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Monkeypox Q&A

June 13, 2022

What is monkeypox? 

Monkeypox is a rare disease that is caused by infection with the monkeypox virus and is related to the smallpox virus. While generally less severe and much less contagious than smallpox, monkeypox can be a serious illness. It spreads from infected humans, animals, and materials contaminated with the virus but primarily through close, personal, often skin-to-skin contact with people who have monkeypox symptoms, such as rash and sores.

Is monkeypox a new disease? 

No, monkeypox is not a new disease. Monkeypox was first discovered in 1958 in monkeys, hence the name 'monkeypox.' The first human case of monkeypox was recorded in 1970 in the Democratic Republic of Congo. Monkeypox is endemic (regularly found) in west and central African countries. 

There is a recent increase in reported cases where monkeypox is not commonly seen, including in the United States and California. While it's good to stay alert about any emerging public health outbreaks, the current risk of getting monkeypox in the general public is very low.  

Monkeypox is a known illness that spreads through very close contact compared to other infectious diseases like COVID-19, that are primarily spread though very small particles in the air. Monkeypox is also thought to be most contagious when symptoms like a rash are present, making it easier for infected individuals to stay away from others to prevent further spread. 

No, monkeypox is a completely different disease and is not related to COVID-19. Monkeypox is much less contagious and spreads differently than COVID-19. This is partly because people with monkeypox are generally thought to be contagious to people with whom they've had very close contact over a long period of time, and when they have symptoms like a rash. This is different from COVID-19, which spreads through the air and when people do not have symptoms. 

Does the monkeypox virus have variants? 

All viruses change and evolve over time, however, the monkeypox virus mutates slower than coronaviruses.  There are two known families or “clades” of monkeypox virus. The clade recently identified in Europe and in the United States is the West African clade, which tends to cause less severe disease.  

Anyone can get monkeypox after having close and prolonged physical contact with someone who has the infection, especially contact with infected lesions (sores), bodily fluids, or other contaminated surfaces. However, the current risk to the general public is very low. 

In 2022, many cases of monkeypox have been reported in several countries that don't normally report monkeypox, like the United States, including in California. Though not exclusively, recent cases include gay, bisexual, and other men and transgender people who have sex with men, and household contacts. 

Monkeypox spreads primarily through direct contact with infectious sores, scabs, or body fluids, including during sex, as well as activities like kissing, hugging, massaging, and cuddling. Monkeypox can spread through touching materials used by a person with monkeypox that haven’t been cleaned, such as clothing and bedding. It can also spread by respiratory secretions (talking, coughing, sneezing, breathing) during prolonged, close, face-to-face contact.  

 Monkeypox can be spread through: 

  • Direct skin-skin contact with rash lesions 
  • Sexual/intimate contact, including kissing  
  • Living in a house and sharing a bed with someone 
  • Sharing towels or unwashed clothing 
  • Respiratory secretions through prolonged face-to-face interactions (the type that mainly happen when living with someone or caring for someone who has monkeypox) 

Monkeypox is NOT spread through: 
  • Casual conversations 
  • Walking by someone with monkeypox, like in a grocery store 
  • Touching items like doorknobs 

Scientists are still learning if monkeypox can be spread through: 
  • Semen or vaginal fluids  
  • Contact with people who have no symptoms (we think people with symptoms are most likely to spread it, but some people may have very mild illness and not know they are infected) 

What are the signs and symptoms of monkeypox? 

Monkeypox might start with symptoms like the flu, with fever, low energy, swollen lymph nodes, and general body aches. Within 1 to 3 days (sometimes longer) after the appearance of fever, the person can develop a rash or sores. The sores will go through several stages, including scabs, before healing. They can look like pimples or blisters and may be painful and itchy. 

The rash or 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. 

People with monkeypox may experience all or only a few of these symptoms. Most people with monkeypox will get the rash or sores. Some people have reported developing the rash or sores before (or without) the flu-like symptoms. 

Monkeypox symptoms usually start within 2 weeks (but can be up to 3 weeks) after exposure to the virus. Usually, people are only thought to be contagious (infectious) when they have symptoms, and until all sores, including scabs, have healed and a fresh layer of skin has formed. This can take several weeks. Researchers are still trying to understand if the virus can spread from someone who has no symptoms. 

Monkeypox is usually a mild disease with symptoms lasting from 2 to 4 weeks. Severe cases can occur. In recent times, 3–6% of people with monkeypox in Africa will die of the disease. 

Is monkeypox a sexually transmitted infection (STI)? 

Monkeypox can spread from skin-to-skin contact, or because of contact with a contaminated surface or material (like bedding and clothing). This includes close or intimate physical contact, including sexual contact, with infected people, especially when touching rashes or contaminated objects or surfaces. Scientists are investigating whether the virus could be present in semen or vaginal fluids, but this has not been previously known to be how the virus spreads.  

Monkeypox may look like sexually transmitted infections that cause rash on the genitals and anus, including herpes and syphilis. It’s important to talk to a health care provider as soon as you notice unusual rashes or sores. This is always a good plan, even if monkeypox isn’t in your area. 

How is monkeypox prevented? 

There are number of ways to prevent the spread of monkeypox, including: 
  • Always talking to your sexual partner/s about any recent illness and being aware of new or unexplained sores or rashes on your body or your partner’s body, including on the genitals and anus 
  • Avoiding close contact, including sex, with people with symptoms like sores or rashes 
  • Avoiding contact with infected animals and materials contaminated with the virus
  • Isolation of infected persons until their symptoms, including rash, have gone away completely
  • Using appropriate personal protective equipment (PPE) (like a mask, gown and gloves) when caring for others with symptoms 
  • Practicing good hand hygiene 

What should someone do if they are exposed to monkeypox or have symptoms? 

Contact a health care provider as soon as possible and let them know you have symptoms or have been exposed to monkeypox. Health care providers can provide testing and care for people who are diagnosed with monkeypox.  

Health care providers and local health departments may also recommend a vaccine for those who are exposed to help prevent infection or decrease the seriousness of the illness.   

What is CDPH doing about monkeypox? 

CDPH has activated our response center and is closely monitoring monkeypox transmission in the U.S. and California to ensure rapid identification of cases. CDPH is working with local health officials, and the U.S. Centers for Disease Control and Prevention (CDC) to ensure appropriate care and response, including laboratory testing, contact tracing, and obtaining vaccine to support local vaccination efforts for high-risk contacts (people who have been exposed). 

Additionally, CDPH is promoting awareness amongst health care providers and the public, to promote testing when appropriate, and ensuring appropriate infection control guidance is provided for caring for monkeypox cases in the healthcare setting. Because monkeypox is rare and the possibility of transmission during intimate or sexual contact may not be well known, CDPH is working to help health care providers and the public become familiar with the symptoms and appearance of monkeypox. 

UC Davis Health: What is Monkeypox? Symptoms, Transmission and Vaccination Questions Answered


(Video courtesy of UC Davis Health)

InterPride: Monkeypox & Pride: Know Before You Go! 


(Video courtesy of InterPride)

Where can I find more information?

Originally published on June 6, 2022

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