Additional Information About Mpox: Questions and Answers

Topics: Mpox Basics | How Mpox Spreads | Mpox Symptoms​​ ​| Mpox Prevention | If You Have Been Exposed​ | Mpox Vaccines | If You Have Mpox Infection​ | Mpox Treatment​ | Infection Control in Workplaces and Healthcare Settings | Where to find more information | ​​​​​ Guidance for Healthcare Providers​ |​​

What are the basics? 

What is mpox? 

Mpoxis an illness caused by infection with the mpox virus. It is related to the smallpox virus. While less severe and much less contagious than smallpox, mpox can be a serious illness.

It can spread from infected humans, animals, and materials contaminated with the virus. Mpox primarily spreads through close, personal, skin-to-skin contact with people who have mpox symptoms, such as rashes and sores. There is a vaccine to protect a​gainst mpox​.

Is mpox a new disease? 

No, mpox is not a new disease. Mpox (formerly known as monkeypox) was first discovered in 1958. Mpox is endemic (regularly found) in parts of west and central African countries.​

Since 2022, there has been an outbreak of mpox in locations where mpox was not commonly seen. This includes Europe, Canada, and the United States, including California.

Does the mpox virus have variants?

There are two types of mpox virus: clade I and clade II. The ongoing global mpox outbreak that began in 2022 is caused by clade II mpox.

Both types can cause similar symptoms, but clade I mpox has historically spread more easily and caused more severe illness than clade II mpox. The mpox vaccine is believed to be effective against both clade II and clade I mpox.

What about clade I mpox virus?

Clade I mpox has been spreading in certain regions in Africa, where there is currently an outbreak. As of August 2024, clade I has been found outside of the African continent. This situation is being monitored by public health authorities, including the Centers for Disease Control and Prevention (CDC) and the California Department of Public Health (CDPH). See the CDC Risk Assessment for mpox in the United States here: CDC | Mpox Rapid Risk Assessment​.

In August 2024, the CDC released a travel health notice​ for travelers going to regions in Africa affected by clade I mpox. If you have mpox symptoms, tell your healthcare provider if you have traveled to Africa or been in close contact with someone who traveled there in the past 21 days. People with mpox symptoms should stay away from others​ until they see their healthcare provider.

Go to Q&A: Mpox Symptoms​

Who can get mpox? 

Anyone can get mpox after close physical contact with someone who has the infection. 

The current risk to the general public is low. Most cases in the United States have occurred in gay, bisexual, transgender, and other men who have sex with men. Some cases were found to be infected through household contact (shared living spaces) with people infected with mpox.

How serious is mpox?

Mpox is usually a mild infection with symptoms lasting from 2 to 4 weeks. Certain people may be at higher risk for severe illness. This includes:

• ​people with weakened immune systems​
• infants under 1 year old
• people with a history of eczema
• people who are pregnant or breastfeeding

Infections in the current global outbreak, including in California, are rarely fatal. Over 99% of people who get this form of the infection are likely to survive. However, symptoms can be extremely painful. Some people might have permanent scarring from the rashes and sores.

Go to Q&A: Mpox Symptoms​

Should parents be concerned about the spread of mpox in classrooms? 

To date, there is very low transmission of mpox in the general population. Of the few likely mpox cases in children, spread has usually been through household contact with someone infected with mpox.

Can animals or pets get mpox? 

Mpox has been known to infect different types of mammals in parts of west and central Africa, where the virus is endemic (regularly found). People can get mpox from direct contact with infected animals, often while hunting, trapping, preparing or eating wild animal meat (bushmeat). A 2003 outbreak in the U.S. was associated with pet prairie dogs that had shared cages with other imported animals that had mpox.

The CDC and CDPH do not believe that mpox currently poses a high risk to pets. However, transmission of mpox between people and animals can potentially occur through close contact. This includes petting, cuddling, and sharing sleeping areas or food. If you have mpox, avoid contact with animals and pets. Ask another household member, or outside friend or outside family member to care for pets until you are fully recovered. For more information, see CDC | Pets & Mpox.​​​​

How does mpox spread? 

Mpox is mainly spread by people with symptoms. Mpox can be spread through close, personal, often skin-to-skin contact, including:

• ​​Direct contact with body fluids of people with mpox, such as drainage from skin sores, saliva, 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 (butt) of a person with mpox
• Hugging, massage, and kissing
• Prolonged face-to-face contact, such as can occur during kissing or cuddling.
• ​Touching items, such as bedding, towels, clothing, cups, and utensils, that previously touched the sores or body fluids of people with mpox is considered lower risk. But take precautions when directly caring for a person with mpox, including wearing appropriate Personal Protective Equipment (PPE) such as masks, gloves, and gowns. 
  
• Infection from a pregnant person with mpox to their fetus or baby.
  

There has been no evidence that mpox is spread by casual contact with other people such as attending an outdoor event with fully clothed people, trying on clothes or shoes at a store, traveling on a plane or other public transit, swimming in a pool or body of water, or going to other public settings such as a grocery store, restaurants, workplaces, restrooms.

See CDC | How Mpox Spreads for more information. 

Go to Q&A: Mpox Symptoms | If You Have Been Exposed​ | Mpox Prevention

When is mpox contagious? 

Mpox symptoms can start anywhere from 3 days to 3 weeks after exposure to the virus. 

A person with mpox can spread it to others from before symptoms start until all sores have healed (when scabs have fallen off, and a fresh layer of skin has formed underneath). This can take several weeks. (CDC | How it Spreads).

Is mpox a sexually transmitted infection (STI)? 

Sex is just one of the ways that the mpox virus can spread. Mpox primarily spreads from skin-to-skin contact, especially close or intimate physical contact such as sex or contact with contaminated materials like utensils, cups, bedding, towels, clothing, or sex toys. 

While helpful, condoms alone cannot adequately protect against mpox since the rash can occur on different parts of the body. Mpox has been found in semen, but scientists are still investigating whether the virus could be spread by exposure to semen or vaginal fluids. For more information on how to protect yourself, see CDPH Factsheet: Safer Sex and Mpox  (PDF). 

Does other STI testing include a mpox test?

Not usually. Only persons who have mpox symptoms can be tested for mpox, which is done with a swab of the rash or sore(s). Mpox may look like other STIs that cause a rash on the genitals and anus, including herpes, syphilis, molluscum contagiosum, and chancroid. Mpox may also cause inflammation of the rectum (proctitis), which can result in rectal pain. This is something that may also be seen with other STIs. It is recommended that people being evaluated for mpox also get tested for HIV and STIs. This is because 35-40%​ of those reported to have mpox infections have also had HIV or a STI.

It's always important to talk to a health care provider as soon as you notice unusual rashes or sores or have rectal pain. Visit CDC GetTested to find STI testing near you.​​​

How is mpox prevented?​

There are actions you can take to prevent the spread of mpox:

• Get vaccinated if you may be at risk for mpox​. For the greatest protection, make sure you get both doses of the vaccine. Find mpox vaccine near you.
• Talk to your sexual partner(s). Ask about recent illnesses. Be aware of new or unexplained sores or rashes on your body or your partner’s body, including on the genitals and on or around the anus.
• Avoid close contact such as hugging, kissing, cuddling, and sexual activity, with people who have a rash or sores that look like mpox.
• Do not share items such as towels, fetish gear, sex toys, and toothbrushes with someone who has mpox.
• Wash your hands often with soap and water or an alcohol-based hand sanitizer.
• Protect yourself when caring for someone with mpox by using masks, gowns, and gloves.
• If you have mpox, prevent spread to others. Avoid contact with others until the rash is healed, clean and disinfect shared areas in the home, and notify close contacts who may have been exposed. See CDC | If You Are Sick for more information.
• ​If you have been exposed to mpox, take precautions. Get the mpox vaccine before symptoms develop and consider avoiding intimate contact with others for 21 days. Watch yourself for symptoms and get tested if they develop. See CDC | If You’re a Close Contact for more information.

See CDPH Safer Sex & Mpox (PDF) and CDC | Safer Sex, Social Gatherings, and Mpox for information on how to lower your chances of getting mpox from sexual or intimate activities. For more information, see CDC | Mpox Prevention​.​

What are the signs and symptoms? ​

Mpox can often start with symptoms like the flu, with fever, low energy, swollen lymph nodes, and general body aches. Most persons with mpox will then go on to develop a rash or sores, usually within several days. However, some people have reported developing the rash or sores before or without other symptoms. 

The sores may be located on or near the genitals (penis, testicles, labia, and vagina) or anus (butt) but could also be on other areas like the hands, feet, chest, and face. They may also be limited to one part of the body.  The rash or sores can look like pimples or blisters. They can go through several stages, including scabs, before healing. They may be painful or itchy. Sometimes the sores can be in places that are difficult for someone to see. Sometimes they can look similar to other illnesses like herpes or cold sores. ​

What should I do if I have symptoms of mpox?

If you have symptoms, seek medical care for an evaluation. Let your provider know if you are worried about mpox. Visit your primary doctor, an urgent care, or see CDC | GetTested​ to find a clinic near you.

People who have mpox symptoms should isolate away from others until their symptoms have gone away completely and until all sores have healed and a fresh layer of skin has formed. Cover up the rash with clothing or bandages and wear a well-fitting face mask if you need to be around others. For more information on isolation and preventing spread to others, see CDC | What to Do If You Are Sick and CDC | Isolation and Infection Control at Home.​​

What should I do if I’ve been exposed to mpox?

• Get vaccinated (if you haven’t already) before symptoms develop. The mpox vaccine can prevent mpox infection if given within 4 days of the exposure. If given 4-14 days after the exposure, the vaccine may not prevent an infection but may still prevent severe symptoms. Find a vaccinating provider near you or call your local health department for assistance getting the vaccine after exposure.
• Take precautions. Watch yourself for symptoms and consider avoiding close or intimate contact with others for 21 days after exposure.
• ​If you have mpox symptoms, get tested. Visit your primary doctor, an urgent care, or see CDC | GetTested to find a clinic near you.

See CDC | If You’re a Close Contact for more information.​​

What is the mpox vaccine? 

​The JYNNEOS vaccine is approved by the U.S. Food and Drug Administration (FDA) to prevent both mpox and smallpox. CDC and CDPH recommend vaccination to people who may be at risk for mpox and for certain people who have been exposed to mpox, like recent partners, household members, and certain healthcare workers.​​

Vaccination is an important tool in preventing mpox. It also provides protection against severe illness from mpox. See CDPH Mpox Vaccination​ to find a vaccinating provider near you. ​​

Healthcare providers and public health jurisdictions should refer to the CDPH Immunization Branch EZIZ Mpox Vaccination Resources​ for up-to-date information about JYNNEOS vaccine ordering, administration, and other resources.

Can I get the vaccine? 

Any person who MAY be at risk for mpox infection or who requests the vaccine may receive vaccination without having to report specific risk factors. Make sure you have gotten both vaccine doses for the most protection. See the CDPH Mpox Vaccination page to find a vaccinating provider near you.

Can I get the vaccine after I was exposed to mpox?

If you have not already been vaccinated and get exposed​ to mpox, getting the vaccine before symptoms develop can still provide some protection.

If given within 4 days of the exposure, the vaccine may prevent mpox infection. If given 4-14 days after the exposure, the vaccine may not prevent the infection but may still prevent severe symptoms. See the CDPH Vaccine page to find a vaccinating provider near you or call your local health department for assistance getting the vaccine after an exposure.

Should I get the vaccine?

The CDC recommends preventive vaccination against mpox for individuals who may be at risk given their personal or partner(s) health history:

• Gay, bisexual, or other men who have sex with men and transgender, nonbinary, or gender-diverse persons who:
  
• Have more than one sex partner or anticipating having more than one sex partner or
• Have a recent diagnosis of chlamydia, gonorrhea, or syphilis in the past 6 months
• Persons who, in the past 6 months, had or anticipate having sex at a commercial sex venue (like a sex club or bathhouse) or sex related to a large commercial event where mpox transmission may occur
• Persons who have a sex partner with any of the above risks or who anticipate experiencing any of the above scenarios
• Persons who are at risk for occupational exposure to orthopoxviruses (e.g., certain people who work in a laboratory or a healthcare facility)

How protected am I after getting the vaccine? 

Mpox vaccination provides protection against severe illness resulting from mpox. Most reported mpox infections have occurred in persons who are unvaccinated.

Studies show that a single vaccine dose can lower your risk of getting mpox by 75%. Two doses can lower your risk up to 86%. Infections have been rare in fully vaccinated persons. Studies have also shown that if infections do occur, infections in vaccinated persons are less severe than infections in unvaccinated persons (CDC | JYNNEOS Vaccine Effectiveness​). 

People are considered fully vaccinated 2 weeks after their second dose. Vaccinated individuals should consider additional measures to protect themselves from mpox and get tested if they have mpox symptoms. CDPH will continue to monitor the effectiveness of the JYNNEOS vaccine during the current outbreak.

What if I still need my second dose?

The second dose of JYNNEOS should be given at least 28 days after the first dose.  If it has been more than 28 days since your first dose, you may still get the second dose to complete the vaccine series. However, a person who is diagnosed with mpox after their first dose of JYNNEOS should not receive a second dose at this time (unless they are immunocompromised).​

When am I considered fully vaccinated?

Individuals are considered fully vaccinated 2 weeks after receiving their second dose of the JYNNEOS vaccine. 

Who should NOT receive the vaccine?

Persons for whom mpox vaccine is not recommended:

• People who have had a serious allergic reaction to a previous dose of the JYNNEOS vaccine or a component in the vaccine 
  
• ​People with mpox symptoms
• People who have tested positive for mpox

Talk with your provider if you have questions about getting the vaccine, are currently feeling ill/sick, are pregnant or breastfeeding, or have a history of allergic reaction to the gentamicin, ciprofloxacin, chicken, or egg protein. See CDC Mpox Vaccine Recommendations​ for more information.

Can I get the vaccine if I have a weakened immune system?

Yes. JYNNEOS vaccine is non-replicating so persons who are immunocompromised, including persons with HIV or AIDS, may receive the vaccine. People who are immunosuppressed are more at risk for severe disease and complications if they get infected with mpox.

What are the side effects? 

Most people who get the JYNNEOS vaccine have minor reactions. These may include pain, redness, swelling, firmness, or itching where the shot was given, especially for intradermal injection (between layers of the skin). There may also be muscle pain, headaches, nausea, chills, or feeling tired. There is a small chance of fever. As with any medicine, there is a very small chance of a vaccine causing a severe allergic reaction. 

What if I have a severe allergic reaction? 

If you have signs of a severe allergic reaction (such as hives, swelling of the face or throat, difficulty breathing, a fast heartbeat, or dizziness), call 911 immediately or go to the nearest hospital. For other concerns, contact a health care provider. ​​​​​​​​

What to Expect If You Are Diagnosed with Mpox​​ 

A public health worker from the health department may contact you about your positive test result to discuss mpox, help notify any potential contacts confidentially, explain home isolation and how to prevent spread to others, and make sure you have important health information. 

Your health care provider can advise about treatment for mpox: Types of treatment may include skin care to help rashes heal, medicines to help manage symptoms like pain or itching, and/or if you’re eligible for antiviral medicine. 

Go to Q&A: Mpox Treatment

How do I prevent spreading mpox to others?

• ​Isolate. Because mpox is contagious until all scabs fall off and heal over, CDC recommends that people with mpox remain isolated at home away from others (including pets) for the duration of illness as much as possible. The public health worker will discuss isolation with you. For more information, see CDC | Isolation and Infection Control At Home​.
• ​Clean bedding and exposed materials. The mpox virus can survive in linens, clothing and on surfaces. Disinfection is recommended for all areas where a person with mpox has spent time, such as the home, vehicle, and any items that may be contaminated. See CDC | Mpox Cleaning and Disinfecting​ for more information, including details on which type of disinfectants to use.

How can I tell my partner(s) or others that they were exposed?

If you believe you may have exposed someone to mpox while you were infectious, you can let them know anonymously. Consider using tellyourpartner.org​​, an anonymous texting service available in English and Spanish. The health department may also assist you in notifying persons who may have been exposed.

Notifying exposed persons is important so they can monitor for any symptoms, get vaccinated, and know to get tested if they currently have or develop symptoms. See CDC | If You’re a Close Contact​ for more information or talk with the public health worker if you have questions.

What about taking time off from work? 

Similar to other medical conditions, your health care provider may be able to provide a doctor’s note if you need to take time off and/or if your infection is impacting your ability to work. Your employer’s human resources (HR) can provide information about what benefits may be available for illness such as paid sick leave, FMLA (Family and Medical Leave Act), or short-term disability insurance. 

Workers who are employed or actively looking for work and who are unable to do their regular work may qualify for financial support from California’s State Disability Insurance. Persons must be under the care of a health care provider who can complete the medical certification part of the application, so talk with your provider if you are applying. 

Your local public health department or 2-1-1 may be able to share information on accessing additional local support or resources. 

Do I have to tell my employer I have mpox? 

The health department will determine if/when employers should be notified due to potential public health risk, such as potential exposures to coworkers or clients. Confidential notifications may be routinely required as part of infection control plans in certain settings, such as healthcare or group settings. 

Unless otherwise advised by the health department, generally the decision to disclose mpox to an employer may be like any other employee medical condition or illness not related to COVID-19. Similar to other medical conditions, your health care provider may be able to provide a doctor’s note if you need to take time off, or need accommodations, and/or if your infection is impacting your ability to work. ​​​

What are the treatment options for mpox?

​What can I get for the pain and other symptoms?

Most mpox infections are mild and heal without any treatment. If you are experiencing pain or irritation due to the mpox rash or sores, talk to your health care provider. They may be able to offer over-the-counter or prescription treatments that are not specific to mpox, but can help reduce your symptoms and discomfort, like prescribed mouth rinses, stool softeners, or topical gels or creams.

Skin care and self-care are also important to promote healing—see CDC What to Do If You Are Sick – Taking Care of Yourself​ for more information.

Is medication for mpox available?

Talk with your provider if you have questions about treament for mpox.

Antiviral drugs, such as tecovirimat (TPOXX), may also be used to treat mpox. TPOXX is thought to reduce the amount of mpox virus in the body. It is prescribed most often for people with severe mpox infection or who are likely to get severely ill. Data about TPOXX for treatment of mpox in people is still limited. Therefore, TPOXX is only available through a clinical trial or for certain patients through a special prescription protocol (experimental compassionate use):

• Oral TPOXX (pills) is primarily available through a clinical trial called Study of Tecovirimat for Human Monkeypox Virus (STOMP)​. The study is open to individuals with suspected or confirmed mpox, regardless of mpox disease severity. Individuals are given either placebo (sugar pill) or treatment TPOXX. Individuals are monitored closely while in the study. If they develop worsening of symptoms, they will be given TPOXX. Providers may refer patients to the study or individuals can self-enroll in the study.
• ​Less commonly, providers may prescribe oral or IV TPOXX to certain patients who meet specific clinical criteria for severe disease or risk of severe disease.

TPOXX information for patients with mpox:

• ​STOMP Informational Handout for Patients (PDF) from CAPTC
• ​CDC CDC Patient’s Guide to Mpox Treatment with Tecovirimat (TPOXX)
• ​STOMP Trial Information and Enrollment Website
  

1. Ensure procedures to identify and respond to suspected mpox cases as per the Cal/OSHA ATD Standard. 
   
• ​Outpatient cases generally do not need to be transferred to a facility for the purposes of airborne isolation only, unless otherwise directed by the local health officer. Transport of patients should be limited to medically essential purposes.​
• Airborne infection isolation rooms (AIIR) should be used when possible and available for facilities as outlined in the ATD Standard.​​
• Generally, if AIIR is not available: a patient with suspected or confirmed mpox should be roomed quickly to a single-person room (with dedicated bathroom if possible) and the door should be kept closed if safe to do so.
  
2. Ensure that patients with suspected or confirmed mpox wear face coverings and use other source control (e.g., clothing or bandage to cover lesions).
3. ​Ensure HCP caring for patients with suspected or confirmed mpox use appropriate PPE.
   
• Respirators (e.g., fit-tested NIOSH-approved N95s or higher) are recommended by CDC to prevent exposure to mpox and their use is required by section 5199 in ATD-covered settings—see Cal/OSHA: Protecting Workers from Mpox for Employers and Workers Covered by the Aerosol Transmissible Disease Standard (Title 8 Section 5199) (PDF).
• Staff who must enter isolation areas should also wear a gown, gloves, and eye protection (goggles or face shield) particularly for direct care or specimen collection. Refer to CDC Personal Protective Equipment (PDF) sequence.
• Providers collecting lesion specimens should not deroof or aspirate lesions due to risk of needlestick injury. Vigorous swabbing of the lesion is sufficient to collect DNA.
4. Ensure environmental infection control procedures are in place.
• Staff involved in cleaning/disinfecting of the room should wear appropriate PPE (including gown, gloves, eyewear, and fit-tested N95 or higher).
• Establish procedures for handling contaminated laundry and cleaning, so that activities which may resuspend infectious particles from lesions (e.g., fanning, dusting, sweeping) are avoided.
• See CDC Environmental Infection Control​ for more information.

• ​Provide information (e.g., fact sheets) on risk factors for mpox, characteristic symptoms suggestive of mpox, and available preventive and treatment measures.
• Develop and share a management plan for HCP who have had occupational and non-occupational mpox exposures, including timely access to post-exposure prophylaxis (PEP) with vaccine. Consult the local health department (LHD)​ and see the CDC's Recommendations for PEP for more information.
• Instruct HCP not to come to work and to seek prompt medical evaluation (including testing and treatment, as appropriate) if having any symptoms characteristic of mpox, including systemic symptoms (e.g., fever, sore throat, swollen glands) in the absence of lesions, as well as presence of characteristic skin lesions.
• Provide guidance to isolate at home​ if mpox is suspected or confirmed. Include instructions to avoid touching lesions and then touching clothing, towels or other materials that are touched by others, with special attention to antiseptic technique when changing bandages on skin lesions.
• Make information about occupational health or public health resources (PDF) available to staff who do not have a healthcare provider.
  
• Share sick leave policies as well as information about short-term disability and other financial support options.
  
• ATD-covered settings should reference Cal/OSHA: Protecting Workers from Mpox for Employers and Workers Covered by the Aerosol Transmissible Disease Standard (Title 8 Section 5199) (PDF).
  

Where can healthcare providers find more information about mpox treatment?

Many patients with mpox have a mild, self-limited disease and recover without medical intervention. Supportive Care should be initiated for all patients who have mpox symptoms. This may include topical or systemic medications or other clinical interventions to control pain, itching, nausea and vomiting. Patients should be monitored closely to ensure resolution of illness without complications that would require further intervention.

Antiviral treatment, such as Tecovirimat (TPOXX), may be used to treat mpox. While there is currently no treatment approved specifically for mpox, antivirals developed for use in smallpox are available and may be beneficial against mpox. Treatment should be considered for patients with severe disease or at risk for severe disease; enrollment in the clinical trial is open to individuals regardless of disease severity. See the CDC Emergency Authorization Investigational New Drug (EA-IND) Protocol for ongoing updates, including eligibility criteria.

• ​At this time, oral TPOXX is available primarily through referral to the NIAD-funded clinical trial STOMP (Study of Tecovirimat for Human Monkeypox Virus). Patients with suspected or confirmed mpox should be informed about STOMP. Providers may refer patients to the study or patients may self-enroll in the study. See STOMP Informational Handout for Providers (PDF) and STOMP Informational Handouts for Patients from CAPTC.
• ​For patients who meet specified clinical eligibility criteria and are either not eligible for STOMP or who decline to participate, oral and IV TPOXX may be prescribed through CDC EA-IND protocol. TPOXX prescribed through this protocol is fulfilled through pre-positioned or stockpiled supplies in consultation with your local health jurisdiction. See CDPH Mpox Tecovirimat Treatment Information for Providers​ for more information on how to obtain TPOXX.

Treatment resources for providers:

• CDPH Supportive Care Suggestions for Patients with Mpox
• CDC Clinical Considerations for Pain Management of Mpox​
• Mpox: Caring for Skin and Mpox: Treating Severe Lesions (American Academy of Dermatology)
• CDPH Mpox Tecovirimat Treatment Information for Providers​
• ​STOMP Informational Handout for Providers from CAPTC (PDF)
• ​CDC Tecovirimat EA-IND Protocol
• CDC Treatment Information [including other antivirals] for Healthcare Professionals
• CDPH Mpox Guidance for Healthcare Providers​​​
  

​Where can providers find mpox vaccine information?

See CDPH Mpox Guidance for information for vaccine providers.​​​