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Division of Communicable Disease Control

Monkeypox (MPX)

The current monkeypox (MPX) situation is rapidly evolving and the information below will be updated as new information emerges.  CDPH is closely monitoring MPX transmission in the U.S. and California to ensure rapid identification of cases. The risk of MPX to the public is currently  low based on the information available. While MPX can infect anyone, many of the recent cases in 2022 have occurred among persons self-identifying as men who have sex with men (MSM).

MPX Data in California

Find the number of reported probable/confirmed cases and demographic data in California by visiting the MPX data webpage.

About MPX

MPX is a rare disease that is caused by infection with the MPX virus.  The MPX virus belongs to the orthopoxvirus genus which includes the variola (smallpox) virus as well as the vaccinia virus, which is used in the smallpox vaccine. MPX is a public health concern because the illness is similar to smallpox and can be spread from infected humans, animals, and materials contaminated with the virus. MPX is less transmissible and usually less severe than smallpox.

MPX was first identified in 1958 and occurs primarily in Central and West African countries. Historically, MPX cases have rarely occurred in the U.S. and had mostly been related to international travel or importation of animals. There is a recent significant increase in reported cases where MPX is not commonly seen, including in Europe, Canada, the United States and California. While it's good to stay alert about any emerging public health outbreaks, the current risk of MPX for the general public is  low.   

Symptoms 

MPX often starts 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, or inside the mouth. They may also be limited to one part of the body.

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

Infectious Period 

MPX can spread from the time symptoms start until all sores have healed, scabs are off and a fresh layer of skin has formed underneath. This can take several weeks.

Transmission

MPX can be spread by:

  • Direct skin-to-skin contact with the sores or scabs of people with MPX

  • Direct contact with body fluids of people with MPX, such as drainage from skin sores or saliva that was in contact with mouth sores

  • Contact with the respiratory secretions of people with MPX, such as saliva, during prolonged, face-to-face contact or during intimate physical contact, such as kissing, cuddling, or sex

  • Touching items (such as bedding, towels, clothing, cups and utensils) that previously touched the sores or body fluids of people with MPX

To date, there has been no evidence that MPX is spread by:

  • Attending an outdoor event with fully clothed people

  • Trying on clothes or shoes at a store

  • Traveling in an airport, on a plane or on other public transit

  • Swimming in a pool or body of water

  • Casual contact with other people

Prevention

There are number of ways to prevent the spread of MPX, 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 hugging, kissing, cuddling and sexual activity with people who have symptoms like sores or rashes

  • Not sharing materials (bedding, towels, clothing, utensils, cups) with someone who has symptoms

  • Washing your hands often with soap and water or an alcohol-based hand sanitizer

  • Using appropriate personal protective equipment (PPE) (like a mask, gown, and gloves) when caring for others with symptoms

  • Avoiding contact with infected animals

Testing & Isolation

If you have a new or an unexplained rash or other symptoms, seek medical care for further testing and evaluation.

  • Wear a well-fitting mask, ensure your rash is covered, and tell your health care provider of your current symptoms of possible MPX. 

  • If you do not have a health care provider or healthcare insurance, visit a public health clinic or local county clinic. You may also contact the Department of Healthcare Services for more available resources.

  • Avoid crowds and close contact, including sexual or intimate contact, until you see your health care provider.

For more information about isolation recommendations, please refer to the CDPH MPX Home Isolation Guidance for the General Public.

Treatment

Most MPX infections are mild and will heal without any treatment. Antiviral drugs, such as tecovirimat (TPOXX), may be used to treat MPX. This drug may be recommended for people who are more likely to get severely ill or for people who are experiencing severe disease. It may also be recommended for people who have rash lesions in areas that may be at higher risk for scarring, such as the eyes or the genital area.

People who may be at risk for more severe illness include those with a weakened immune system, children (particularly those younger than 8 years of age), those who are pregnant or breastfeeding, and those with a history of certain skin diseases like eczema.

It is important to talk to your health care provider if you have symptoms of MPX and are experiencing pain or irritation due to the rash or sores. Your provider may also be able to offer treatments that are not specific to MPX, but may help to reduce your symptoms, like prescribed mouth rinses, stool softeners for those with rectal pain, or topical gels or creams.

Vaccination

Vaccination helps protect against MPX when given before or shortly after an exposure. At this time, the federal government has allocated a limited number of JYNNEOS vaccine doses to Californians. See the CDPH MPX vaccine page to learn more about the JYNNEOS vaccine and find out if you're eligible.

Additional Information

For more information about MPX, visit the Q&A

How Can We Help You?

Connect with CDPH for additional monkeypox (MPX) resources.

Contact CDPH Guidance and Policy

If you need further clarification or have questions, comments, and concerns regarding CDPH MPX Guidance and Policy submit an inquiry

Contact Your Local Public Health Department

Reach out to your local health department with any questions.

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