Mpox (monkeypox) Q&A

Mpox (monkeypox) is a disease caused by the monkeypox virus. It is a viral zoonotic disease, meaning that it can spread from animals to humans. It can also spread between people.

The manifestation of mpox typically includes fever, intense headache, muscle aches, back pain, low energy, swollen lymph nodes, and a skin rash or lesions. The rash usually begins within one to three days of the start of a fever. Lesions can be flat or slightly raised, filled with clear or yellowish fluid, and can then crust, dry up and fall off. The number of lesions on one person can range from a few to several thousand. The rash tends to be concentrated on the face, palms of the hands, and soles of the feet. They can also be found on the mouth, genitals, and eyes.

Symptoms typically last between 2 to 4 weeks and go away on their own without treatment. If you think you have symptoms that could be monkeypox, seek advice from your health care provider. Let them know if you have had close contact with someone who has suspected or confirmed mpox.

In most cases, the symptoms of mpox go away on their own within a few weeks, but in some individuals, they can lead to medical complications and even death. Newborns, children, and people with underlying immune deficiencies may be at risk of more serious symptoms and death from mpox.

Complications from severe cases of mpox include skin infections, pneumonia, confusion, and eye infections which can lead to loss of vision. Around 3–6% of reported cases have led to death in endemic countries in recent times, often in children or persons who may have other health conditions.  It is important to note that this may be an overestimate because surveillance in endemic countries is limited.

Mpox can spread to people when they come into physical contact with an infected animal. Animal hosts include rodents and primates. The risk of catching mpox from animals can be reduced by avoiding unprotected contact with wild animals, especially those that are sick or dead (including their meat and blood). In endemic countries where animals carry mpox, any foods containing animal meat or parts should be cooked thoroughly before eating.

People with mpox can transmit the virus while they have symptoms (normally for between two and four weeks). You can catch mpox through close physical contact with someone who has symptoms. The rash, bodily fluids (such as fluid, pus, or blood from skin lesions), and scabs are particularly infectious. Clothing, bedding, towels, or objects like eating utensils/dishes that have been contaminated by contact with a person with the virus can also infect others.

Ulcers, lesions, or sores in the mouth can also be infectious, meaning the virus can spread through saliva. People who closely interact with someone who has the virus, including health workers, household members, and sexual partners are therefore at greater risk for infection.

The virus can also be transmitted from someone who is pregnant to the fetus from the placenta, or from a parent with the disease to their child during or after birth through skin-to-skin contact.

It is not clear whether people who do not have symptoms can transmit the disease.

Anyone who has close physical contact with someone who has symptoms of mpox, or with an animal with the virus is at the highest risk of infection. People who were vaccinated against smallpox are likely to have some protection against mpox infection. However, younger people are unlikely to have been vaccinated against smallpox because smallpox vaccination stopped worldwide after smallpox became the first human disease to be eradicated in 1980. Even though people who have been vaccinated against smallpox will have some protection against monkeypox, they also need to take precautions to protect themselves and others.

Newborns, children, and people with underlying immune deficiencies may be at risk of more serious symptoms and death from mpox. Health workers are also at higher risk due to longer virus exposure.

You can reduce your risk by limiting contact with people who have suspected or confirmed mpox. 

If you do need to have physical contact with someone who has mpox because you are a health worker or live together, encourage the person with the virus to self-isolate and cover any skin lesion if they can (e.g., by wearing clothing over the rash). When you are physically close to them, they should wear a medical mask, especially if they are coughing or have lesions in their mouth. You should wear one also. Avoid skin-to-skin contact whenever possible and use disposable gloves if you have any direct contact with lesions. Wear a mask when handling any clothes or bedding if the person cannot do it themselves.

Regularly clean your hands with soap and water or an alcohol-based hand rub, especially after contact with the person with the virus, their clothes, bed sheets, towels, and other items or surfaces they have touched or that might have come into contact with their rash or respiratory secretions (e.g., utensils, dishes). Wash the person’s clothes, towels and bedsheets, and eating utensils with warm water and detergent. Clean and disinfect any contaminated surfaces and dispose of contaminated waste (e.g., dressings) appropriately.

Children are typically more prone to have severe symptoms than adolescents and adults. The virus can also be passed to a fetus or to a newborn through birth or early physical contact.

If you think you have symptoms or have been in close contact with someone with mpox, contact your health worker for advice, testing, and medical care. If possible, self-isolate and avoid close contact with others. Clean hands regularly and take the steps listed above to protect others from infection. Your health worker will collect a sample from you for testing so that you can get appropriate care.

Mpox symptoms often resolve on their own without the need for treatment. It is important to take care of the rash by letting it dry if possible or covering it with a moist dressing to protect the area if needed. Avoid touching any sores in the mouth or eyes. Mouth rinses and eye drops can be used as long as cortisone-containing products are avoided. Vaccinia immune globulin (VIG) may be recommended for severe cases. An antiviral that was developed to treat smallpox (tecovirimat, commercialized as TPOXX) was also approved for the treatment of mpox in January 2022. 

Since 1970, human cases of mpox have been reported in 11 African countries – Benin, Cameroon, the Central African Republic, the Democratic Republic of the Congo, Gabon, Côte d’Ivoire, Liberia, Nigeria, the Republic of the Congo, Sierra Leone, and South Sudan.

Cases occur occasionally in non-endemic countries. These are typically reported in persons who have traveled to endemic countries. One outbreak was caused by contact with animals who had been infected by other imported small mammals.

In May 2022, multiple cases of mpox are being identified in several non-endemic countries, including in the Region of the Americas. This is not typical of past patterns of mpox. WHO is working with all affected countries to enhance surveillance and provide guidance on how to stop the spread and how to care for those infected.

Mpox can spread from one person to another through close physical contact, including sexual contact. It is currently not known whether monkeypox can be spread through sexual transmission routes (e.g., through semen or vaginal fluids), but direct skin-to-skin contact with lesions during sexual activities can spread the virus.

Mpox rashes are sometimes found on genitals and in the mouth, which is likely to contribute to transmission during sexual contact. Mouth-to-skin contact could thus cause transmission where skin or mouth lesions are present.

Mpox rashes can resemble some sexually transmitted diseases, including herpes and syphilis. This may explain why several of the cases in the current outbreak have been identified amongst men seeking care in sexual health clinics.

The risk of catching mpox is not limited to people who are sexually active or men who have sex with men. Anyone who has close physical contact with someone with the virus is at risk. Anyone who has symptoms that could be mpox should seek advice from a health worker immediately.

Mpox is spread from person to person through close physical contact. The risk of mpox is not limited to people who are sexually active or men who have sex with men. Anyone who has close physical contact with someone who is infectious is at risk. Anyone who has symptoms that could be mpox should seek advice from a health care provider immediately. This includes people who have connections to communities where cases have been reported.

Several of the cases that have been reported from non-endemic countries have been identified in men who have sex with men. These cases were identified at sexual health clinics. The reason we are currently hearing more reports of cases of mpox in communities of men who have sex with men may be because of positive health-seeking behavior in this demographic. Mpox rashes can resemble some sexually transmitted diseases, including herpes and syphilis, which may explain why these cases are being picked up at sexual health clinics. It is likely that as we learn more, we may identify cases in the broader community

We have seen messages stigmatizing certain groups of people around this outbreak of mpox. We want to make it very clear that this is not right. First of all, anyone who has close physical contact of any kind with someone who has mpox is at risk, regardless of who they are, what they do, who they choose to have sex with, or any other factor. Secondly, stigmatizing people because of an illness or a disease is unacceptable. Stigma is only likely to make things worse and stop us from ending this outbreak as fast as we can. We need to all pull together to support anyone who has been infected or who is helping to take care of people who are unwell. We know how to stop this disease, and how we can all protect ourselves and others. Stigma and discrimination are never okay, and it is not okay in relation to this outbreak. We are all in this together.

The disease is called monkeypox (mpox) because it was first identified in colonies of monkeys and kept for research in 1958. It was only later detected in humans in 1970.

Hay dos grandes clados del virus que causa la mpox: el clado I y el clado II. Este último ocasionó el brote mundial que comenzó en 2022. 

Se sabe que el clado I provoca cuadros más graves y más fallecimientos que el clado II en los lugares donde es endémico. Sin embargo, las diferencias entre los brotes anteriores —por ejemplo, en cuanto a los grupos de población afectados— no permiten sacar conclusiones definitivas. 

Los consejos de salud pública de la OMS permiten prevenir y tratar la mpox causada por cualquiera de los dos clados. 

En 2023 se notificó por primera vez en la República Democrática del Congo un nuevo tipo de virus del clado I, denominado clado Ib, que se ha estado propagando por contacto sexual y por otros tipos de contacto estrecho. Se están realizando estudios para conocer las características de esta nueva cepa. 

Más de 120 países han notificado casos de mpox entre enero de 2022 y agosto de 2024, con más de 100.000 casos confirmados por laboratorio y más de 220 fallecimientos entre los casos confirmados.  

En la región de las Américas, los brotes de mpox hasta agosto de 2024 han afectado principalmente a hombres (94%), con la transmisión predominantemente sexual entre gais, bisexuales y otros hombres que tienen sexo con hombres. Esta infección se puede presentar también en poblaciones con redes sexuales extensas como personas trabajadoras sexuales. 

El Director General de la OMS ha emitido recomendaciones temporales a los países, tras la declaración de la ESPII. https://www.who.int/news/item/19-08-2024-first-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-upsurge-of-mpox-2024

Incluyen recomendaciones sobre:

- Coordinación de emergencias

- Vigilancia de la enfermedad y capacidad de diagnóstico de laboratorio

- Atención clínica a los pacientes de viruela símica

- Viajes y comercio internacionales

- Vacunación

- Comunicación de riesgos y participación de la comunidad

- Financiación e integración de la mpox en los programas de salud existentes

- Vacíos en la investigación

- Presentación de informes a la OMS

Estas recomendaciones temporales se emiten para los Estados Miembros que están experimentando un recrudecimiento de la mpox, incluidos, entre otros, la República Democrática del Congo y Burundi, Kenya, Rwanda y Uganda.

Además, las actuales recomendaciones permanentes para la mpox se aplican a todos los países, y se han prorrogado hasta el 20 de agosto de 2025.

Mpox Vaccines Q&A

The vaccines produced for Smallpox can protect against mpox. These vaccines include a) Dryvax, a vaccine licensed in the 1930s by the US Food and Drug Administration (FDA); b) ACAM2000, licensed in 2007; and c) a newer vaccine that was developed for smallpox (MVA-BN, also known as Imvanex, Imvamune, or Jynneos) approved by the National Regulatory Authorities of the European Union, Canada and United States to prevent smallpox and mpox.

Since smallpox was eradicated in 1980, most of these vaccines are not widely available and there is no certainty as to when they will be available to the public. In some countries, vaccines may be available in limited quantities and for use in accordance with national guidance.

Some studies shown that people who have been vaccinated against smallpox could have some protection against mpox. These persons may require a single booster dose. 

In the current epidemiological situation of mpox outbreaks outside of endemic countries, PAHO and WHO do recommend that only close contacts of a mpox case should be offered vaccination.

PAHO and WHO do not recommend mass vaccination. Regardless of vaccine supply, mass vaccination of the population is not required nor recommended for mpox.  Every effort must be made to control human-to-human spread of mpox through early case-finding and diagnosis, isolation, and contact-tracing.

A close contact is a person who, has been exposed to someone who is a confirmed or probable case of mpox, beginning from when symptoms first appeared to when all scabs have fallen off, under the following circumstances:

  • Face-to-face exposure (including health workers without appropriate personal protective equipment [PPE]). 
  • Direct physical contact (including health workers without appropriate PPE), including sexual contact. 
  • Contact with contaminated materials such as clothing or bedding (including health workers without appropriate PPE). 

All available vaccines against mpox may generate adverse events. When offering vaccination to a close contact of a confirmed case, it is important to inform the person of the possible side effects of vaccination and offer alternative infection control measures, if possible, to ensure that immunization decisions are made while balancing risks and benefits.

Through its Revolving Fund for Access to Vaccines, PAHO negotiated in 2022 with the manufacturer of the third-generation vaccine and thirteen countries in the region have since been able to access doses of this vaccine. 

Due to the new public health emergency of international concern (PHEIC) declared in August 2024, PAHO will avail itself of the technical recommendations and global supply in case it is recommended to explore the procurement of more doses for the region. 
While vaccines are an important tool, they are not the only one. Increased disease surveillance and community involvement are critical to stopping mpox. Mass vaccination is not currently recommended.

No. There is no evidence of a causal link between the COVID-19 vaccines and the recent spread of mpox in Europe and the Americas. Mpox has been circulating in central and west Africa since its first detection in animals in 1958 in the Democratic Republic of the Congo, long before the COVID-19 virus was discovered, and the vaccines were developed.

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