Monkeypox

Anyone can contract monkeypox after having close physical contact with someone who is infected, especially direct contact with infected lesions (sores), bodily fluids, or other contaminated surfaces. 

Monkeypox spreads primarily through direct contact with infectious sores, scabs, or body fluids, including during sex, as well as activities like kissing, hugging, massaging, and cuddling. 

Monkeypox can spread through touching materials used by a person with monkeypox that haven't been cleaned, such as clothing and bedding. 

It can also spread by respiratory secretions (talking, coughing, sneezing, breathing) during prolonged, close, face-to-face contact. 

Monekypox can be spread through:

Direct skin-to-skin contact with rash lesions

Sexual/intimate contact, including kissing

Living in a house and sharing a bed with someone

Sharing towels or unwashed clothing

Respiratory secretions through prolonged face-to-face interactions (the type that mainly happen when living with someone or caring for someone who has monkeypox)

Monkeypox is not spread through: 

Casual conversations

Walking by someone with monkeypox indoors (e.g., in a grocery store, atrium, or hallway)

Scientists are still learning if monkeypox can be spread through: 

Semen or vaginal fluids

Contact with people who have no symptoms (experts believe people with symptoms are most likely to spread monkeypox, but some people may have very mild illness and not know they are infected).

Symptoms of monkeypox 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 may be located near the genitals (penis, testicles, labia, and vagina) or rectum (butt). They also could appear on other areas like the hands, feet, chest, face, or mouth. 
  • The rash will go through several stages, including scabs, before healing. 
  • The rash can look like pimples or blisters, and may be painful or itchy.

Individuals with monkeypox may experience all or only a few symptoms

• Sometimes, people get a rash first, followed by other symptoms. Others only experience a rash. 
• Most people with monkeypox will get a rash. 
• Some people have developed a rash before (or without) other symptoms. 

Monkeypox symptoms usually start within 3 weeks of exposure to the virus. People infected with monkeypox who first have flu-like symptoms typically will develop a rash 1-4 days later. 

Monkeypox can be spread from the time symptoms start until a rash has healed,  all scabs have fallen off, and a fresh layer of skin has formed. The illness typically lasts 2-3 weeks. 

Monkeypox rashes can appear different at various stages. Generally, the rash starts with red, flat spots that then become bumps. Those bumps then become filled with fluid which turns to pus. The pus bump then breaks and crusts over into a scab. The scabs may be itchy. 

You can view pictures of the monkeypox rash on this page of the CDC website. 

Individuals must have a visible rash, or spots, to receive a monkeypox test. 

The monkeypox test involves a health provider rubbing a swab against spots on the skin, or parts of a rash. The provider (or other clinic/hospital staff) then sends the sample to a specialized lab for testing. 

Students with rashes or other monkeypox symptoms should promptly contact University Health & Counseling Services for evaluation. Providers will assess the symptoms and rash and conduct testing as appropriate, including testing for monkeypox. 

While you are waiting for your test results you may be asked to: 

• Stay away from other people
• Avoid public transportation
• Contact people with whom you have had close or intimate contact with and encourage them to get tested

If you think you may be at risk for monkeypox you should:

• Cover exposed skin whenever around others
• Avoid sharing bedding, linens or clothing
• Ask anyone with whom you have had sex or close contact about their health
• Stay aware of potential risks when traveling

If you already have symptoms: 

• Cover the area of the rash with clean, dry, loose-fitting clothing
• Wear a well-fitted mask
• Avoid skin-to-skin or other close contact
• Contact a healthcare provider as soon as possible
• Avoid being around others
• Inform sexual partners or others with whom you have been in close contact of symptoms you experience.

It is important that you follow your healthcare provider's guidance to keep yourself healthy and avoid infecting others. You may also be contacted by a local health department for contact tracing. 

If you have a rash, isolate in your residence until it is fully healed- i.e., scabs have fallen off, and a fresh layer of intact skin has formed.

If you received a notice that you may have been exposed, think about people with whom you have been in close contact over the past few weeks. 

If you had close, physical contact with others at an event (like kissing or sex) you are at high risk of direct exposure. To prevent an infection, you should try to get a monkeypox vaccine as soon as possible. 

If you were at the event where the health department indicates an exposure may have taken place, but did not have close, physical contact with others, you may not need a vaccine. Watch for the monkeypox symptoms and talk to your healthcare provider. 

If you have been contacted by a public health representative because you are a known close contact of someone with diagnosed monkeypox, that individual will guide you on how to obtain a post-exposure vaccine if you are eligible.

Most people recover from monkeypox without needing any medicines or other treatment. 

The Food and Drug Administration (FDA) has not approved any specific treatment for monkeypox. 

However, there is one medicine that is used for severe monkeypox, called tecovirimat, or TPOXX. It is allowed as an "investigation" drug for special circumstances for people who have severe monkeypox. 

As of Aug. 2, the city of Cleveland only has a few TPOXX pills available. Providers at University Health & Counseling Services will discuss risk factors, including whether you are immunocompromised and/or at risk for serious illness. If you need TPOXX, UHCS will work with the health department and other providers to secure TPOXX for you. 

Most people get well from monkeypox without pills or treatment of any kind. But for some people monkeypox  can cause serious consequences. 

If you experience any of the following symptom\s, please contact UHCS: 

• any blisters or spots on or near your eyes
• spots that spread all over your body or blend together
• problems with bleeding or bruises all over
• any trouble breathing, or thinking, or continuing to feel worse and not improving over time

Groups who may be at higher risk for getting severe monkeypox include: 

• children under age 8
• people who are pregnant
• people whose immune system is not as strong because of a disease, an infection or from taking particular medicines
• people with a history of eczema and other skin conditions

If you are among those groups, see your provider early. You should contact your provider or UHCS (216.368.2450) if you are worried you may be getting severe monkeypox. If your symptoms are so severe that you are having severe trouble breathing and/or in excruciating pain, you should call 911 or go to a hospital emergency room. 

Individuals can spread monkeypox to others once symptoms start (like feeling like you have the flu or seeing the start of a rash). They can continue to infect others until all scabs have fallen off and new skin covers all the monkeypox spots.

The infectious period can last 2 to 4 weeks.

Vaccine supplies are extremely limited. Students with known exposure(s) should contact UHCS for assistance. 

The CDC recommends vaccination for people who have been exposed to monkeypox and people who may be more likely to get monkeypox. 

People more likely to get monkeypox include: 

• People who have been notified by public health officials as a close contact of someone with monkeypox
• People who are aware that 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 a area with known monkeypox
• People whose jobs may expose them to orthopoxviruses, such as: 
  • Laboratory workers who perform testing for orthopoxviruses
  • Laboratory workers who handle cultures or animals with orthopoxviruses
  • Some designated healthcare or public health workers

The U.S. Environmental Protection Agency (EPA) has a list of approved cleaning solutions, or disinfectants for monkeypox. The list includes popular products that many people already use, such as Lysol and Clorox. In addition, the EPA has approved special product labeling for cleaning solutions to prevent monkeypox. The list of approved products can be found on the EPA website. 

According to the CDC, people who have monkeypox should clean and disinfect living spaces that they regularly use to prevent the spread of monkeypox to others in the household or residence. These activities include regular washing of bedding and towels. Do not shake out any linens. 

Once people have fully recovered from monkeypox and new skin replaced sores or spots, they should wipe down and clean their living spaces as thoroughly as possible. The virus can live on surfaces such as bedding for as long as 15 days.