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Monkeypox

FAQs & Guidance

There is a lot of misinformation and confusion about Monkeypox.  That’s why we created detailed Monkeypox FAQs to give you the clear information you need.  

Please read below and reach out if you have any questions.  We’re here to help.

What is Monkeypox?

Monkeypox is a rare disease caused by infection with the Monkeypox virus.   Monkeypox can occur on any part of the body. 

Monkeypox typically is spread when skin touches the infectious rash or sores directly or when skin directly touches an object that has been in contact with the infectious rash. Monkeypox can also spread by inhaling droplets in close contact.

Symptoms usually start within 3 weeks of exposure to the virus. It can spread from the time symptoms start until the rash has healed. The illness typically lasts 2-4 weeks. Monkeypox is rarely fatal.  

Please read below for more information include detailed Monkeypox FAQ

How can I protect myself?

Alcohol-based hand sanitizer is very effective in reducing the likelihood of spreading the virus to other parts of your body and to others, and you should wash your hands thoroughly or use hand sanitizer should you touch the rash.

Limiting your number of sexual partners reduces your risk of exposure. So does avoiding group sex venues such as sex parties or bathhouses. Don’t forget that it’s ok to have open discussions with your potential partners about their recent sexual activities or Monkeypox exposures. It’s likely that your partner may have anxieties about monkeypox too, and these conversations can help put both of you at ease.

Wearing a condom does help prevent STIs and HIV, but not Monkeypox. Although Monkeypox is not an STI, intimate contact is the most significant risk factor at present for acquiring the infection.

what are common symptoms?

People with Monkeypox get a rash that may be located on or near the genitals (penis, testicles, labia, and vagina) or anus (butthole) and could be on other areas like the hands, feet, chest, face, or mouth.  

Some may also have flu symptoms like fever, aches and chills.  Symptoms may appear before or after the rash and some may only get a rash without other symptoms.

The rash can initially look like pimples or blisters and may be painful or itchy.

The rash will go away through several stages, including scabing before healing.  Monkeypox is considered  healed once all scabs have fallen off and a fresh layer of skin has formed.

What should I do If i have symptoms?

Avoid close contact, including sex or being intimate with anyone, until you have been checked out by a healthcare provider.  Make and appointment and see a healthcare provider as soon as possible.

There is no treatment specifically for Monkeypox.  Your healthcare provider can help you create a plan to take care of yourself and manage your symptoms.   For additional information see the FAQs below for guidance on managing the rash, symptoms and advice on taking care of yourself.

 

HOw can I prevent the Spread?

If you have monkeypox, you are advised to stay at home (isolate) if you have monkeypox symptoms, including until your Monkeypox 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 Monkeypox.  

You can help prevent the spread of Monkeypox by washing your hands frequently, using hand sanitizer and avoiding sex with others.

Monkeypox can also spread to animals, so staying away from pets, livestock and other animals is important.

 

FAQs

General Monkeypox information

Monkeypox 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. Monkeypox symptoms are similar to smallpox symptoms, but milder, and monkeypox is rarely fatal. Monkeypox is not related to chickenpox.

Monkeypox 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 monkeypox was recorded in 1970. Prior to the 2022 outbreak, monkeypox had been reported in people in several central and western African countries. Previously, almost all monkeypox 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.

While the outbreak is attracting headlines, there is little threat of a massive global pandemic – and no comparison to COVID-19.

There are important differences that make monkeypox a much less serious threat than COVID-19:

 These include:

  • Monkeypox does not spread easily.
  • Infected people are easier to identify.
  • Outbreaks are easier to contain.
  • There are two vaccines that are effective against monkeypox.

Unlike COVID-19, this virus doesn’t transmit human to human very efficiently and It’s also much easier prevent the spread and isolate infected individuals

Monkeypox can more accurately be described as “sexually transmissible.” In other words, sex is just one of the ways that monkeypox can be spread. In the past, monkeypox outbreaks have been linked to direct exposure to infected animals and animal products, with limited person-to-person spread. In the current monkeypox 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 monkeypox can spread the virus. The contact does not have to be exclusively intimate or sexual.

Monkeypox can spread between animals and people.  It is possible that people who are infected can spread Monkeypox virus to animals through close contact, including petting, cuddling, hugging, kissing, licking, sharing sleeping areas, and sharing food.  Infected people should not take care of their pets.  Unexposed pets should be cared for by uninfected people in a separate house.  Exposed pets should be kept at home an isolated for 21 days.  Infected people should not take care of exposed pets.  Visit the CDC website for additional guidance.

prevention

Avoid close, skin-to-skin contact with people who have a rash that looks like monkeypox.
  • Do not touch the rash or scabs of a person with monkeypox.
  • Do not kiss, hug, cuddle or have sex with someone with monkeypox.
Avoid contact with objects and materials that a person with monkeypox has used.
  • Do not share eating utensils or cups with a person with monkeypox.
  • Do not handle or touch the bedding, towels, or clothing of a person with monkeypox.
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.

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

  • Take a temporary break from activities that increase exposure to monkeypox 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 monkeypox.
  • Condoms (latex or polyurethane) may protect your anus (butthole), mouth, penis, or vagina from exposure to monkeypox. However, condoms alone may not prevent all exposures to monkeypox 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 monkeypox 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 monkeypox 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. Learn more about infection control.
  •  

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 monkeypox 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 monkeypox 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 monkeypox.

If you or a partner has monkeypox or think you may have monkeypox, 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.

 

 

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 monkeypox.
  • 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 monkeypox.

Monkeypox Vaccine

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

The preferred vaccine to protect against monkeypox is JYNNEOS, which is a two-dose vaccine. It takes 14 days after getting the second dose of JYNNEOS for its immune protection to reach its maximum.

JYNNEOS (also called Imvamune or Imvanex) is approved by the U.S. Food and Drug Administration(FDA) to prevent Monkeypox infection if you are 18 years or older.
• If given before exposure or within 4 days of exposure, JYNNEOS may reduce the chance of infection. If given between 5 and 14 days after exposure, it may lower the severity of symptoms.
REMEMBER – You will not be fully vaccinated and getting the most benefit from this vaccine until 2 weeks after your second shot of JYNNEOS.

The ACAM2000 vaccine may be an alternative to JYNNEOS. ACAM2000 is a single-dose vaccine, and it takes four weeks after vaccination for its immune protection to reach its maximum. However, it has the potential for more side effects and adverse events than JYNNEOS. It is not recommended for people with severely weakened immune systems and several other conditions.

People should take precautions to reduce their exposure to Monkeypox until immune protection from vaccines has reached its maximum. Consult your healthcare provider to see if you should get vaccinated against Monkeypox, and if you should receive ACAM2000 instead of JYNNEOS.

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

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

There are currently limited supplies of the Monkeypox vaccines and the CDC does not recommend widespread vaccination against Monkeypox at this time. During this outbreak, people who are sexually active are not considered to be at risk for Monkeypox unless their sexual partners have Monkeypox or they have had multiple sexual partners within the past 14 days in areas where Monkeypox cases have been reported.

If you are healthy the most common reactions are:
o Pain and redness at the injection site
o Swelling, firmness, or itching near the injection site
o Muscle pain
o Headache
o Fatigue
o Nausea
o Chills
• If you are an adult with HIV-infection or eczema, you are about as likely as those who don’t have those conditions to experience the skin-related reactions listed above.
• Contraindications for JYNNEOS include severe or immediate reaction to any component of the vaccine (e.g., gentamicin, ciprofloxacin, egg protein, benzonase).The risk for a severe allergic reaction should be weighed against the risk for disease due to monkeypox.
• A person who is diagnosed with monkeypox virus infection after their first dose of JYNNEOS is not recommended to receive the second dose at this time. A person who is eligible for the vaccine but has been diagnosed with monkeypox during this outbreak, which started in the United States on May 17, 2022, is not recommended to be vaccinated at this time. If you had any reaction or side effect to the
first dose of vaccine, notify your health care provider and discuss the benefits and risk of getting the second dose.
• Call 911 immediately if you experience symptoms of an allergic reaction. These symptoms may include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, or weakness. Report any reactions to your health care provider or to the Vaccine Adverse Event Reporting System at 1-800-822-7967 or www.vaers.hhs.gov

Symptom management

  • 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.

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.

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.

HIV & MOnkeypox

CDC doesn’t know if having HIV increases the likelihood of getting Monkeypox. Monkeypox can spread to anyone through prolonged, close, personal, often skin-to-skin contact, as well as through contact with objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with Monkeypox, or contact with respiratory secretions, through kissing and other face-to-face contact.

CDC continues to monitor monkeypox among people with HIV. During the current monkeypox outbreak, there does not appear to be more severe monkeypox illness in people who have HIV and are virally suppressed (having less than 200 copies of HIV per milliliter of blood). In fact, the World Health Organization (WHO) monkeypox guidance states, “People living with HIV on antiretroviral therapy with suppressed viral load are not considered to be immunosuppressed.” However, people with HIV who are not virally suppressed may be at increased risk for severe illness and death from monkeypox.

 

Vaccination is recommended for anyone with a probably exposure to Monkeypox but you should speak with your healthcare provider to find out what is best for you.  

Data is limited, but most HIV treatment can be safely given with Monkeypox treatment and smallpox vaccines. People with HIV should inform their healthcare provider of all their medications to help determine if any interactions exist.

Household Isolation & Cleaning

Monkeypox spreads between people through direct contact with an infectious rash, body fluids, or by respiratory secretions during prolonged, face-to-face contact. Transmission of Monkeypox virus is possible from the onset of the first symptoms until the scabs have separated and the skin has fully healed.

During the infectious period of time, body fluids, respiratory secretions, and lesion material from people with monkeypox can contaminate the environment. Poxviruses can survive in linens, clothing and on environmental surfaces, particularly when in dark, cool, and low humidity environments. In one study, investigators found live virus 15 days after a patient’s home was left unoccupied. Studies show that other closely related Orthopoxviruses can survive in an environment, similar to a household, for weeks or months. Porous materials (bedding, clothing, etc.) may harbor live virus for longer periods of time than non-porous (plastic, glass, metal) surfaces.

Orthopoxviruses are very sensitive to UV light. Despite the ability of Orthopoxviruses to persist in the environment, they are also sensitive to many disinfectants, and disinfection is recommended for all areas (such as home and vehicle) where a person with monkeypox has spent time, as well as, for items considered to be potentially contaminated.

Use an EPA-registered disinfectant, in accordance with the manufacturer’s instructions. Follow all manufacturer directions for use, including concentration, contact time, and care and handling. When choosing a disinfectant, it is important to consider any potential health hazards, and do not mix disinfectants or add other chemicals. More considerations can be found here: Hazard Communication for Disinfectants Used Against Viruses | NIOSH | CDC. Follow these steps for safe and effective disinfectant use:

  • Check that your product is EPA-registered: Find the EPA registration number on the product.
  • Read the directions: Follow the product’s directions. Check “use sites” and “surface types” to make sure this is the right product for your surface. Next, read the “precautionary statements.”
  • Pre-clean the surface: Make sure to wash the surface with soap and water if the directions mention pre-cleaning or if the surface is visibly dirty. Dirt can keep the disinfectant from working.
  • Follow the contact time: Follow the instructions: The surface should remain wet for the amount of time indicated to ensure the product is effective. Reapply if necessary.

During isolation at home, people with monkeypox should clean and disinfect the spaces they occupy regularly to limit household contamination.

  • ISOLATING ALONE IN HOME: People with monkeypox who are isolating alone at home should regularly clean and disinfect the spaces they occupy, including commonly touched surfaces and items, to limit household contamination. Perform hand hygiene afterwards using an alcohol-based hand rub (ABHR) that contains at least 60% alcohol, or soap and water if ABHR is unavailable.
  • ISOLATING WITH OTHERS IN HOME: People with monkeypox who are isolating in a home with others who don’t have monkeypox should follow the isolation and infection control guidance, and any shared spaces, appliances, or items should be disinfected immediately following use.

People who have recovered from monkeypox and whose isolation period has ended should conduct a thorough disinfection of all the spaces within the home that they had been in contact with. Follow the steps below to minimize risk of infection to others in your home after recovery.

  • If cleaning and disinfection is done by someone other than the person with monkeypox, that person should wear, at a minimum, disposable medical gloves and a respirator or well-fitting mask.
  • Standard clothing that fully covers the skin should be worn, and then immediately laundered according to recommendations below.
  • Hand hygiene should be performed using an ABHR, or soap and water if ABHR is unavailable.
  • Focus on disinfecting items and surfaces that were in direct contact with the skin of the person with monkeypox, or often in the presence of the person with monkeypox, during isolation. If unsure, disinfect.
  • Do not dry dust or sweep as this may spread infectious particles.
    • Wet cleaning methods are preferred such as disinfectant wipes, sprays, and mopping.
    • Vacuuming is acceptable using a vacuum with a high-efficiency air filter. If not available, ensure the person vacuuming wears a well-fitting mask or respirator.
  • Clean and disinfect household in the following order:
    1. General waste containment
      1. Collect and contain in a sealed bag any soiled waste such as bandages, paper towels, food packaging, and other general trash items.
    2. Laundry
      1. Gather contaminated clothing and linens before anything else in the room is cleaned. Do not shake the linens as this could spread infectious particles.
    3. Hard surfaces and household items
    4. Upholstered furniture and other soft furnishing
    5. Carpet and flooring
    6. Waste disposal

 

 

 

Laundry

Used or contaminated clothing, linens and bedding materials, towels, and other fabric items should be contained until laundering. When at all possible, people with monkeypox should handle and launder their own soiled laundry. Laundry should not be mixed with that of other members of the household.

Follow these laundering procedures:

  • Handle soiled laundry according to standard practices, avoiding contact with contaminates from the rash that may be present on the laundry.
  • Soiled laundry should never be shaken or handled in a manner that may spread infectious particles.
  • In-home laundry facilities:
    • Transfer soiled laundry items to be laundered in an impermeable container or bag that can be disinfected afterwards. Alternatively, a fabric bag may be used that can also be laundered along with the soiled items.
    • Wash laundry in a standard washing machine with detergent, following label instructions. Laundry sanitizers may be used but are not necessary.
  • In-home laundry facilities not available:
    • When in-home laundry facilities (facilities not shared with other households) are not available, individuals should coordinate with their local public health department to determine appropriate laundering options.

Hard Surfaces (and non-porous car interiors)

Routinely clean and disinfect commonly touched surfaces and items (such as counters or light switches) using an EPA-registered disinfectant in accordance with the manufacturer’s instructions.

  • This includes surfaces like tables, countertops, door handles, toilet flush handles, faucets, light switches, and floors.
  • Include interior surfaces of refrigerator, freezer, other appliances, interior cabinet spaces, or drawers if they have been accessed by the person with monkeypox.
  • Items and surfaces within the home that have likely not been in contact with the person while sick with monkeypox do not need to be disinfected.
    • This includes clothing and items in drawers or boxes that have not been in contact with, or in the direct presence of the person with monkeypox.
  • Wash soiled dishes and eating utensils in a dishwasher with detergent and hot water or by hand with hot water and dish soap.

Upholstered Furniture, Carpet and Soft Furnishing (and porous car interiors)

  • If the person with monkeypox had direct skin contact and/or excessive drainage of fluids from rashes onto soft furnishings, such as upholstered furniture, carpets, rugs, and mattresses, steam cleaning can be considered. Discuss with state or local health authorities for further guidance.
  • If the person with monkeypox had minimal contact with soft furnishings, disinfect the surface with a surface-appropriate disinfectant.

Waste Disposal

Generally, management of waste from homes, including those of people with monkeypox isolating at home, should continue as normal. Municipal waste management systems routinely collect and dispose of waste materials from individuals with infectious diseases and can do so safely using existing procedures.

  • The person with monkeypox 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 monkeypox or other household members 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. For more information, the Department of Transportation has monkeypox-specific information in Appendix F-2 of the federal interagency guidance for managing solid waste contaminated with a Category A infectious substance.

We offer no-cost sexual health services to all members of the community regardless of race, creed, gender identity and expression, immigration status, sexual orientation, insurance status or ability to pay. 

We also have patient advocates with expertise serving the LGBTQIA+ community, who are with you every step of the way to make sure you receive all medications at little-to-no cost even without insurance. 

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