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Monkeypox

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.

  • 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 monkeypox 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.
  • Monkeypox 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 monkeypox 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 monkeypox spreads from people with no symptoms. CDC will continue to monitor for new or changing information about transmission.

Monkeypox spreads in a few ways.

Close or Intimate Contact
  • Monkeypox can spread to anyone through close, personal, often skin-to-skin contact, including:
    • Direct contact with monkeypox rash and scabs from a person with monkeypox, 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 monkeypox
        • Hugging, massage, and kissing
        • Prolonged face-to-face contact
  • The risk is considered low for getting monkeypox by touching objects, fabrics, and surfaces that have been used by someone with monkeypox and not disinfected, such as clothing, bedding, towels, fetish gear, or sex toys.
Monkeypox 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 monkeypox can become infected and should take steps to protect themselves.
  • The most common route for transmission of monkeypox 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 monkeypox can spread it to animals through close contact, including petting, cuddling, hugging, kissing, licking, sharing sleeping areas, and sharing food.
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 monkeypox can be spread through semen, vaginal fluids, urine, or feces
When to Get Tested
  • Currently, testing is only recommended if you have a rash consistent with monkeypox.
  • If you think you have monkeypox or have had close personal contact with someone who has monkeypox, consider taking precautions and visit a healthcare provider to help you decide if you need to be tested for monkeypox.
Where to Get Tested
  • Only a healthcare provider can order a monkeypox 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 monkeypox virus from the specimens.
  • The specimens will be tested in a lab to see if the monkeypox 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 monkeypox 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 monkeypox. 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.
  • There are no treatments specifically for monkeypox. But because the viruses that cause monkeypox and smallpox are similar, antiviral drugs developed to protect against smallpox may be used to treat monkeypox 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 monkeypox.
  • 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 monkeypox. Investigational means there is not currently enough data available from testing in people on the safety and effectiveness of tecovirimat for treating people with monkeypox.
  • Research is currently happening to test the safety and effectiveness for all people with monkeypox.
  • Tecovirimat is currently only for people with severe monkeypox 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 monkeypox 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 monkeypox symptoms, visit a healthcare provider.

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

1. Avoid close, skin-to-skin contact with people who have a rash that looks like monkeypox. 
  • 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 monkeypox.
  • Do not kiss, hug, cuddle, or have sex with someone with monkeypox.
2. 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.

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.

4. Get vaccinated! 

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

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.

For more information on Monkeypox infection and JYNNEOS, visit www.cdc.gov/poxvirus/monkeypox.

JYNNEOS vaccine

This vaccine is approved by the state of Tennessee for post-exposure prophylaxis for people with a known or possible exposure to someone with Monkeypox infection. It can prevent severe disease when given after exposure to Monkeypox infection. It is most effective when given within 4 days of exposure but can be given up to 14 days after exposure. It requires 2 doses, 28 days apart. The vaccine is offered to:

  1. Anyone with a known contact/exposure to Monkeypox infection that was identified through contact tracing by public health authorities
  2. Anyone that might have been exposed to Monkeypox infection in the past 14 days, including if they:
    1. Are aware that a sexual partner was diagnosed with Monkeypox infection in the past 14 days
    2. Have had multiple sexual partners in the past 14 days

Currently, the state of Tennessee has not approved the vaccine for pre-exposure prophylaxis due to supply concerns. As the supply of the vaccine increases, the state of Tennessee will likely add this approval. If you are interested in receiving this vaccine or have questions, call Boyd Health Services at (931) 221-7107 and schedule an appointment. 

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