Monkeypox is a virus that causes fever, swollen lymph nodes, and a painful rash. While rare, the virus has been spreading in the United States, with a third of the cases in New York City. These have been found predominantly among men who have sex with men, but anyone can get the virus, primarily through skin-to-skin contact. Vaccination to prevent mpox, the disease caused by the monkeypox virus, is not necessary for most people, though they are available for people who have been exposed or are at high risk.

In this Q&A, Bernard Camins, MD, Medical Director for Infection Prevention at the Mount Sinai Health System, offers some important insight on how to protect yourself from the virus.

What is mpox, and what are the symptoms to look out for?

 If you are infected with mpox, you will first experience a flu-like illness characterized by fatigue, fever, muscle aches, and painful and swollen lymph nodes. These symptoms may be followed by a rash that can be described as blisters with pus. The rash can occur anywhere on the body but usually starts where the exposure occurred. If you are exposed during sex, the rash may first appear in the genital area.

Bernard Camins, MD

Do most people need to get vaccinated?

No. Vaccination is appropriate for people who are at high risk for mpox, or who were exposed to it and do not yet have symptoms. If you had close contact with someone diagnosed with mpox, see your doctor. It is generally recommended that you take the vaccine within four days of exposure to prevent infection. However, the vaccine can still be administered within 14 days of exposure as long as the person who exposed you remains asymptomatic. This may not prevent you from getting infected, but it may reduce the symptoms. Check this link from the New York City Department of Health to see if you are eligible to get vaccinated.

How is mpox treated?

There is no specific treatment approved for mpox. Most cases are mild and get better on their own. However, antivirals developed for use in patients with smallpox may prove beneficial.

Is mpox sexually transmitted? Should men who have sex with men be especially on alert?

Mpox is not a sexually transmitted disease. The virus can be spread through through skin-to-skin contact, respiratory droplets passed through prolonged face-to-face contact, or exposure to contaminated bedding—and sexual activity is just one way these things can happen. Men who have sex with men, and have multiple or anonymous sex partners, are at heightened risk for getting mpox because they are a small group with a lot of physical contact. However, anyone can get the virus through any direct or close physical contact.

How can I stay safe?

Casual contact, such as hugging a friend, does not put you at much risk, but you should avoid close skin-to-skin contact or sex if you or your sexual partners feel sick, especially if you or they have a rash or sores anywhere on the body. Other important ways to stay safe if you are infected or at high risk include:

  • Continue to avoid physical contact until all sores have healed and a fresh layer of skin has formed, which can take two to four weeks.
  • Wash your hands, bedding before and after sex, and any areas of your body that came into close physical contact with your partners, whether or not you or they have symptoms. And don’t share items like towels or bedding with anyone who is infected or may have been exposed.
  • When making plans, consider the level of risk. Having sex or other close physical contact with multiple or anonymous sexual partners increases your chance of exposure.
  • Consider that going to clubs, raves, saunas, and other places where you are likely to experience skin-to-skin or face-to-face contact with many people may also increase your risk.

 Are children at risk for getting mpox, especially when schools reopen in the fall?

Though a handful of children have been diagnosed with mpox in the United States, their overall risk for getting it is currently low, as it is for the general population. However, children who are infected with mpox may experience more severe outcomes than adults, according to the World Health Organization. We have yet to see if mpox will spread when schools reopen, but this is just another reason it is important to reduce the spread now.

Learn more about mbox and how to protect yourself on mountsinai.org, the New York City Department of Health, and the Centers for Disease Control and Prevention.

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