Monkeypox (MPV)

Monkeypox virus (MPV) infection can cause an illness that includes rashes and other symptoms. It does not commonly occur in the United States, but there is currently an outbreak of MPV with cases spreading in Washington state and across the country, as well as in other countries.

MPV can spread person-to-person with any kind of close, skin-to-skin contact, regardless of sexual orientation or gender identity, or age, including children. Anyone can get MPV. MPV can also spread between animals and from animals to people.

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Call 1-833-829-HELP if you have questions about MPV risk factors, vaccines, testing, or treatment. Language assistance is available in 240 languages.

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Four pictures with examples of Monkeypox rash


About MPV

How is MPV spread?

Transmission of MPV requires close contact with a symptomatic person. Brief interactions that do not involve physical contact and healthcare interactions conducted using appropriate protective equipment are not high risk.

The MPV virus can be transmitted from person to person by:

  • Direct contact with the skin or body fluids of an infected person (including sexual contact).
  • Contact with virus-contaminated objects (such as bedding or clothing).
  • Respiratory droplets during direct and prolonged face-to-face contact.

People with a confirmed case of MPV are contagious as soon as they develop symptoms and continue to be contagious until the scabs fall off the rash. A person with MPV should isolate from others until the scabs fall off.

Humans can also get MPV from contact with infected animals.

What are the symptoms?

MPV can cause a range of symptoms including, fever, headache, swollen lymph nodes, followed by a rash that can appear anywhere on the body. Some people may not have any symptoms before the start of the rash. In the current outbreak, many infected people have lesions on the genitals or in the anal area. Some people have initially had pain in the anal region, with or without other symptoms such as fever and headache.

Usually the rash will turn into raised bumps, which then fill with fluid. The rash eventually scabs over, and the scabs fall off. Typically, the rash is mostly on the face, arms, legs, and hands. However, if a person was infected during sexual contact, the rash might only be on the genitals or anal region.

The incubation period (time from exposure to the start of symptoms) for MPV is usually 7-14 days but can range from 5-21 days.

Most people recover in 2-4 weeks although the lesions can leave scars. The disease can be serious, especially for immunocompromised people, children, and pregnant people.

People with symptoms of MPV should contact their primary health care provider or clinic. Before the visit, they should tell the provider or clinic that they are concerned about MPV and tell them whether they recently had close contact with a person who had a similar rash or who was diagnosed with MPV. If you don't have a provider, find one here.

Who is at risk?

Anyone can get MPV, but some people are at a higher risk. MPV is primarily spread through close (skin to skin) contact. It also can be spread through respiratory droplets during prolonged face-to-face contact, but does not spread through the air over longer distances. Brief interactions that do not involve physical contact and health care interactions conducted using appropriate protective equipment are generally considered low risk.

Anyone who is sexually active is at risk, and risk increases with more sexual partners.

Other risk factors may include travel to areas where MPV is spreading; close, non-sexual contact with someone who is infected; or contact with sick animals. To protect yourself and others from MPV or sexual infectious diseases, DOH recommends:

  • Practicing safe sex and harm reduction methods such as reducing your number of sexual partners. 
  • Avoiding sexual contact with anyone who has open wounds, sores, or rashes.
  • Avoiding other skin-to-skin contact with anyone who has open wounds, sores, or rashes, or anyone who is infected with MPV.
What needs to be done to bring MPV under control in Washington state?

Controlling the outbreak is possible. MPV is mostly spread through close, skin-to-skin contact, and is less likely to be spread in the air.

  • We must stop person-to-person transmission, and we need to make sure we prevent transmission to pets and wildlife.
  • Public health will help control this disease by rapidly identifying cases, providing information to the public, and helping those who are infected know what to do.
  • Vaccinating those who have been exposed to MPV and who are the highest risk of infection is another important control strategy.

Individuals can help control the outbreak by following the prevention guidelines on this webpage, and getting vaccinated if your health care provider indicates it’s recommended for you. 

What should you do if you have been exposed to MPV?

If you have had close contact with a person who has confirmed or probable MPV, getting vaccinated right away may prevent an infection. Close contact can include being together for several hours, hugging, cuddling, kissing, or sharing a bed or clothing.

Contact your health care provider or your local health department for information if you think you’ve been exposed. If you don't have a provider, find one here.

What should people do if they think they have MPV or test positive for MPV?

If you have a new or unexplained rash and think you may have had close, skin-to-skin contact with someone who could have MPV in the last 21 days, talk to your medical provider or local clinic to find out if you should be tested, get vaccinated, or receive antiviral medication. If you don't have a provider, find one here.

You can spread MPV from the start of symptoms until the rash has fully healed, which can take two to four weeks. To keep from spreading the infection:

  • Separate yourself from other people and animals (mammals).
  • Restrict family, friends, or other visitors to those with an essential need to be in the home.
  • Wear a well-fitting medical mask when in close contact with others at home.
  • Do not let others touch your skin, especially any areas with a rash. Consider wearing disposable gloves if you have lesions on your hands and live with others.
  • Stay home except for getting health care. If you have a medical appointment, call the office before you go in to see if they have any special procedures for you to follow.
  • Keep lesions covered and remain separate until the rash is gone, all scabs have fallen off, and the skin below is healed.
  • Do not share bedding, towels, dishes, or utensils.
  • 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.
  • Wash your own laundry and dishes.
  • Routinely clean and disinfect commonly touched surfaces and items.
  • Have somebody else take care of animals (mammals) like pets and livestock.
  • Avoid use of contact lenses to prevent unintentional infection of the eye.
  • Avoid shaving rash-covered areas of your body.
  • Do not use commercial travel (airplane, bus, train/light rail, taxi, rideshare services).
  • Do not kiss, hug, cuddle, sleep, or have sex with others.

If you are infected with MPV and are in severe pain, or you are more likely to become severely ill, you may need antiviral treatment. Have your health care provider call your local health department for information.

If you already have symptoms of MPV, MPV vaccine is not recommended. Ask your provider about anti-viral treatment. If you don't have a provider, find one here.

What causes MPV? How did it get to humans?

MPV was discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research. The first human case was recorded in 1970.

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.

We are seeing more cases of MPV now for several reasons.

  • The main reason is that we no longer vaccinate against smallpox. Smallpox vaccination also protected people against MPV. 
  • Some cases of MPV in the past probably were misdiagnosed as smallpox, so we see more cases now partly due to more accurate testing. 
  • Globally, modern-day cases of MPV are often linked to international travel or exposure to imported animals, practices that are more common now than in the past.
Can animals, especially pets, get MPV?

Mammals can get MPV. Here’s how to prevent spreading the virus to animals.

Is MPV deadly?

Infections of MPV identified in the 2022 outbreak are fortunately rarely fatal.

  • People with weakened immune systems, children under 8 years of age, people with a history of eczema, and people who are pregnant or breast/chest feeding may be more likely to get seriously ill or die.
  • While MPV is rarely fatal, symptoms can be extremely painful, and people might have permanent scarring resulting from the rash.
  • In this current outbreak, there has been one death in the U.S. A small number of people have died in other countries.
If you have MPV, do you need to stay home or go to hospital?

If you suspect you have MPV, isolate yourself from others in a single-person room if available and immediately talk to your health-care provider. Ask if you need to go to a medical office or the hospital. It is important to call as soon as you think you have symptoms of the disease because antiviral treatments may be available for those at high risk of severe illness. If you have been exposed and do not have symptoms yet, you may be able to be vaccinated. If you don't have a provider, find one here.

What groups are more at risk for severe infections?

People with weakened immune systems, children under 8 years 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.

If you have had smallpox vaccination in the past, you may be at lower risk for MPV. However, it may not be lifelong. During the 2003 MPV outbreak and during the current MPV outbreak, several people who were infected with MPV had previously been vaccinated against smallpox decades prior.

During this MPV outbreak response, vaccines and other medical measures should be given to eligible people who were previously vaccinated against smallpox.

What are some examples of the MPV rash?

MPV lesions (bumps) are often rubbery, with a dot on top of the lesion. If you have a new or unexplained rash and think you may have had close, skin-to-skin contact with someone who could have MPV in the last 21 days talk to your medical provider to find out if you should be tested. If you don't have a provider, find one here.

Monkeypox lesions
Images of monkeypox lesions


How do I get tested?

If you have symptoms of MPV, or have been in close contact with someone diagnosed with MPV in the last 21 days,  contact a health care provider to see if you should be tested.

Washington state has no shortage of testing capacity for MPV. The Washington State Public Health Laboratory (PHL) has been able to test every suspect case that medical providers in our state have reported to their local health departments. In addition, commercial labs are now able to test for MPV. If you don't have a provider, find one here.

Can physicians and other medical providers order a MPV test in Washington?

Yes. Here’s how testing currently works in our state:

  • People who have symptoms of MPV (including a rash on one or more parts of the body) should visit a health care provider. If the provider suspects MPV, they will swab the rash for testing. Providers may test for other conditions at the same time and may need to take other kinds of samples. If you don't have a provider, find one here.
  • These swabs (specimens) are sent to a laboratory for testing. Specimens might go to the Washington State PHL or to other clinical labs in the area.
  • If a specimen tests positive, the state or local health jurisdiction will contact the patient. Public health will recommend what actions to take, including if the person needs to isolate, or if antiviral medication is needed. They also will ask questions to see if any people the patient has been in close contact with need vaccination, testing, or treatment.
Is there a shortage of available testing?

There is no shortage of testing supplies in Washington state.

Testing for MPV is done by the Washington State Public Health Laboratories and specific clinical laboratories.

Are we undercounting cases because of testing issues?

It is likely that some people have had MPV without being counted. Cases may have gone unrecognized in the United States and around the world because of the unusual clinical presentation of this current outbreak, not because of testing shortages in the United States.

Unusual clinical presentation includes different symptoms than medical providers have seen in previous cases, including rashes on different parts of the body and transmission through sexual contact, which was not common before this current outbreak.

For current case counts see: 2022 U.S. Map & Case Count | Monkeypox | Poxvirus | CDC


What is the treatment for people with MPV?

Most people recover without treatment. Antiviral medications are available to treat MPV in specific circumstances. If symptoms have not started, post-exposure vaccination may be an option. Post-exposure vaccination can reduce symptoms or prevent symptoms.

Who should be treated?

Anybody with severe pain, widespread infection, at higher risk of getting severe illness, or infection of the eyes should ask their health care provider about being treated. If you don't have a provider, find one here.

People who are at risk for severe infection, include:

  • People with weakened immune systems.
  • Children under 8 years of age.
  • People with a history of eczema. 
  • People who are pregnant or breast/chest feeding.

Treatment can start before testing if MPV is highly suspected and there is severe infection or risk for severe infection. The local health jurisdiction may help to locate antiviral medications.

Vaccines to Prevent MPV

What about the vaccine?

To help stop the spread of MPV virus, the Centers for Disease Control and Prevention (CDC) is distributing  a vaccine called JYNNEOS in the US. For up to date MPV vaccine data, visit the MPV data page.

Washington State Department of Health (DOH) is working to ensure vaccine delivery to as many people in high-risk populations as possible. To make sure that vaccines get to people at risk of infection, we’re working with Tribal partners, local health jurisdictions and community partners to reach vulnerable communities and ensure equitable access.

If you believe you have had recent close contact with someone who was diagnosed with MPV and need to be vaccinated, please reach out to your health care provider. If you don't have a provider, find one here.

On August 9th 2022, the FDA granted emergency use authorization for JYNNEOS vaccine to be given to children under 18 years. JYNNEOS is already authorized in those ages 18 and older.

What does the vaccine do?

For people who have had recent contact with someone who tested positive for MPV, the vaccine can reduce the chance of developing a MPV infection. Considerations for Monkeypox Vaccination | Monkeypox | Poxvirus | CDC

Two currently licensed vaccines, JYNNEOS (also known as Imvamune or Imvanex) and ACAM2000, are available in the United States to prevent smallpox (which is a type of orthopox virus).

  • Both help protect people from the MPV virus, which is also an orthopox virus. JYNNEOS is also licensed specifically to prevent MPV.
  • These vaccines are available from the US Strategic National Stockpile (SNS).
  • Both JYNNEOS and ACAM2000 can be used before and after exposure to MPV in an outbreak setting.
  • At present DOH is not offering ACAM2000 due to the higher risk of side effects.
  • There is an ample supply of ACAM2000. However, this vaccine has more side effects and should not be used in people who have some health conditions, including a weakened immune system, skin conditions like atopic dermatitis/eczema, or pregnancy.
  • If you receive an MPV vaccination, you should still practice other prevention measures afterward, such as not having skin-to-skin contact with someone who is infected with MPV. You are not considered fully vaccinated until two weeks after your second dose of JYNNEOS, and the vaccine may not be 100% effective. No data are available yet on the effectiveness of these vaccines in the current outbreak.
Who is eligible to be vaccinated right now?

Vaccination of individuals who meet the categories below should be prioritized with vaccine supply limitations.

  • Gay and bisexual men and transgender individuals who have had multiple or anonymous gay, male bisexual, or transgender sex partners in the last 3 months.
  • People who have used methamphetamine in the last 3 months.
  • People who have exchanged sex for money, drugs, or other purposes in the past 3 months.
  • People who have been sexually assaulted, regardless of gender or sexual orientation.
  • People who have had sexual contact or prolonged skin-to-skin exposure with people who were exposed to MPV.

For more information see Guidelines for JYNNEOS Vaccine Use

Who is considered a close contact?

A close contact is a person who:

  • Had contact with someone who had a rash that looks like MPV or someone who was diagnosed with confirmed or probable MPV. This could include close contact with the clothing, bedding, towels, etc. used by the person who has MPV.
  • Had skin-to-skin contact with someone in a social network experiencing MPV activity.
  • Had contact with a dead or live wild animal or exotic pet that exists only in Africa or used a product derived from such animals (e.g., game meat, creams, lotions, powders, etc.)
How much vaccine has the federal government allotted to Washington state?

Washington state has been allotted thousands of courses of the two-dose JYNNEOS vaccine.

  • Of that allotment, most courses have already been distributed to jurisdictions with known cases and close contacts.
  • The federal government will allot more vaccine as it becomes available.
Where can I get a vaccination?
  • People identified as close contacts of known cases can get vaccinated by their medical providers or local health jurisdiction. If you don't have a provider, find one here.
  • Some vaccine locations are listed here, though this is not a complete list.
  • Health care providers are working with their local health jurisdictions to secure the vaccine.
  • The JYNNEOS vaccine is a two-dose series with the first dose given as soon as possible after exposure, and the second dose given 28 days later. You should receive your second dose from the same place as your first dose. You are considered fully vaccinated two weeks after the second dose. Even when fully vaccinated, you should continue other safety and prevention practices such as not having skin-to-skin contact with someone who has a rash or has a confirmed or probable case of MPV. 
Should health care professionals get vaccinated?

Health care professionals who do not perform diagnostic testing for MPV are not currently recommended to receive vaccination.

Will there be mass vaccination sites?

Without additional supplies from CDC or a broader recommendation for the vaccine, Washington state has no plans to hold mass vaccination clinics. DOH is working closely with local health jurisdictions and tribal health partners to offer support with mobile vaccination services to supplement efforts.

Does the COVID-19 vaccine work against MPV?

No. Vaccines work differently depending on the virus they are targeting. The COVID-19 vaccine was developed to help prevent serious illness and death from COVID-19. It does not prevent any other disease, like flu or MPV. Only the licensed MPV and smallpox vaccinations work against MPV infection.

Can people travel out of country without the MPV vaccination?

There are no travel restrictions or requirement for the MPV vaccine to travel. However, many countries require other vaccines before you travel, so check with your local health department or your health care provider before traveling internationally to make sure you have all the vaccines you need. If you don't have a provider, find one here.