Monkeypox is an infection caused by a virus. It starts with flu-like symptoms and then a rash that may look like pimples. The rash turns into blisters, which, over time, change into scabs.

Monkeypox is contagious. This means that it spreads from person to person. It becomes contagious at the time the symptoms start. It remains contagious until the rash has healed and a new layer of skin has formed. You should stay away from other people during this time. It may take 2–4 weeks to recover from monkeypox.

What are the causes?

• Having direct contact with body fluids or the rash or scabs of an infected person.
• Breathing in droplets from an infected person.
• Touching something that has been used by a person with the virus, such as clothes, bedding, or towels.
• Being bitten or scratched by an infected animal.

The virus can also be passed to a fetus during pregnancy.

What increases the risk?

• You take care of a person with monkeypox.
• You live in or travel to an area with cases of monkeypox.
• You have sex with more than one person.
• You are a man who has sex with men.

What are the signs or symptoms?

• Fever or chills.
• Sore throat or cough.
• Stuffy nose (nasal congestion).
• Headache.
• Muscle aches.
• Swollen lymph nodes.
• Rash on the face, mouth, genitals, anus, hands, or feet. The rash may hurt or itch.

• Weakness.
• Pain or bleeding in the rectum.

Most people with monkeypox get the rash. Some people only have the rash and no other symptoms.

How is this diagnosed?

• Your signs and symptoms.
• A physical exam.
• Lab tests. Scabs or fluid from the rash will be collected for testing.

How is this treated?

• Taking medicines. Medicines help to:
  • Reduce fever or pain.
  • Shorten the illness and make it less severe. An antiviral may be prescribed for people who are at risk for severe infection, such as those with weak body defense systems (immune systems).
  • Reduce itching.
• Taking care of your skin.

Serious symptoms may be treated in the hospital.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Use an anti-itch cream or numbing cream on the rash as told by your health care provider.
• If you were prescribed an antiviral medicine, take it as told by your health care provider. Do not stop using the medicine even if you start to feel better.

Relieving itching and discomfort

• Apply cold, wet cloths (cold compresses) to the rash or blisters as told by your health care provider.
• Take cool baths to soothe itching skin. Try adding baking soda, Epsom salts, or dry oatmeal to the water. Do not bathe in hot water.
• If you have blisters in your mouth:
  • Do not eat or drink foods and beverages that are spicy, salty, or acidic. Soft, bland, and cold foods and beverages are easiest to swallow.
  • Gargle with a mixture of salt and water 3–4 times a day, or as needed. To make salt water, completely dissolve ½–1 tsp (3–6 g) of salt in 1 cup (237 mL) of warm water.

Blister and rash care

• Keep your rash dry and uncovered. Wear loose-fitting clothing. This will ease the pain of clothing rubbing against the rash.
• Wash your hands with soap and water for at least 20 seconds after touching the rash. If soap and water are not available, use hand sanitizer.
• Keep your rash and blisters clean. Wash the area with mild soap and cool water as told by your health care provider.
• Check your rash every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood coming from the blisters.
  • Warmth.
  • Pus or a bad smell.
• Do not scratch your rash or pick at your blisters. To help prevent scratching:
  • Keep your fingernails short and clean.
  • Wear cotton gloves or mittens while you sleep.

General instructions

• If you are sick, stay home except to get medical care. Your health care provider will tell you how long to stay home.
  • If you suspect monkeypox, let the health care provider know before you go in to a clinic or doctor's office.
• To help prevent spreading the rash:
  • Do not touch your eyes. Do not use contact lenses.
  • Do not shave close to the areas that have the rash.
• Drink enough clear fluid to keep your urine pale yellow.
• Disinfect objects and surfaces that you touch a lot.
• Return to your normal activities as told by your health care provider.
• Ask your health care provider when it is safe for you to be around other people.

How is this prevented?

To protect yourself:

• Stay away from people who are sick.
• Do not touch a rash on someone else's skin.
• Avoid crowded indoor spaces. Follow guidance from your country and local health authorities.
• Talk to your health care provider about your risk and whether you should get the monkeypox vaccine.

To protect others:

• Call your health care provider before you go for medical care.
• Wear a cloth face covering or face mask when around others. Make sure it covers your nose and mouth.
• Cough or sneeze into a tissue or your sleeve or elbow. Do not cough or sneeze into your hand or into the air.
• Stay away from other members of your household. Let healthy household members care for children and pets.
• If possible:
  • Stay in your own room, away from others.
  • Use a separate bathroom.
  • If you must be around people, cover your rash with a loose bandage (dressing).
  • Stay home.
• Do not use public transport, if possible.
• Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use alcohol-based hand sanitizer.
• Make sure that all people in your household wash their hands well and often.

Where to find more information

• Centers for Disease Control and Prevention: www.cdc.gov
• World Health Organization: www.who.int

Contact a health care provider if:

• You have symptoms that get worse.
• You have a fever and medicines do not help.
• You have any of these signs of skin infection:
  • More redness, swelling, or pain around the rash.
  • More fluid or blood coming from the rash.
  • Warmth around the rash.
  • Pus or a bad smell coming from the rash.

Get help right away if:

• You have confusion.
• You have unusual drowsiness.
• You have seizures.
• You have vision changes.
• You have trouble breathing.

• Do not wait to see if the symptoms will go away.
• Do not drive yourself to the hospital.

Summary

• Monkeypox is an infection caused by a virus.
• It tends to start with flu-like symptoms and then a rash that may look like pimples. The rash turns into blisters, which, over time, change into scabs.
• If you are sick, stay home except to get medical care. Call your health care provider and tell him or her that you suspect monkeypox before you go for medical care.
• Treatment for monkeypox includes taking medicines and caring for your skin.