Mpox

Signs and symptoms

In humans, the symptoms of Mpox are similar to but milder than the symptoms of smallpox.

The illness typically lasts 2–4 weeks.

Symptoms can include:

  • A rash that can look like pimples or blisters that appears on the face, inside the mouth, and on other parts of the body, such as hands, feet, chest, genitals, or anus
  • Fever
  • Headache
  • Muscle aches
  • Backache
  • Swollen lymph nodes (lymphadenopathy)
  • Chills
  • Exhaustion
  • Respiratory symptoms (for example, sore throat, nasal congestion, or cough)

The rash goes through different stages before healing completely.

Sometimes, individuals have flu-like symptoms prior to the rash. Others, get a rash first, followed by other symptoms. Some may only experience a rash.

Generally, within 1 to 3 days (sometimes longer) after the appearance of fever, the patient develops the rash, often beginning on the face then spreading to other parts of the body.

Lesions progress through the following stages before falling off: macules, papules, vesicles, pustules, and scabs.

Transmission and incubation period

The incubation period for Mpox (the time from exposure to symptoms) is within 3 weeks of exposure to the virus. If someone has flu like symptoms, they will usually develop a rash 1 to 4 days later. As of February 2023, new data show that some people can spread mpox to others from 1 to 4 days before symptoms appear.  There is no current evidence showing that people who never develop symptoms have spread the virus to someone else.

Mpox spreads in different ways. The virus can spread from person-to-person through:

  • Direct contact with the infectious rash, scabs, or body fluids
  • Respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact, such as kissing, cuddling, or sex
  • Touching items (such as clothing or linens) that previously touched the infectious rash or body fluids
  • Pregnant people can spread the virus to their fetus through the placenta.

It's also possible for people to get Mpox from infected animals, either by being scratched or bitten by the animal or by preparing or eating meat or using products from an infected animal.

Mpox can spread from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed.

People who do not have Mpox symptoms cannot spread the virus to others. At this time, it is not known if Mpox can spread through semen, vaginal fluids, urine, or feces.

Prevention

Take the following steps to prevent getting Mpox:

  • 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.
    • 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.

Isolation and monitoring of contacts

Individuals experiencing symptoms of monkeypox should isolate and seek testing and medical care as necessary. You are considered infectious and should isolate until the rash has fully healed and a fresh layer of skin has formed, which can take 2 to 4 weeks.

Close contacts should monitor for symptoms for 21 days from the time of their last known exposure to Mpox. Medium and high-risk close contacts are recommended for vaccination, which generally would include those who had direct contact with, or were within six feet of the individual for three hours or more, while that individual was symptomatic. Contacts do not need to quarantine from work, school, or other activities as long as they remain symptom-free. If a contact develops symptoms within the 21-day period, they should isolate, seek testing, and contact their primary care provider as needed.

Treatment

There are no treatments specifically for Mpox virus infections. However, Mpox and smallpox viruses are genetically similar, which means that antiviral drugs and vaccines developed to protect against smallpox may be used to prevent and treat Mpox virus infections.

Antivirals, such as tecovirimat (TPOXX), may be recommended for people who are more likely to get severely ill, like patients with weakened immune systems.

If you have symptoms of Mpox, you should talk to your health care provider, even if you don’t think you had contact with someone who has Mpox.

If you are a student and believe you may have Mpox, or a new rash, or have been exposed to Mpox, contact your campus health center or email the Office of the Chief Health Officer at cho@iu.edu for further guidance.

Additional resources