow the same recommendations as everyone else to protect yourself from mpox. Taking your HIV medication as prescribed and keeping an undetectable viral load are the best things you can do to stay healthy and doing so also prevents you from sexually transmitting HIV to your HIV-negative partner. Learn more about how to live well with HIV.

Mpox Vaccines and People with HIV

CDC recommends vaccination for people who have been exposed to mpox virus and people who may be more likely to get mpox. Learn more about who should get vaccinated.

There are currently two vaccines (JYNNEOS and ACAM2000) that can be used to prevent mpox.

• JYNNEOS vaccine is authorized for the prevention of mpox and is considered safe for people with HIV. This is the vaccine currently being offered in the United States.
• CDC does not recommend the ACAM2000 vaccine for people with HIV due to the increased risk of serious side effects.

Talk to your health care provider to see if you should get vaccinated against mpox.

Getting Mpox When You Have HIV

• Limited data suggest that people with HIV, particularly people with low CD4 counts (350 cells/ml) or who are not virally suppressed, are more likely to be hospitalized if they get mpox than people without HIV.
• Medicines used to treat smallpox are considered safe and may be used to treat people who are more likely to get severely ill with mpox. If you have HIV, ask your healthcare provider about what treatment options you should consider.
• Based on what we know, mpox treatments have few interactions with HIV medicines. If you have HIV, let your health care provider know before starting mpox treatment.

Mpox and HIV PrEP and HIV PEP

HIV pre-exposure prophylaxis (PrEP) and HIV post-exposure prophylaxis (PEP) are still effective for preventing HIV even if you have received the mpox vaccine, have mpox, or are taking mpox treatment.  If you have been prescribed HIV PrEP or HIV PEP by your health care provider, you should continue taking your medicine as prescribed.

You may have heard of mpox PrEP and PEP. This can be confusing because we use the terms PrEP and PEP in HIV prevention as well. Here’s how they are different:

• HIV PrEP (pre-exposure prophylaxis) is medicine that reduces your chances of getting HIV.
• When you get the mpox vaccine to reduce your chances of getting mpox in the future, this is sometimes called mpox vaccine PrEP.
• HIV PEP (post-exposure prophylaxis) is medicine that can reduce your chances of getting HIV after a possible exposure.
• When you get the mpox vaccine to reduce your chance of getting mpox because you were exposed or think you might have been exposed, this is sometimes called mpox vaccine PEP.

While CDC works to contain the current mpox outbreak and learn more about the virus, this information can help you make informed choices when you are in situations or places where mpox could be spread. Mpox is often transmitted through close, sustained physical contact, almost exclusively associated with sexual contact in the current outbreak.

How can a person lower their risk during sex?

Vaccination is an important tool in preventing the spread of mpox (formerly known as monkeypox). If you are at risk for mpox but haven’t received your two-dose vaccine yet, temporarily changing some parts of your sex life might reduce the risk of exposure to the virus. This includes the time between your first and second shots of vaccine. Your protection will be highest two weeks after your second dose of vaccine.

Make a habit of exchanging contact information with any new partner to allow for sexual health follow-up, if needed.

Talk with your partner about any mpox symptoms and be aware of any new or unexplained rash or lesion on either of your bodies, including the mouth, genitals (penis, testicles, vulva, or vagina), or anus (butthole). If you or your partner has or recently had mpox symptoms, or you have a new or unexplained rash anywhere on your body, do not have sex and see a healthcare provider. In some cases, symptoms may be mild, and some people may not even know they have mpox.

If you or a partner has mpox or think you may have mpox, the best way to protect yourself and others is to avoid sex of any kind (oral, anal, vaginal) and kissing or touching each other’s bodies—while you are sick. Especially avoid touching any rash. Do not share things like towels, fetish gear, sex toys, and toothbrushes.

Even if you feel well, here are some ways to reduce your chances of being exposed to mpox if you are sexually active:

• Take a temporary break from activities that increase exposure to mpox until you are two weeks after your second dose. This will greatly reduce your risk.
• Limit your number of sex partners to reduce your likelihood of exposure.
• Spaces like back rooms, saunas, sex clubs, or private and public sex parties, where intimate, often anonymous sexual contact with multiple partners occurs—are more likely to spread mpox.
• Condoms (latex or polyurethane) may protect your anus (butthole), mouth, penis, or vagina from exposure to mpox. However, condoms alone may not prevent all exposures to mpox since the rash can occur on other parts of the body.
• Gloves (latex, polyurethane, or nitrile) might also reduce the possibility of exposure if inserting fingers or hands into the vagina or the anus. The gloves must cover all exposed skin and be removed carefully to avoid touching the outer surface.
• Avoid kissing or exchanging spit since mpox can spread this way.
• Masturbate together at a distance without touching each other and without touching any rash.
• Have virtual sex with no in-person contact.
• Consider having sex with your clothes on or covering areas where rash is present, reducing as much skin-to-skin contact as possible. Leather or latex gear also provides a barrier to skin-to-skin contact; just be sure to change or clean clothes/gear between partners and after use.
• Be aware that mpox can also spread through respiratory secretions with close, face-to-face contact.
• Remember to wash your hands, fetish gear, sex toys, and any fabrics (bedding, towels, clothes) after having sex. 

What should a person do if they have a new or unexplained rash or other symptoms?

• Avoid sex or being intimate with anyone until you have been checked out by a healthcare provider.
• If you don’t have a provider or health insurance, visit a public health clinic near you.
• When you see a healthcare provider, wear a mask, and remind them that this virus is circulating in the area.
• Avoid gatherings, especially if they involve close, personal, skin-to-skin contact.

Think about the people you have had close, personal, or sexual contact during the last 21 days, including people you met through dating apps. To help stop the spread, you might be asked to share this information if you have received an mpox diagnosis.

How can a person lower the chance of getting mpox at places like raves, parties, clubs, and festivals?

When thinking about what to do, seek out information from trusted sources like the local health department. Second, consider how much close, personal, skin-to-skin contact is likely to occur at the event you plan to attend. If you feel sick or have a rash, do not attend any gathering, and see a healthcare provider.

• Festivals, events, and concerts where attendees are fully clothed and unlikely to share skin-to-skin contact are safer. However, attendees should be mindful of activities (like kissing) that might spread mpox.
• A rave, party, or club where there is minimal clothing and where there is direct, personal, often skin-to-skin contact has some risk. Avoid any rash you see on others and consider minimizing skin-to-skin contact.
• Enclosed spaces, such as back rooms, saunas, sex clubs, or private and public sex parties where intimate, often anonymous sexual contact with multiple partners occurs, may have a higher likelihood of spreading mpox.

Mpox is a disease that can cause flu-like symptoms and a rash. In general, infectious diseases involving person-to-person contact may spread more easily within congregate settings and may spread among staff (paid or unpaid) and residents. For the purposes of this document, congregate living settings are facilities or other housing where people who are not related reside in close proximity and share at least one common room, such as a sleeping room, kitchen, bathroom, or living room. Congregate living settings can include:

• Correctional and detention facilities.
• Homeless, emergency, and domestic violence shelters and transitional housing.
• Group homes.
• Dormitories at institutions of higher education (IHE) such as colleges and universities.
• Seasonal worker housing.
• Residential substance use treatment facilities.
• Assisted living communities.
• Hotels, motels, and hostels.

Mpox in Congregate Living Facilities

If an mpox case has been identified in a congregate living facility, consider the following actions:

• Communicate with staff and residents—Provide clear information to staff and residents about mpox prevention, including the potential for spread through close, sustained physical contact, including sexual activity. Provide prevention guidance including considerations for safer sex. IHEs and shelters for youth can share additional information for young adults. Keep messages fact-based to avoid introducing stigma when communicating about mpox.
• Respond to cases—Consider the following actions to respond to cases in the facility:
  • Test and medically evaluate staff and residents who are suspected to have mpox.
  • Isolate staff who have mpox away from congregate settings until they are fully recovered. Flexible sick leave policies for paid staff members are critical to prevent spread of mpox.
  • Isolate residents with mpox away from others, to the extent possible, until there is full healing of the rash with formation of a fresh layer of skin, which typically takes two to four weeks.
    • Some congregate living facilities may be able to provide isolation on-site while others may need to move residents off-site to isolate. Isolation spaces should have a door that can be closed and a dedicated bathroom that other residents do not use.
    • Multiple people who test positive for mpox can stay in the same room.
    • If it is not possible to follow isolation recommendations fully, consult CDC’s webpage on Preventing Spread to Others.
    • Consult your state, tribal, local, or territorial health department before ending isolation.
  • Reduce the number of staff who are entering the isolation areas to staff who are essential to isolation area operations.
  • Residents who are not under isolation for mpox should not enter the isolation area.
  • Residents with mpox should help clean and disinfect the isolation spaces they occupy regularly to limit contamination.
  • Dedicated laundry space should be identified for residents in isolation. If dedicated laundry space is not able to be identified, refer to Cleaning and Disinfecting Your Home, Workplace, and Other Community Settings for Mpox for additional laundering options.
  • Manage waste appropriately.
    • Generally, management of waste should continue as normal. Facilities should comply with state and local regulations for handling, storage, treatment, and disposal of waste. Healthcare facilities should follow guidance specifically for that setting.
    • The person with mpox should use a dedicated, lined trash can in the room where they are isolating. Any gloves, bandages, or other waste and disposable items that have been in direct contact with skin should be placed in a sealed plastic bag, then thrown away in the dedicated trash can.
    • The person with mpox or other facility staff should use gloves when removing garbage bags and handling and disposing of trash.
    • If professional cleaning services are used, treat and/or dispose of waste in accordance with applicable state, local, tribal, and territorial laws and regulations for waste management.

If Someone May Have Been Exposed

Facilities should work with their state, tribal, local, or territorial health department to identify and monitor the health of any staff or residents who might have had close contact with someone who has mpox. Contact tracing can help identify people with exposure and help prevent additional cases. However, this might not be feasible in all settings.

• Use exposure risk assessment recommendations to identify people who had high degree of exposure to someone with mpox, where possible. The state, tribal, local, or territorial health department can provide post-exposure vaccination for people with high degree exposures.
• In facilities where contact tracing is not feasible, staff and residents who spent time in the same area as someone with mpox should be considered to have intermediate or low degree of exposure, depending on the characteristics of the setting and exposure (e.g., level of crowding). Post-exposure vaccination is not necessary for low or intermediate degree exposures unless deemed appropriate by the state or local health department.
• Ensure access to handwashing. Soap and water or hand sanitizer with at least 60% alcohol should be available at all times and at no cost to all staff and residents. Anyone who touches the rash, or clothing, linens, or surfaces that may have had contact with the rash, should wash their hands immediately.
• Provide appropriate personal protective equipment (PPE) for staff entering isolation areas—Employers are responsible for ensuring that workers are protected from exposure to Monkeypox virus and that workers are not exposed to harmful levels of chemicals used for cleaning and disinfection. Staff who enter isolation areas should wear a gown, gloves, eye protection, and a NIOSH-approved particulate respirator equipped with N95 filters or higher. Staff should consult CDC guidance for Cleaning and Disinfecting Your Home, Workplace, and Other Community Settings for Mpox for further details on how to clean and disinfect isolation areas.
• Employers must comply with OSHA’s standards on Bloodborne Pathogens (29 CFR 1910.1030), PPE (29 CFR 1910.132), Respiratory Protection (29 CFR 1910.134), and other requirements, including those established by state plans, whenever such requirements apply.

It is possible that people with mpox can spread the virus to animals through close contact, including petting, cuddling, hugging, kissing, licking, sharing sleeping areas, and sharing food. Additionally, some animals infected with mpox virus can spread it to people and other animals.

People with mpox should avoid contact with animals, including pets, domestic animals, and wildlife to prevent spreading the virus. If your pet is exposed to mpox virus:

• Do not surrender, euthanize, or abandon pets just because of a potential exposure to mpox virus.

• Do not wipe or bathe your pet with chemical disinfectants, alcohol, hydrogen peroxide, or other products, such as hand sanitizer, counter-cleaning wipes, or other industrial or surface cleaners.

If the person with mpox did NOT have close contact with pets after symptom onset, ask friends or family members who live in a separate home to be the animal’s caretaker until the person with mpox fully recovers. Close contact includes petting, cuddling, hugging, kissing, licking, sharing sleeping areas, and sharing food.

After the person with mpox is recovered, disinfect your home before bringing healthy animals back; follow guidance in Disinfecting Home and Other Non-Healthcare Settings.

Pets that had close contact with a person with mpox symptoms should be kept at home and away from other animals and people for 21 days after the most recent contact. If possible, infected people should not continue to take care of exposed pets. The person with mpox should avoid close contact with the exposed animal, and when possible, ask another household member to care for the animal until the person with mpox is fully recovered.

In some cases, it may be necessary to isolate and care for animals that have been exposed to mpox in a location other than the home. For example, people who are immunocompromised, pregnant, have young children present (under 8 years of age), or with a history of atopic dermatitis or eczema, should not provide care for animals that had close contact with a person with mpox as they may be at increased risk for serious illness from mpox.

If you have mpox and must care for your healthy pets during home isolation, wash your hands, or use an alcohol-based hand rub, before and after caring for them. It is also important to cover any skin rash to the best extent possible (for example, wear long sleeves or long pants), and wear gloves and a well-fitting mask or respirator while providing care for your animals.

• Do not put a mask on your pet.
• Avoid close contact with your pet.
• Ensure your pet cannot inadvertently come into contact with contaminated items in the home such as clothing, sheets, and towels used by the person with mpox.
• Do not let animals come into contact with rashes, bandages, and body fluids.
• Ensure food, toys, bedding, or other items that you provide for your animal during its isolation do not come in direct contact with skin or uncovered rash.

What to do if a pet shows signs of mpox

While we do not know all the symptoms infected animals may have, watch the animal for potential signs of illness including lethargy, lack of appetite, coughing, nasal and/or eye secretions or crust, bloating, fever, and/or pimple- or blister-like skin rash. Call your veterinarian if you notice an animal appears sick within 21 days of having contact with a person who has probable or confirmed mpox. A veterinarian can help notify your state public health veterinarian or state animal health official.

• Do not euthanize pets with suspected mpox unless directed by a veterinarian.
• Do not wipe or bathe your pet with chemical disinfectants, alcohol, hydrogen peroxide, or other products, such as hand sanitizer, counter-cleaning wipes, or other industrial or surface cleaners.

Steps to take if you think your pet has mpox

• Get your pet tested if they have had close contact with a person with probable or confirmed mpox and they have a new rash or two other clinical signs. Call your veterinarian if you notice an animal appears sick within 21 days of having contact with a person who has probable or confirmed mpox. A veterinarian can help notify your state public health veterinarian or state animal health official.
  • Possible clinical signs of mpox in animals include lethargy, lack of appetite, coughing, bloating, nasal and/or eye secretions or crust, fever, and/or pox-like skin lesions (may initially resemble a pimple or blister before progression to a characteristic mpox lesion) or rash.
• Separate the sick pet or animal from other pets or animals and minimize direct contact with people for at least 21 days after becoming ill or until fully recovered.
  • It is preferable to keep pets or animals with signs of illness isolated in their home and away from anyone who has not had mpox.
  • People who are immunocompromised, pregnant, have young children present (under 8 years of age), or with a history of atopic dermatitis or eczema, should not provide care for sick pets or animals that had close contact with a person with mpox.
• Wash your hands often and use personal protective equipment (PPE) when caring for and cleaning up after sick pets or animals. PPE includes wearing gloves, using eye protection (safety glasses, goggles, or face shield), wearing a well-fitting mask or respirator (ideally a disposable NIOSH-approved N95 filtering facepiece respirator), and wearing a disposable gown.
  • If a disposable gown is not available, wear clothing that fully covers the skin (i.e. long sleeves, long pants), and immediately remove and launder clothing after contact with the animal, animal enclosures, or animal bedding.
  • Carefully remove PPE to avoid self-contamination.
  • Use an alcohol-based hand rub or wash hands with soap and water after PPE has been removed.
• Consult your local public health department for guidelines for waste disposal, but general precautions include:
  • Use a dedicated, lined trash can for all potentially contaminated waste.
  • Do not leave or dispose of waste outdoors as mpox virus infections in wildlife may occur.
  • If appropriate for the species and your plumbing system, flush animal waste down the toilet.
  • Disposable animal housing, disposable rodent bedding, and animal waste that cannot be flushed down the toilet should be sealed in a bag and disposed of properly to prevent these materials from infecting people or other animals, including wild animals and household pests like mice and rats. 
• Bedding, enclosures, food dishes, and any other items in direct contact with infected animals must be properly disinfected following the Disinfecting Home and Other Non-Healthcare Settings.
• Soiled laundry and bedding (including disposable rodent bedding) should not be shaken or otherwise handled in a manner that may disperse infectious particles.

Mpox spreads in a few ways.

Close or Intimate Contact

Mpox can spread to anyone through close, personal, often skin-to-skin contact, including:

• Direct contact with mpox rash and scabs from a person with mpox, as well as contact with their saliva, upper respiratory secretions (snot, mucus), and areas around the anus, rectum, or vagina

This direct contact can happen during intimate contact, including:

• Oral, anal, or vaginal sex, or touching the genitals (penis, testicles, labia, and vagina) or anus of a person with mpox
• Hugging, massage, and kissing
• Prolonged face-to-face contact

The risk is considered low for getting mpox by touching objects, fabrics, and surfaces that have been used by someone with mpox and not disinfected, such as clothing, bedding, towels, fetish gear, or sex toys.

A person with mpox can spread it to others from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. Some people have been found to have infection but no symptoms. CDC will continue to monitor for new or changing information about transmission.

Is Mpox a Sexually Transmitted Infection (STI)?

In the current mpox outbreak, the virus is spreading primarily through sexual contact; however, infections have occurred through other exposures, including non-sexual contact with infectious lesions and from contaminated instruments in clinic settings.

Mpox and Pregnancy

Monkeypox virus can be spread to the fetus during pregnancy or to the newborn by close contact during and after birth.

Infected Animals

Anyone in close personal contact with a person or animal with mpox can become infected and should take steps to protect themselves.

The most common route for transmission of mpox from infected animals to people is direct contact with the infectious rash, scabs, crusts or fluids from sores, saliva, or infected bodily fluids, including respiratory secretions. Urine and feces that contain infectious viral particles may also be a source of infection. It is possible that people with mpox can spread it to animals through close contact, including petting, cuddling, hugging, kissing, licking, sharing sleeping areas, and sharing food.

Can mpox spread through water in pools, hot tubs, or splash pads?

No studies have found a clear link between mpox and water in pools, hot tubs, or splash pads. The monkeypox virus is killed in water at the chlorine levels recommended for disinfection in recreational water venues by CDC and required by U.S. jurisdictions.

However, it is possible to spread mpox to others through close, skin-to-skin contact. It can also be spread by sharing objects that a person with mpox used, such as towels, kickboards, pool toys, or clothing.

Scientists are Still Researching

• How often the virus can be spread when someone has no symptoms
• How often and the circumstances in which monkeypox virus is spread through respiratory secretions
• Whether mpox can be spread through semen, vaginal fluids, urine, or feces

Mpox symptoms

People with mpox often get a rash that may be located on hands, feet, chest, face, or mouth or near the genitals, including penis, testicles, labia, and vagina, and anus.  The incubation period is 3-17 days. During this time, a person does not have symptoms and may feel fine.

• The rash will go through several stages, including scabs, before healing.
• The rash can initially look like pimples or blisters and may be painful or itchy.

Other symptoms of mpox can include:

• Fever
• Chills
• Swollen lymph nodes
• Exhaustion
• Muscle aches and backache
• Headache
• Respiratory symptoms (e.g., sore throat, nasal congestion, or cough)

You may experience all or only a few symptoms

• Sometimes, people have flu-like symptoms before the rash.
• Some people get a rash first, followed by other symptoms.
• Others only experience a rash.

How long do mpox symptoms last?

Mpox symptoms usually start within 3 weeks of exposure to the virus. If someone has flu-like symptoms, they will usually develop a rash 1-4 days later.

A person with mpox can spread it to others from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. Some people have been found to have infection but no symptoms.  CDC will continue to monitor for new or changing information about transmission.

If You Have a New or Unexplained Rash or Other Symptoms...

People who think they have mpox or have had close personal contact with someone who has mpox should visit a healthcare provider to help them decide if they need to be tested for mpox. If they decide that you should be tested, they will work with you to collect the specimens and send them to a laboratory for testing.

• Avoid close contact, including sex or being intimate with anyone, until you have been checked out by a healthcare provider.
• If you don’t have a provider or health insurance, visit a public health clinic near you.
• Remind the healthcare provider that mpox is present in the United States.
• When you see a healthcare provider, wear a mask, and remind them that this virus is circulating in the area.

Mpox Rash Photos

If You Are Sick with Mpox

Mpox typically lasts 2-4 weeks. Learn what you can do to take care of yourself as you recover, including managing symptoms and rash relief.

What to Do If You Are Sick

If you are sick with mpox or think you might have mpox, know what you can do to prevent the spread to others.

Preventing Spread to Others

• Notifying Close Contacts
• Treatment
• Home Disinfection

There is no treatment specifically for mpox. Because the viruses that cause mpox and smallpox are closely related, drugs and vaccines developed to treat and protect against smallpox may be effective for mpox.

However, the type of treatment for a person with mpox will depend on how sick someone gets or whether they’re likely to get severely ill. Most people with mpox recover fully within 2 to 4 weeks without the need for medical treatment.

Some people, like those with a weakened immune system or genital or rectal rashes, may need treatment. Drugs used to treat mpox require a prescription and must be requested by a healthcare provider through the local or state health department.

Taking Care of Yourself

• Use gauze or bandages to cover the rash to limit spread to others and to the environment.
• Don’t lance (pop) or scratch lesions from the rash. This does not speed up recovery and can spread the virus to other parts of the body, increase the chance of spreading the virus to others, and possibly cause the open lesions to become infected by bacteria.
• Do not shave the area with the rash until the scabs have fallen off and a new layer of skin has formed. Shaving can spread the virus and cause more lesions.
• Keep skin lesions/rash clean and dry when not showering or bathing.
• Wash hands often with soap and water or use an alcohol-based hand sanitizer, especially after direct contact with the rash.
  • If you have rash on your hands, be careful when washing or using sanitizer so as not to irritate the rash.
• If you have rash on your hands, wear gloves that are non-irritating when handling common objects or touching surfaces in shared spaces. If you can, use disposable gloves that can be discarded after each use (e.g., latex, polyurethane, or nitrile gloves). Reusable gloves should be washed with soap and water between use.
• Wear a well-fitting mask around other people until the rash and all other symptoms have resolved.
• Eat healthy and get plenty of rest to allow your body to heal.

Managing Your Symptoms

Medicines like ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) can help you feel better. Your healthcare provider may prescribe stronger pain relievers as well.

For rash in the mouth, rinse with salt water at least four times a day. Prescription mouthwashes, sometimes called miracle or magic mouthwash, or local anesthetics like viscous lidocaine can be used to manage pain. Oral antiseptics like chlorhexidine mouthwash can be used to help keep the mouth clean.

Contact your healthcare provider if pain becomes severe and unmanageable at home.

Rash Relief

The most important thing is to try to not touch or scratch the rash. This can spread the rash to other parts of the body, increase the chance of spreading the virus to others, and possibly cause open lesions to become infected by bacteria. If you do accidentally touch the rash, wash your hands with soap and water and avoid touching sensitive areas like your eyes, nose, mouth, genitals and rectum (butthole).

Topical benzocaine/lidocaine gels can be used for temporary relief. Oral antihistamines such as Benadryl and topical creams such as calamine lotion or petroleum jelly may help with itching.

Soaking in a warm bath (using oatmeal or other over-the-counter bath products for itchy skin) may offer some relief to the dry, itchy sensations that can come with the rash.

People who have the rash in or around their anus (butthole) or genitals (penis, testicles, labia, vagina), or perineum (taint) may also benefit from a sitz-bath. A sitz bath is a round, shallow basin that can be purchased online or at a pharmacy. Most fit over the rim of a toilet but can also be placed in a bathtub. There is also the option to sit in a bathtub with shallow water. Your healthcare provider may prescribe medication like povidone-iodine or other products to be added to the water in a sitz bath. Adding Epsom salt, vinegar, or baking soda to the water can be soothing.

If you have mpox, you are advised to stay at home (isolate) if you have mpox symptoms, including until your mpox rash has healed and a new layer of skin has formed. Staying away from other people and not sharing things you have touched with others will help prevent the spread of mpox. Mpox can also spread to animals, so staying away from pets, livestock and other animals is important.

Not every person has the same ability or resources to remain at home for a long period of time. The table below provides options for how to prevent spreading mpox to others, organized by the risk of spread. Whenever possible, higher risk options should be avoided, and the lowest risk options should be followed.

*From the time symptoms start until the rash has fully healed and a fresh layer of skin has formed.

**Persons with mpox may need to work with their employer on accommodations if they are unable to stay home from work during the period when isolation is recommended.

If you have been diagnosed with mpox, it’s important to notify your close contacts that they may have been exposed to mpox as soon as possible, so they can watch for signs and symptoms, get tested, and isolate if they have symptoms. They should consider getting vaccinated if exposed less than 14 days ago, ideally within 4 days of exposure. Vaccination provides the best chance to prevent the disease or make it less severe. By letting your close contacts know they may have been exposed to mpox, you are helping to protect them and everyone around them.

Who Are Your Close Contacts?

A close contact is anyone, since the start of your mpox symptoms you:

• Have had sex with; this includes oral, anal, or vaginal sex.
• Have touched or who came in contact with the rash on your body.
• Have hugged, cuddled, kissed, or had other prolonged skin-to-skin contact with.
• Shared cups, utensils, towels, clothing, bedding, blankets, or other objects and materials with.

Make a List of Close Contacts to Notify

Think about:

• Who were/are your sex partners?
• Who lives with you (including family members, roommates, or overnight guests)?
• Who have you recently had prolonged skin-to-skin contact with? Consider the following:
  • In-person meetings or gatherings you attended.
  • People you have met with recently (i.e., for a home visit, at a restaurant, for drinks, for dancing, for exercise, or for a party).
  • People you played contact sports with (for example, basketball or wrestling).
  • Appointments with health care providers, including dentists.
  • People who have provided you services, such as childcare providers, house cleaners, barbers, hairdressers, nail salon workers, massage therapists, adult care workers, etc.
  • People you work or volunteer with outside of the home.

Tips on Preparing and What to Say

If you are feeling a little uncertain about notifying your contacts, it can be helpful to prepare beforehand to make sure the communication goes smoothly. Below are few tips that may be useful:

• Think through how you would want to be notified in the same situation.
• Consider safety and privacy. If texting, messaging, or emailing, consider whether other people might be able read your communication. If you are notifying by phone, first ask your contact if they are in a place where they can speak privately.
• Saying the words out loud can help you think through what you want to say and how you want to say it before you reach out.
• Consider the person and prepare how you would want to calmly react to the different types of responses you might get.

An example of what you can say to your close contacts could be:

“Hi. I need to talk to you about something important. Do you have a few minutes to talk privately? I was diagnosed with mpox (or tested positive) on [xxx date]. Mpox can spread through close or intimate contact. Since we spent time together on [xxx date], I wanted to let you know. You should check for symptoms and get tested ASAP if you have symptoms. The CDC has information on their website at www.cdc.gov/monkeypox.”

Other Options for Notifying Your Close Contacts

If you are unable to notify your close contacts yourself, there are other options available to you:

• Health Department Assistance. You may be contacted by a public health professional from your local health department, typically called a disease intervention specialist or DIS. A DIS may reach out to you to discuss your diagnosis, answer any questions you have, and, if you want help, confidentially notify your contacts. They will protect your privacy and not disclose anything about you. When they notify your contacts, they will connect them to services that they may need, including medical care, testing, treatment, and/or vaccines, as appropriate. However, some health departments may not be able to provide this service depending on local resources.
• Anonymous Notification Services. You can use a reputable, online service that can notify your contacts of their possible exposure to mpox while protecting your anonymity. One such site is tellyourpartner.org. The service is free. You can first explore the site to learn more about how they protect your privacy and the language that will be used in the notification. This site also will let your contacts know where they can obtain additional information about mpox.

Choose the method of notifying your contacts that you are most comfortable with. You can use different methods for different contacts. The important thing is to make sure that your contacts have the information they need in time to make decisions about their health and prevent spreading mpox to others.

Mpox spreads between people through direct contact with an infectious rash, body fluids, or by respiratory secretions during prolonged, face-to-face contact. A person with mpox can spread it to others from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. Some people have been found to have infection but no symptoms. To date, however, there is no evidence that mpox spreads from people with no symptoms. CDC will continue to monitor for new or changing information about transmission.

It may be possible to become infected after touching a surface that has been used by someone with mpox. However, in most situations, the risk of infection from touching a surface is low.

The most reliable way to prevent infection from surfaces is to wash your hands often with soap and water, or use an alcohol-based hand sanitizer with at least 60% alcohol before eating or touching your eyes, nose, or mouth. Cleaning and disinfecting surfaces that have been touched by a person with mpox can also help prevent the spread to others.

This document provides considerations for cleaning and disinfecting homes, workplaces, and community settings for the monkeypox virus. It is not intended for healthcare settings.

Cleaning and Disinfecting Homes When Someone Is Sick

To prevent the spread to others when staying at home (isolating), people with mpox should follow the guidance in this section until your mpox rash has healed and a new layer of skin has formed.

ISOLATING ALONE AT HOME: During isolation at home, people with mpox should clean and disinfect their living spaces to minimize the risk of infection to others. If you have rash on your hands, wear gloves when cleaning and disinfecting items. Throw away the gloves after use and wash hands with soap and water.

ISOLATING WITH OTHERS AT HOME: The isolation and infection control guidance should be followed if the person with mpox shares living space with others during isolation. Ways to prevent the spread to others include:

• If cleaning and disinfection is done by someone other than the person with mpox (for example, an uninfected family member or friend), they should protect themselves by wearing disposable gloves, a well-fitting mask or respirator, such as an N95, and clothing that fully covers their arms and legs.
• Do not share items that may have the virus on them such as bed linens, clothing, towels, wash cloths, drinking glasses, or eating utensils until the items are disinfected.
• Cover upholstered furniture and porous materials that cannot be washed with sheets, blankets, tarps, and other covers.

People who have recovered from mpox and can end their isolation should clean and disinfect their entire living space, including frequently touched surfaces, shared items or items that may be used by others in the home, and any objects or fabrics that were used during isolation.

How to Protect Yourself When Cleaning and Disinfecting at Home

Protect yourself by following these steps for safe and effective cleaning practices and disinfectant use:

• If your disinfectant product label does not say that it can be used for both cleaning and disinfection, clean visibly dirty surfaces with soap and water before disinfection.
• Use an EPA-registered disinfectant from List Q: Disinfectants for Emerging Viral Pathogens. Always read the product label to make sure it can be used on the type of surface you are disinfecting (such as hard or soft surfaces).
• Always follow the directions on the label to ensure safe and effective use of the product.
• Check the product label to see if personal protective equipment (PPE) (such as gloves and goggles) is required for safe use.

Do not dry dust or sweep, which may spread dust particles that contain virus into the air.

• Wet cleaning methods are preferred, such as disinfectant wipes, sprays, and mopping.
• Vacuuming is okay if you are using a vacuum with a high-efficiency air filter. If a high-efficiency air filter is not available, make sure the person vacuuming wears a respirator (such as an N95).

Wash your hands with soap and water for 20 seconds after cleaning. Be sure to wash your hands immediately after removing gloves.

• If soap and water are not available, use an alcohol-based sanitizer that contains at least 60% alcohol.
• If hands are visibly dirty, always wash hands with soap and water before using hand sanitizer.

Clean and disinfect in the following order to minimize spreading the virus in the household:

1. Collect and throw away general waste, such as bandages, paper towels, food packaging, and other general trash items
2. Laundry
3. Hard surfaces
4. Soft Surfaces
5. Carpet and flooring
6. Throw away waste generated from cleaning and disinfecting (such as disinfectant wipes)
7. Wash your hands

How to Clean and Disinfect Types of Surfaces

Laundry

• Contaminated laundry, which is laundry used by a person with mpox, should not be mixed with other laundry.
• Put used or contaminated clothing, linens and bedding materials, towels, and other fabric items in either:
  •  A waterproof container or bag that can be disinfected or thrown away afterwards
  •  A fabric bag that may be used and can be washed along with the dirty or contaminated items
• Do not shake or handle dirty or contaminated laundry in a way that may spread particles with virus into the air
• Wash laundry in a standard washing machine with detergent, following instructions on the label. Laundry sanitizers may be used but are not necessary.

Options when in-home laundering is not available:

While using laundry services outside of the home by a person isolating for mpox is not ideal, in-home laundry may not be available for all people. If possible, the person with mpox should wait until isolation ends and then wash and dry their clothes. If it is necessary to clean laundry outside of the home before isolation ends, the following may be considered:

• The person with mpox can do their own laundry at a self-service laundry facility.
• A family member or friend that does not have suspected or confirmed mpox and can follow appropriate precautions (such as, use of gloves, well-fitting mask or respirator, such as an N95, and clothing that covers exposed skin) may wash and dry clothes outside of the home.
• If you need to use commercial laundry services for washing and drying contaminated fabric materials (such as, clothing, linens, and bedding), coordinate first with public health department and the laundry facility to make sure workers know to take appropriate precautions.
• Dry cleaning is not recommended.

Hard (non-porous) Surfaces

• Routinely clean and disinfect commonly touched surfaces and items using soap and water and an EPA-registered disinfectant from List Q: Disinfectants for Emerging Viral Pathogens that can be used on hard surfaces.
  • Commonly touched items include surfaces like tables, countertops, door handles, toilet flush handles, faucets, light switches, and floors.
• Surfaces inside refrigerators, freezers, other appliances, interior cabinet spaces, or drawers should be cleaned and disinfected if they have been used by the person with mpox.
• Wash soiled dishes and eating utensils in a dishwasher with detergent and hot water or by hand with hot water and dish soap.

Soft (porous) Surfaces

• If the person with mpox had direct skin contact or drainage of fluids from rashes onto soft surfaces, such as upholstered furniture, carpets, or rugs, you can use steam cleaning.
• Disinfection may not be possible for some soft surfaces, like mattresses, if the item has been heavily contaminated with excessive drainage of body fluids from rashes and may need to be thrown out and replaced.
• If the person with mpox did not have a lot of contact with soft furnishings, disinfect the surface with an EPA-registered disinfectant from List Q: Disinfectants for Emerging Viral Pathogens that can be used on soft surfaces.

Waste Disposal

The person with mpox should use a dedicated, lined trash can in the room where they are isolating. Collect any soiled waste, such as bandages, paper towels, food packaging, and other general trash items and make sure it’s put in a sealed bag.

• Any gloves, bandages, or other waste and disposable items that have been in direct contact with skin should be placed in a sealed plastic bag, then thrown away in the dedicated trash can.
• The person with mpox or other household members should use gloves when removing garbage bags and handling and getting rid of trash.

Cleaning and Disinfecting Workplaces and Community Settings

If employers, administrators, or operators are notified that a person with suspected or confirmed mpox was in your facility, clean and disinfect the space. Focus on items and surfaces that were in direct contact with the skin of the person with mpox.

If you use contract cleaning services or commercial laundry facilities, talk with the contractor about the risks so that cleaning staff can take the proper precautions. Restaurants, bars, and other establishments with special cleaning and sanitation requirements should also follow rules according to state and local requirements.

How to Protect Employees When Cleaning and Disinfecting at Work

Workers cleaning and disinfecting areas or performing laundry for a person with suspected or confirmed mpox should wear personal protective equipment (PPE). PPE can help protect workers from exposure to Monkeypox virus and harmful levels of chemicals used for cleaning and disinfection.

Provide the recommended PPE for protection from Monkeypox virus, which includes:

• Well-fitting mask or NIOSH-approved particulate respirator with an N95 filter or higher
• Gloves
• Gown
• Eye protection

Do not dry dust or sweep, which may spread dust particles that contain virus into the air.

• Wet cleaning methods are preferred, such as disinfectant wipes, sprays, and mopping.
• Vacuuming is okay if you are using a vacuum with a high-efficiency air filter. If a high-efficiency air filter is not available, make sure the person vacuuming wears a respirator (such as an N95).

Workers should wash their hands with soap and water for 20 seconds after cleaning. Be sure to wash hands immediately after removing gloves.

• If soap and water are not available, use an alcohol-based sanitizer that contains at least 60% alcohol.
• If hands are visibly dirty, always wash hands with soap and water before using hand sanitizer.

How to Clean and Disinfect Types of Surfaces

Laundry

• Contaminated laundry, which is laundry used by a person with mpox, should not be mixed with other laundry.
• Put used or contaminated clothing, linens and bedding materials, towels, and other fabric items in either:
  • A waterproof container or bag that can be disinfected or thrown away afterwards
  • A fabric bag that may be used and can be washed along with the dirty or contaminated items
• Do not shake or handle dirty or contaminated laundry in a way that may spread particles with virus in the air.
• Wash laundry in a standard washing machine with detergent, following instructions on the label. Laundry sanitizers may be used but are not necessary.

Hard (non-porous) Surfaces

• Clean and disinfect commonly touched surfaces and items using soap and water and an EPA-registered disinfectant from List Q: Disinfectants for Emerging Viral Pathogens that can be used on hard surfaces.
  • Commonly touched items include surfaces like desks, conference tables, countertops, door handles, toilet flush handles, faucets, light switches, and floors.
• Wash soiled dishes and eating utensils in a dishwasher with detergent and hot water or by hand with hot water and dish soap.

Soft (porous) Surfaces

• If the person with mpox had direct skin contact or drainage of fluids from rashes onto soft surfaces, such as upholstered furniture, carpets, or rugs, you can use steam cleaning.
• Disinfection may not be possible for some soft surfaces, like mattresses, if the item has been heavily contaminated with excessive drainage of body fluids from rashes and may need to be thrown out and replaced.
• If the person with mpox did not have a lot of contact with soft furnishings, disinfect the surface with an EPA-registered disinfectant from List Q: Disinfectants for Emerging Viral Pathogens that can be used soft surfaces.

Waste Disposal

Treat or get rid of waste in accordance with applicable waste management laws.

Additional Consideration for Employers

Develop policies for worker protection and train all cleaning staff on site before providing cleaning tasks. Employers must follow applicable Occupational Safety and Health Administration standards, including:

• Hazard Communication standard (29 CFR 1910.1200), including training workers on the hazards of the cleaning chemicals used in the workplace.
• PPE (29 CFR 1910.132) and Respiratory Protection (29 CFR 1910.134) standards.
• Other OSHA requirements, including those established by state plans, whenever such requirements apply.
• OSHA’s Bloodborne Pathogens standard (29 CFR 1910.1030) applies to occupational exposure to human blood and other potentially infectious materials that typically do not include respiratory secretions, or rash lesions fluid or pus, that may contain monkeypox virus (unless visible human blood is present). However, the provisions of the standard offer a framework that may help control some sources of the virus, including exposures to body fluids (such as, respiratory secretions) not covered by the standard.

Talk to Your Healthcare Provider If You Were Exposed or Have Symptoms

• If you have mpox symptoms or had close contact with someone who has mpox, talk to your healthcare provider. If you have symptoms, do not travel until you confirm that you do not have mpox.
• CDC recommends vaccination for people who have been exposed to mpox and for people who are at higher risk of being exposed to mpox.

Do Not Travel If You Have Mpox

• Isolate at home or in another location until your symptoms are gone and your rash has healed; this means until all scabs have fallen off and a fresh layer of skin has formed.
• If you have mpox and must travel:
  • Make sure that you do not have fever or respiratory symptoms such as sore throat, nasal congestion, or cough.
  • Cover your rash and wear a well-fitting mask.
  • Take additional steps to prevent spread to others.

Additional Travel Considerations

Learn how you can protect yourself and others from mpox during your trip.

• If you test positive for mpox while at an international destination, you may be subject to local public health laws and regulations. These could include requirements to isolate and to not travel until you are no longer considered contagious.
• If you have been in close contact with a person who has mpox and travel internationally, you may be subject to local public health laws and regulations. These could include requirements to quarantine and not travel until you are no longer at risk for developing mpox.
• Some countries are screening arriving passengers for mpox symptoms. If you have symptoms, you may be required to isolate and to be tested for mpox. Check your destination’s ministry of health or US embassy website to learn about arrival procedures.
• If you need medical care abroad, see Getting Health Care During Travel. Consider travel health and medical evacuation insurance. Some treatment options may not be available in some countries.

When to Get Tested

• Currently, testing is only recommended if you have a rash consistent with mpox.
• If you think you have mpox or have had close personal contact with someone who has mpox, consider taking precautions and visit a healthcare provider to help you decide if you need to be tested for mpox.

Where to Get Tested

• Only a healthcare provider can order an mpox test. The healthcare provider may take a specimen and send it to a lab for testing or they may send you to a lab for both specimen collection and testing.
• Contact your local health department with any questions and to find out what the testing options are for your community.

What to Expect When You Get Tested

• You will likely need to fill out paperwork before you get tested.
• To get a specimen to test, the healthcare provider will use a swab to rub vigorously across lesions of your rash. They will take swabs from more than one lesion.
• This swabbing may be uncomfortable but is necessary to get enough material to detect the mpox virus from the specimens.
• The specimens will be tested in a lab to see if the mpox virus is detected.
• Results are usually available within a few days.
• While you are waiting for your results, take precautions to avoid getting or spreading mpox virus to others.

What Your Results Mean

• If your test result is positive, take the necessary steps to protect yourself and others until you have completely recovered from your infection.
• If your test result is negative: a negative test result means the test did not detect the virus and you probably do not have mpox. Continue to take steps to protect yourself and others.
• If your test result is inconclusive: that means that your test will need to be conducted again because not enough of the specimen was taken.

Paying for Testing

The cost of mpox testing depends on where you get it.

• Tests conducted by public health departments are usually free.
• Testing referrals from a private healthcare provider to a commercial lab or tests done in the hospital may involve a fee.
• For information on testing options in your community contact your local health department.

Patient's Guide to Tecovirimat

What You Need to Know

• There are no treatments specifically for mpox. But because the viruses that cause mpox and smallpox are similar, antiviral drugs developed to protect against smallpox may be used to treat mpox effectively.
• The antiviral drug tecovirimat (TPOXX) has been approved by the Food and Drug Administration (FDA) to treat smallpox in adults and children. Drugs developed to treat smallpox may be used to treat mpox.
• If you are prescribed tecovirimat, you will be asked to sign a consent form stating you understand tecovirimat is an investigational drug that has not yet been approved by the FDA for treatment of mpox. Investigational means there is not currently enough data available from testing in people on the safety and effectiveness of tecovirimat for treating people with mpox.
• Research is currently happening to test the safety and effectiveness for all people with mpox.
• Tecovirimat is currently only for people with severe mpox disease or who are at high risk of severe disease, like people with weakened immune systems or skin conditions, such as HIV that is not virally suppressed and eczema.
• Tecovirimat may help prevent or minimize severe mpox disease involving the eyes, mouth, throat, genitals, and anus (butthole). It may provide relief for short-term symptoms such as pain, swelling, and abscesses and long-term effects such as scarring.
• If you have mpox symptoms, visit a healthcare provider.

About Tecovirimat

• Tecovirimat is for people with severe disease or those at high risk of developing severe disease.
• Tecovirimat can reduce the amount of the virus in the body. Tecovirimat is considered investigational for the treatment of mpox because sufficient data are not yet available on the safety and effectiveness of tecovirimat in treating people with mpox.
• Research focused on safety in healthy people without mpox virus infection showed the drug was safe.
• There are current studies looking at tecovirimat as a treatment for mpox in people. Additionally, previous studies including a variety of animal species show tecovirimat can be an effective treatment for orthopoxviruses (such as mpox) in animals.
• Drugs that are effective in animal studies are not always effective in humans. Conducting studies to assess tecovirimat’s safety and efficacy in humans with mpox infections is essential.

The FDA has not yet approved tecovirimat for treatment against mpox. Under the expanded access investigational new drug (EA-IND) protocol, CDC, in partnership with FDA, has made tecovirimat easier for healthcare providers to prescribe to people with mpox who have or who are at high risk of severe disease.

CDC is providing this information as a resource for people who may be interested in the NIH-funded tecovirimat study.

Tecovirimat is not right for everyone

• Healthcare providers should not prescribe tecovirimat to people with milder mpox symptoms.
• When tecovirimat is prescribed too often to people with milder mpox symptoms, it may increase the chance that the mpox virus develops resistance to the medication. This means the drug might no longer work for mpox.
• The CDC and FDA are taking steps to reduce the possibility of resistance from happening by recommending that tecovirimat only be prescribed to those who need it the most at this time.
• Treatment for mpox should also include efforts to manage your symptoms. Medicines like ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) can help you feel better.

How to know if it is right for you

Most people with mpox recover fully within 2 to 4 weeks without the need for medical treatment. 

A healthcare provider may prescribe tecovirimat for the following people:

• With severe mpox disease such as:
  • bleeding or infected lesions/rash
  • lesions that have merged into larger lesions
  • any other conditions that require hospitalization
• With immunocompromised conditions (such as HIV that is not virally suppressed, leukemia, lymphoma, persons undergoing chemotherapy, organ transplantation, or autoimmune diseases)
• With rash or lesions in areas such as the eyes, mouth, throat, genitals, and anus (butthole) that are at risk for severe disease in both the short-term (pain, swelling, abscesses etc.) and the long-term (scarring, etc.)
• With an active disease or condition that affects the skin (such as atopic dermatitis, eczema, psoriasis, impetigo, severe acne, herpes, or burns)
• Who are children, particularly those under 1 year old
• Who are pregnant or breastfeeding

If you are prescribed tecovirimat, you will be asked to sign a consent form stating you understand tecovirimat is an investigational drug that has not yet been approved by the FDA for treatment of mpox.

Based on community feedback and the need to understand tecovirimat for treating mpox in people with severe and mild disease, the National Institutes of Health, in association with the AIDS Clinical Trials Group, will be conducting a research study to understand its effectiveness.

How to pay for Tecovirimat

• Tecovirimat is currently free.

Contact a healthcare provider

• To find out if tecovirimat is right for you.
• If you have mpox symptoms.
• If your mpox symptoms get worse.

What is Mpox?

Mpox is a disease caused by infection with mpox virus. An outbreak is occurring around the world in areas where mpox is not usually found. Previously, mpox was found mainly in Central and West Africa, often in forested areas.

People infected with mpox develop a rash that can look like pimples or blisters and the rash may be painful or itchy.

What are the symptoms?

Symptoms of mpox can include:

• Fever
• Headache
• Muscle aches and backache
• Swollen lymph nodes
• Chills
• Exhaustion
• Respiratory symptoms (e.g. sore throat, nasal congestion, or cough)
• A rash that can look like pimples or blisters and may be painful or itch that may be located on or near the genitals (penis, testicles, labia, and vagina) or anus (butthole) but could also be on other areas like the hands, feet, chest, face, or mouth. The rash will go through several stages, including scabs, before healing. The illness typically lasts 2–4 weeks.

How does mpox spread?

Mpox can spread to anyone through close, personal, often skin-to-skin contact, including:

• Direct contact with mpox rash, scabs, or body fluids from a person with mpox.
• Touching objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with mpox.
• Contact with respiratory secretions from someone with mpox.
• Direct contact can happen during intimate contact, including:
  • Oral, anal, and vaginal sex or touching the genitals (penis, testicles, labia, and vagina) or anus (butthole) of a person with mpox.
  • Hugging, massage, and kissing.
  • Prolonged face-to-face contact.
  • Touching fabrics and objects during sex that were used by a person with mpox and that have not been disinfected, such as bedding, towels, fetish gear, and sex toys.

It’s also possible for people to get mpox from infected animals if they are scratched or bitten by the animal or by preparing or eating meat or using products from an infected animal.

Who is at risk?

Anyone in close contact with a person with mpox can get it and should take steps to protect themselves. 

Travelers who plan to attend gatherings that may place them in close, skin-to-skin contact with someone who has mpox may be at higher risk of getting infected.

People who care for someone who has mpox without wearing gloves and a well-fitting mask are also more likely to get infected. Travelers such as veterinarians and wildlife professionals may be at risk if they work with infected animals.

What can travelers do to prevent mpox?

Travelers can protect themselves against infection by taking the following steps.

• Avoid close, skin-to-skin contact with people who have a rash that looks like mpox.
  • Do not touch the rash or scabs of a person with mpox.
  • Do not kiss, hug, cuddle or have sex with someone with mpox.
• Avoid contact with objects and materials that a person with mpox has used.
  • Do not share eating utensils or cups with a person with mpox.
  • Do not handle or touch the bedding, towels, or clothing of a person with mpox.
• Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially before eating or touching your face and after you use the bathroom.

In Central and West Africa, avoid contact with animals that can spread mpox virus, usually rodents and primates. Also, avoid sick or dead animals, as well as bedding or other materials they have touched.

What should you do if you develop mpox symptoms?

If you have symptoms of mpox or had close contact with someone who has mpox, talk to your healthcare provider. If you have symptoms, do not travel until you confirm you do not have mpox.

Do Not Travel if You Have Mpox

• Isolate at home or in another location until your symptoms are gone and your rash has healed; this means all scabs have fallen off and a fresh layer of skin has formed.
• If you have mpox and must travel:
  • Make sure that you do not have fever or respiratory symptoms such as sore throat, nasal congestion, or cough.
  • Cover your rash and wear a well-fitting mask.

Additional Travel Considerations

• If you test positive for mpox while at your international destination, you may be subject to local public health laws and regulations. These could include requirements to isolate and not being allowed travel until you are no longer considered contagious.
• If you have been in contact with a person who has mpox and travel internationally, you may be subject to local public health laws and regulations. These could include requirements to quarantine and not being allowed travel until you are no longer at risk for developing mpox.
• Some countries are screening arriving passengers for symptoms of mpox. If you have symptoms, you may be required to isolate and be tested for mpox. Check your destination’s ministry of health or US embassy website to learn about arrival procedures.
• If you need medical care abroad, see Getting Health Care During Travel. Consider travel health and medical evacuation insurance. Options for treatment may not be available in some countries.

What is mpox?

Mpox, which used to be called monkeypox, is a rare disease caused by infection with the mpox virus. The mpox virus is in the same family of viruses as the smallpox virus. But mpox is less contagious than smallpox. And its disease causes milder symptoms and is usually not fatal.

In the past, most of the people who got mpox lived in certain parts of central and western Africa, had traveled there, or had been exposed to infected animals imported from there. During the recent outbreak, the disease has been found in people who live in other countries, including the United States.

How does mpox spread?

Mpox spreads in different ways:

• Through close, personal, often skin-to-skin contact with someone who has the virus:
  • Through direct contact with their rash, scabs, or body fluids.
  • By breathing in the virus during prolonged, face-to-face contact.
  • During intimate physical contact such as kissing, cuddling, hugging, massage or sex.
• During pregnancy, from the pregnant person to the baby.
• From touching items (such as clothes, bedding, or towels) that were used by someone who has the virus. The risk of getting mpox this way is low.
• From infected animals:
  • By being scratched or bitten by the animal.
  • By preparing or eating meat or using products from the animal.

Someone who has mpox can spread it from the time their symptoms start until their rash has fully healed, all scabs have fallen off, and a fresh layer of skin has formed. This usually takes 2-4 weeks.

What are the symptoms of mpox?

The symptoms of mpox usually start within 3 weeks from the time you were exposed to the virus. The symptoms may include:

• A rash with sores that can look like pimples or blisters. It could be on the face, inside the mouth, and on other parts of the body, like the hands, feet, chest, genitals, or anus. It goes through different stages, including scabs, before healing. This can take 2-4 weeks.
• Fever.
• Chills.
• Swollen lymph nodes ("swollen glands").
• Exhaustion.
• Headache.
• Muscle aches and backache.
• Respiratory symptoms, such as a sore throat, nasal congestion, or cough.

You may have all or only a few symptoms:

• You may get a rash first, followed by other symptoms
• You may have flu-like symptoms and then develop a rash 1-4 days later
• You may only get a rash

How is mpox diagnosed?

To find out if you have mpox, your provider:

• Will ask about your symptoms and health history.
• Will look at your rash.
• Will take a sample of tissue from one of the sores so it can be tested for mpox virus.
• May do blood tests to check for mpox virus or for antibodies to the virus. Antibodies are proteins that your immune system makes to fight foreign substances, such as viruses and bacteria.

What are the treatments for mpox?

There are no treatments specifically for mpox, but many people get better on their own.

Since mpox and smallpox are similar, antiviral medicines that protect against smallpox may also help treat mpox. Antiviral medicines may be recommended for people who are more likely to get severely ill, such as patients who have weakened immune systems.

Can mpox be prevented?

There are steps you can take to help prevent mpox:

• Avoid close, skin-to-skin contact with the mpox rash. So, while a person is sick with mpox:
  • Do not touch their rash or scabs.
  • Do not kiss, hug, cuddle, or have sex with them.
  • Do not share eating utensils or cups with them.
• Do not touch the bedding, towels, or clothing of a person who has mpox.
• Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially after contact with sick people.
• In Central and West Africa, avoid contact with animals that can spread mpox virus, such as rodents and primates. Also, avoid sick or dead animals, as well as any bedding or other materials they have touched.

If you are sick with mpox it is recommended that you stay home while you are sick, if possible. If you have an active rash or other symptoms, it would be best to stay in a separate room from your family members and pets if you can.

The U.S. government has two vaccines in the U.S. to protect against mpox. One was approved for smallpox and mpox (JYNNEOS), and the other was approved for smallpox (ACAM2000):

• JYNNEOS is the preferred vaccine to protect against mpox. It is a two-dose vaccine.
• ACAM2000 may be an alternative to JYNNEOS. ACAM2000 is a single-dose vaccine. But it has the potential for more side effects and adverse events than JYNNEOS. And it is not recommended for people who are pregnant, are under 12 months old, have severely weakened immune systems, or have certain medical conditions.

The U. S. Centers for Disease Control and Prevention (CDC) recommends vaccination for people who have been exposed to mpox or who are more likely to get mpox.

What is mpox?

Mpox is a rare disease caused by infection with the mpox virus. Mpox virus is part of the same family of viruses as variola virus, the virus that causes smallpox. Mpox symptoms are similar to smallpox symptoms, but milder, and mpox is rarely fatal.

When should someone get tested for mpox?

People who think they have mpox or have had close personal contact with someone who has mpox should visit a healthcare provider to help them decide if they need to be tested for mpox. If they decide that you should be tested, they will work with you to collect the specimens and send them to a laboratory for testing.

What are the symptoms of mpox?

Symptoms of monkeypox can include:

• Fever
• Headache
• Muscle aches and backache
• Swollen lymph nodes
• Chills
• Respiratory symptoms (e.g. sore throat, nasal congestion, or cough)
• A rash that can look like pimples or blisters that appears on the face, inside the mouth, and on other parts of the body, like the hands, feet, chest, genitals, or anus.
  • The rash goes through different stages before healing completely. The illness typically lasts 2-4 weeks.

Sometimes, people get a rash first, followed by other symptoms. Others only experience a rash.

What should I do if I have symptoms?

• See a healthcare provider if you notice a new or unexplained rash or other mpox symptoms.
• Remind the healthcare provider that mpox is present in the United States.
• Avoid close contact (including intimate physical contact) with others until you see a healthcare provider.
• Avoid close contact with pets or other animals until you see a healthcare provider.
• If you’re waiting for test results, follow the same precautions.
• If your test result is positive, stay isolated and observe other prevention practices until your rash has healed, all scabs have fallen off, and a fresh layer of intact skin has formed.
• Remain isolated if you have a fever, sore throat, nasal congestion, or cough. Only go out to see a healthcare provider or for an emergency. Avoid public transportation.
• If you must leave isolation, cover the rash and wear a well-fitting mask.

How does mpox spread?

Mpox can spread from person to person through direct contact with the infectious rash, scabs, or body fluids. It also can be spread by respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact, such as kissing, cuddling, or sex.

A person with mpox can spread it to others from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. Some people have been found to have infection but no symptoms. To date, however, there is no evidence that mpox spreads from people with no symptoms. CDC will continue to monitor for new or changing information about transmission.

Is mpox a sexually transmitted infection (STI)?

Mpox can more accurately be described as “sexually transmissible.” In other words, sex is just one of the ways that mpox can be spread. In the past, mpox outbreaks have been linked to direct exposure to infected animals and animal products, with limited person-to-person spread. In the current mpox outbreak, the virus is spreading primarily through close personal contact. This may include contact with infectious lesions or respiratory secretions via close, sustained skin-to-skin contact that occurs during sex. However, any close, sustained skin-to-skin contact with someone who has mpox can spread the virus. The contact does not have to be exclusively intimate or sexual.

Can mpox spread through water in pools, hot tubs, or splash pads?

No studies have found a clear link between mpox and water in pools, hot tubs, or splash pads. The mpox virus is killed in water at the chlorine levels recommended for disinfection in recreational water venues by CDC and required by U.S. jurisdictions.

However, it is possible to spread mpox to others through close, skin-to-skin contact. It can also be spread by sharing objects that a person with mpox used, such as towels, kickboards, pool toys, or clothing.

How can mpox be prevented?

• Avoid close, skin-to-skin contact with people who have a rash that looks like mpox.
• Avoid contact with objects and materials that a person with mpox has used.
• Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially before eating or touching your face and after you use the bathroom.

Should people be concerned about going to crowded events?

People can get mpox if they have close, skin-to-skin contact with someone who has mpox. Early indications are that events with activities in which people engage in close, sustained skin-to-skin contact have resulted in cases of mpox. If you plan to attend an event, consider how much close, personal, skin-to-skin contact is likely to occur there.

What treatments are available for mpox?

There are no treatments specifically for mpox virus infections. However, because of genetic similarities in the viruses, antiviral drugs used to treat smallpox may be used to treat mpox infections.

Is there a vaccine to prevent mpox?

Because mpox and smallpox viruses are genetically similar, vaccines developed to protect against smallpox viruses may be used to prevent mpox infections.

The U.S. government has two stockpiled vaccines—JYNNEOS and ACAM2000—that can prevent mpox in people who are exposed to the virus.

Who should get vaccinated?

CDC recommends vaccination for people who have been exposed to mpox and people who may be more likely to get mpox, including:

• People who have been identified by public health officials as a contact of someone with mpox
• People who know one of their sexual partners in the past 2 weeks has been diagnosed with mpox
• People who had multiple sexual partners in the past 2 weeks in an area with known mpox

Where can you find out if you’re eligible for a vaccine?

If you think you may be eligible for vaccination, contact a healthcare provider or your local health department. They can help you determine if you should get vaccinated.

If I am a man and have had multiple male sexual partners recently, does that automatically make me eligible for the vaccine?

No. Having multiple sexual partners is one consideration, but there are others, such as whether you live in an area with ongoing spread of mpox or if one of your partners has recently been infected with mpox. If you think you have mpox or might be at risk for infection, contact a healthcare provider.

Could my pet get mpox?

Mpox is zoonotic, meaning it can spread between animals and people. However, CDC does not currently believe that mpox poses a high risk to pets. We are continuing to monitor the situation closely.