What is Mpox (Monkeypox)?

Causes of Mpox (Monkeypox)

Mpox is a rare disease caused by the mpox virus, which can affect anyone. Historically endemic to Africa, mpox began appearing in other regions, including the US and Australia, starting in 2022. The virus has two main types, or clades:

• Clade I: Originating in Central Africa, this clade is associated with more severe illness and a higher mortality rate, with some outbreaks resulting in up to 10 percent mortality. It remains endemic to Central Africa.
• Clade II: This type, which caused the global outbreak beginning in 2022, is less severe, with a survival rate of over 99.9 percent. It is endemic to West Africa.

Both clades can be fatal, but Clade I has a higher death rate, as per Infectious Medicine and the Centers for Disease Control and Prevention (CDC).

Transmission

Mpox is a zoonotic disease, meaning it was first developed in animals before being transmitted to humans. The virus is transmitted to humans through close contact with infected animals. Once in humans, it can spread from person to person. According to the WHO, mpox primarily spreads through:

• Direct contact with rashes, scabs, or bodily fluids of an infected person.
• Prolonged close contact (over four hours) with respiratory droplets from an infected person, including kissing, sexual contact, or oral sex.
• Animal-to-human transmission through bites, scratches, or activities involving infected animals, such as hunting or cooking.
• Contact with contaminated objects like sheets, clothes, or needles, followed by touching the face.
• Pregnant women can transmit the virus to their unborn babies.

The virus enters the body through broken skin, mucosal surfaces (e.g., mouth, eyes, genitals), or the respiratory tract. Mpox can spread within households and among sexual partners, with those having multiple sexual partners at higher risk.

If you have mpox:

• Inform people with who you had recent close contacts
• Stay at home until all scabs have fallen off and new skin has formed
• Cover lesions and wear a well-fitting mask around others
• Avoid physical contact

Generally, closer and longer interactions with others pose a higher risk of Mpox transmission.

Risk factors

While mpox is generally not life-threatening, some people may be at higher risk for severe illness, including:

• Those with severely weakened immune systems
• Children under one year old
• Individuals with a history of eczema
• Pregnant individuals

Key Facts of Mpox (Monkeypox)

Major Symptoms	Fever Skin rash Swollen lymph nodes Chills Headache Sore throat Muscle aches Back pain Fatigue
Necessary Health Tests	Polymerase chain reaction (PCR) Staying hydrated
Treatment	Staying hydrated Pain-relieving medications Topical creams Vaccine Isolation

Symptoms of Mpox (Monkeypox)

Mpox symptoms typically develop 3–17 days after exposure, known as the incubation period. Common signs include:

• Fever
• Skin rash
• Swollen lymph nodes
• Chills
• Headache
• Sore throat
• Muscle aches
• Back pain
• Fatigue

The rash may start as a flat, red bump or sore, developing into a blister filled with fluid. The rash can be itchy or painful and eventually dries up, crusts over, and falls off. The number of skin lesions can vary widely, from a few to hundreds, and can appear anywhere on the body, including the palms, soles, face, mouth, throat, groin, genitals, and anus. Some individuals may also experience painful rectal swelling or difficulty urinating. Mpox remains contagious until all sores have healed and new skin has formed. Children, pregnant individuals, and those with weakened immune systems are at higher risk for complications.

Mpox can be present with minimal or no symptoms, but even asymptomatic individuals can spread the virus through prolonged close contact.

When to see a doctor?

You should see a doctor if you suspect have mpox or experiencing symptoms such as sudden fever, headache, muscle aches, swollen lymph nodes, and a distinctive rash that evolves from flat spots to raised bumps and then blisters. Seek medical attention if you have been in contact with someone diagnosed with mpox or have traveled to an area with an outbreak, even if symptoms are mild or absent. If you experience severe symptoms, such as difficulty breathing or persistent pain, seek immediate medical care. Early consultation can help diagnose the disease and prevent the spread of the virus.

Diagnosis of Mpox (Monkeypox)

Monkeypox is a viral infection caused by the monkeypox virus, which is related to smallpox but generally less severe. It primarily spreads to humans through contact with infected animals, but it can also be transmitted between people via respiratory droplets or contaminated materials. Symptoms include rashes, fever, headache, muscle aches, backache, swollen lymph nodes, chills, and exhaustion.

Diagnosis is confirmed through laboratory tests, primarily polymerase chain reaction (PCR). A healthcare provider will collect a sample from a lesion or sore and send it to a lab for analysis. If no skin lesions are present, testing can be done using oropharyngeal, anal, or rectal swabs. A blood sample may also be taken to detect the virus or antibodies, though blood tests alone are not recommended as they may not differentiate between orthopoxviruses. It can take a few days to receive the results.

Before testing, the provider may rule out other conditions with similar symptoms, such as chickenpox, measles, or syphilis, and may also screen for sexually transmitted infections like HIV. Swollen lymph nodes can help distinguish monkeypox from other pox infections.

Here’s what the test results may mean:

• Positive: The virus is detected, you need to follow precautions to protect yourself and others until recovery.
• Negative: The virus is not detected, you likely do not have monkeypox but should continue to practice protective measures.
• Inconclusive: The sample was insufficient or unclear, testing will need to be repeated.

Treatment of Mpox (Monkeypox)

The primary goal in treating monkeypox is to manage the rash, alleviate pain, and reduce the risk of complications. Treatment includes pain relief medications, staying hydrated to maintain stool softness and managing fever. In severe cases or for those at high risk, antiviral drugs such as cidofovir or tecovirimat may be recommended. Isolating infected individuals helps prevent the spread of the virus. Topical creams may be prescribed by a healthcare provider to relieve itching and discomfort from the rash.

Vaccination can help prevent monkeypox. It is most effective when administered within 4 days of exposure but can still be given up to 14 days after contact with an infected person if no symptoms are present. Vaccination is recommended for people at high risk, especially during outbreaks, including:

• Health workers
• Individuals with close contact with someone with monkeypox
• Someone who had sex with an infected person
• People with multiple sexual partners, sex workers, and men who have sex with men
• Transgender and nonbinary individuals, especially those with recent sexually transmitted infections or multiple partners

Talk to a healthcare provider if you are unsure if you should get vaccinated.

How to prevent monkeypox?

Most people with monkeypox will recover within 2–4 weeks. To manage symptoms and prevent the spreading of the virus, follow these guidelines:

Do:

• Stay home and isolate yourself, particularly during an outbreak or if infected.
• Avoid close contact with individuals showing symptoms or those diagnosed with monkeypox.
• Wash hands frequently with soap and water or use hand sanitizer, especially before and after touching sores.
• Wear a mask and cover lesions when around others until your rash heals.
• Keep your skin dry and uncovered (unless in a room with someone else).
• Avoid touching items in shared spaces and disinfect shared areas regularly.
• Use saltwater rinses for sores in the mouth.
• Take sitz baths or warm baths with baking soda or Epsom salts for body sores.
• Use over-the-counter pain relievers like paracetamol (acetaminophen) or ibuprofen.
• Avoid handling wild animals, especially if they are sick, and cook meat thoroughly.
• Use personal protective equipment (PPE) if you are caring for someone with monkeypox.

Do not:

• Pop blisters or scratch sores, as this can slow healing, spread the rash to other parts of the body, and cause infections.
• Shave areas with sores until the scabs have healed and new skin has formed, to prevent spreading the rash.