Freaking out about monkeypox? Here’s what you need to know.

Don’t panic, just get the facts

Since May of 2022 an increasing number of people around the world have been diagnosed with monkeypox infections. With cases increasing in the US, monkeypox was declared a public health emergency on August 4, 2022. Here’s what you need to know.

What is monkeypox?

Monkeypox is a virus that can spread from person to person. It’s not a new virus (like COVID was in 2019), but it has generally been diagnosed in limited areas of the world. Researchers are not sure yet what has caused the virus to spread and create outbreaks around the globe.

How do I know if I have monkeypox?

Monkeypox symptoms usually start within three weeks of exposure to the virus (see below for more on how it’s spread). The most common symptoms are fever, headache, swollen lymph nodes, fatigue, body aches, and chills, as well as cough, sore throat, and congestion.

The initial flu-like symptoms are usually followed one to four days later by a rash, although some people have developed a rash without having a fever or other symptoms first. The monkeypox rash is most likely to be on your face, arms, and legs, including the palms of your hands and soles of your feet, but it can be on other parts of your body, including your genitals. The rash progresses from small bumps to larger blisters filled with yellow fluid over five to seven days before crusting over, drying out, and being replaced by new skin.

The number and size of blisters can vary a lot between people, from one or just a few to covering the entire body and unfortunately, the rash can be itchy and quite painful. While most monkeypox infections are mild and symptoms resolve on their own without treatment, it can take two to four weeks for the blisters to completely heal. In some cases, monkeypox can lead to complications and even death.

Could I get monkeypox?

There are three main ways that we know of right now that monkeypox can pass from person to person. The first way is if someone touches the blisters of a person with monkeypox or touches surfaces or objects that have been contaminated with the monkeypox virus, such as clothing, bedding, or towels. It can also be passed through respiratory fluids from close face-to-face contact, like through heavy breathing during sex, or during kissing, cuddling, or close conversations. It’s also possible for a pregnant person to pass monkeypox through the placenta during pregnancy.

Someone with monkeypox can pass the virus from the time they first experience symptoms until the blisters are completely healed, which could take several weeks. It’s possible that the monkeypox virus that’s causing the current outbreak has mutated to be more transmissible or to be passed through the air without close physical contact, but we don’t know that for sure yet.

Is monkeypox a sexually transmitted infection (STI)?

It’s not yet known whether monkeypox is spread through semen, vaginal fluids, or blood. However, it is spread through close physical contact, which is often involved in sex. So monkeypox is definitely passing between sexual partners, but what isn’t clear is if it’s just from the close contact, or if semen or vaginal fluids are also contributing to passing monkeypox.

It’s important to keep in mind that anyone who is exposed to the virus can get monkeypox, regardless of your age, what kind of sex you have, who you have sex with, or what your gender identity is.

What can I do to prevent monkeypox?

The good news is that we already have a vaccine available for monkeypox, but the bad news is that supplies are limited right now so not everyone can get a monkeypox vaccine yet. Priority for vaccination is being given to people who are at highest risk, including people who know they have been exposed to monkeypox and those who are more likely to be exposed.

Until we know more about how monkeypox is passed (or not) during sex, the current recommendation is to use condoms or internal condoms if you have sex with someone who has had monkeypox for eight to 12 weeks after the infection. We know that’s a big range, but scientists haven’t been able to narrow it down yet.

Because monkeypox can be passed from contaminated surfaces and objects, including fabrics and sex toys, it’s also important to make sure you are immediately disinfecting any items and areas someone with monkeypox has used or touched .

What should I do if I think I have monkeypox?

Contact a health care provider and find out if they can test you for monkeypox. There are tests for monkeypox, but you’ll need to see a health care provider to get tested. Now that monkeypox has been classified as a public health emergency there is more funding for making testing accessible.

There are currently no treatments specifically for monkeypox, however treatments developed for smallpox, including anti-retroviral medications, immune therapies, and post-exposure prophylaxis with a vaccine within three days to two weeks of exposure, can be effective.

Written by Robin Watkins, CNM, WHNP-BC

Robin Watkins is the Senior Director, Health Care at Power to Decide. Robin is a midwife and women’s health nurse practitioner focused on helping other providers learn how to offer high-quality sexual and reproductive health care. Robin provides clinical care at a community health center in Washington, DC. When she is not talking sex, placing IUDs, or asking One Key Question, you can find her riding her bike on the streets of DC or eating ice cream for dinner.

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