Monkeypox Appears to Recede, but Risks and Uncertainties Linger (2022)

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Monkeypox Appears to Recede, but Risks and Uncertainties Linger (1)

By Apoorva Mandavilli

Nearly four months after the first report of monkeypox in the United States, the virus is showing promising signs of retreat, easing fears that it may spill over into populations of older adults, pregnant women and young children.

Supplies of the vaccine have improved, and federal health officials have begun clinical trials to gain a better understanding of who benefits, and how much, from both the vaccine and the drug used to treat those who become infected.

That’s the good news. But unhappily, case numbers are accelerating in a few states and jurisdictions, including Indiana, Virginia and Massachusetts. Black and Hispanic men make up nearly two-thirds of the infected, but only about one-fourth of those vaccinated so far.

“Our progress is incredibly uneven,” said David Harvey, the executive director of the National Coalition of STD Directors.

(Video) Monkeypox Appears to Recede but Risks and Uncertainties Linger

“This outbreak is far from finished,” he added.

Recent reports suggest that a single dose of the vaccine, Jynneos, may not be protective enough, raising fresh concerns about the Biden administration’s plan to distribute fractional doses.

And federal health officials have warned that the virus could become resistant to tecovirimat, the only safe treatment for those who are infected.

“When you only have one drug in your armamentarium, that can be somewhat precarious,” said Dr. Anthony S. Fauci, the Biden administration’s top medical adviser. “But you’ve got to go with what you have at the same time as you try and develop additional drugs.”

As of Friday, there were nearly 25,000 cases of monkeypox in all 50 states, the District of Columbia and Puerto Rico. The United States accounts for nearly 40 percent of the global tally.

But new cases have been decreasing steadily for weeks, to a daily average of 208 on Sept. 22 from more than 500 in early August.

The Los Angeles Department of Public Health recently confirmed the nation’s first death from monkeypox, in a severely immunocompromised individual. Health officials in Texas are investigating another death that may be related to the infection.

Two cases of encephalomyelitis — inflammation in the brain and spinal cord — have been reported, both in previously healthy gay men in their 30s.

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Overall, however, federal health officials are optimistic that the epidemic is waning. While testing and vaccines will continue to be important, officials envision a future in which monkeypox is not gone, but manageable with contact tracing, vaccination and early treatment.

“I think it’s going to look a little bit more like more episodic cases, smaller clusters,” said Dr. Demetre Daskalakis, the deputy coordinator of the White House’s monkeypox response.

What to Know About the Monkeypox Virus

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What is monkeypox? Monkeypox is a virus similar to smallpox,but symptoms are less severe. It was discovered in 1958, after outbreaks occurred in monkeys kept for research. The viruswas primarily found in parts of Central and West Africa, butrecently it has spread to dozens of countries and infected tens of thousands of people, overwhelmingly men who have sex with men.

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What are the symptoms? People who get sick commonly experience a fever, headache, back and muscle aches, swollen lymph nodes,and exhaustion. A few days after getting a fever, most people also develop a rash that starts with flat red marks that become raised and filled with pus. On average, symptoms appear within six to 13 days of exposure, but can take up to three weeks.

How does it spread? The monkeypox virus can spread from person to person through close physical contactwith infectious lesions or pustules, by touchingitems — like clothing or bedding — that previously touched the rash,or via the respiratory droplets produced bycoughing or sneezing. Monkeypox can also be transmitted from mother to fetus via the placenta or through close contact during and after birth.

I fear I might have monkeypox. What should I do? There is no way to test for monkeypox if you have only flulikesymptoms. But if you start to notice red lesions, you should contact an urgent care center or your primary care physician, who can order a monkeypox test. Isolate at home as soon as you develop symptoms,and wear high-qualitymasks if you must come in contact with others for medical care.

What is the treatment for monkeypox? If you get sick, the treatment for monkeypox generally involves symptom management. Tecovirimat, a hard-to-obtain antiviral drug also known as TPOXX, occasionally can be used for severe cases. The Jynneos vaccine, which protects against smallpox and monkeypox, can also help reduce symptoms, even if taken after exposure.

Who can get the vaccine? Jynneos vaccine is most commonly used to prevent monkeypox infections,and consists of two doses given four weeks apart. It has mostly been offered to health careworkers and people who have had a confirmed or suspected exposure due to limited supplies, though new doses should become available in the coming months. A few states, including New York, have also made vaccines available among higher-risk populations.

I live in New York. Can I get the vaccine? Adult men who have sex with men and who have had multiple sexual partners in the past 14 days are eligible for a vaccine in New York City, as well as close contacts of infected people. Eligible people who have conditions that weaken the immune system or who have a history of dermatitis or eczema are also strongly encouraged to get vaccinated. People can book an appointment through this website.

The recent decline is most likely the result of a combination of vaccinations, immunity gained from infection in the population most at risk, and a change in behavior in this group, Dr. Daskalakis said.

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In a survey conducted by the C.D.C. in August, roughly half of men who have sex with men said they had reduced the number of their partners and one-time sexual encounters.

But falling case numbers may soon lead these men to believe that the threat has passed. “We can’t ask people to change their behavior forever,” Dr. Daskalakis said. “That didn’t really work with H.I.V., so it’s not going to work here, either.”

Vaccination is likely to be a more effective containment strategy in the long term, he added.

As of Sept. 20, health officials had administered nearly 700,000 doses of Jynneos in the 48 jurisdictions for which data were available. While that is a substantial improvement over the early weeks of the outbreak, it accounts for only 22 percent of the doses needed to protect the 1.6 million Americans estimated to be at high risk.

Even as infections decline, the proportion of cases among Black and Hispanic men has grown to 70 percent in mid-September from 37 percent in late May. Yet Black men have received less than 9 percent of the doses administered so far, and Hispanic men about 16 percent.

Federal health officials are intensifying efforts to reach high-risk groups and have vaccinated at least 11,000 attendees at large gatherings where Black and Hispanic men congregate, such as Atlanta Black Pride.

The C.D.C. has announced a new program that would make up to 10,000 vials of vaccine — or 50,000 doses, under the new dose-sparing strategy — available to communities where hesitancy, language barriers, immigration status or other obstacles prevent widespread vaccination.

Eligibility for the vaccine is scattershot by location, and the criteria often opaque, according to an analysis by the Kaiser Family Foundation. Some states, like Indiana and New Mexico, offer no information online about who qualifies. Laboratory and health care workers who may be exposed to the virus are eligible in only 18 states and cities.

Many men at high risk have opted for a single dose, which may not be sufficiently protective. Although the proportion of second doses has increased, so far 77 percent of administered doses are first doses.

A new study suggests that will not be enough to prevent infection or severe symptoms. Dutch researchers found that one full dose of Jynneos produces low levels of antibodies to monkeypox.

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Two full doses are better but still “modest,” said Dr. Marion Koopmans, the head of virology at Erasmus Medical Center in Rotterdam, the Netherlands, who led the study.

“It does raise the question how good protection will be,” she said. “Since we don’t know a whole lot about this, I do think we really need to figure out what’s going on.”

In a bid to stretch the vaccine supply, the Biden administration has embraced a dose-splitting strategy, in which one-fifth of a regular dose is delivered into the skin — a so-called intradermal method — rather than the fat underneath. This approach has been tried in other instances of vaccine shortage.

But activists and some scientists have decried the administration’s reliance on fractional dosing, noting that federal officials moved slowly to make available millions of Jynneos doses held by the manufacturer in Denmark.

“What’s so bizarre about this whole thing is we should have never gotten into the situation,” said James Krellenstein, a founder of PrEP4All, a group that promotes access to H.I.V. care.

There is minimal research to support fractional doses instead of the full regular doses, Mr. Krellenstein noted: “They may be equivalent, but there’s a real good chance that they’re not.”

The Dutch team did not look at how well a one-fifth dose of Jynneos protects against monkeypox. But in an earlier study, they tested a bird flu vaccine similar to Jynneos and found that two fractional doses produced much lower levels of antibodies than two full doses.

Still, it’s possible that a combination of one full dose and one fractional dose may work well, Dr. Koopmans said.

Little is known about the effectiveness of regular doses, let alone fractional doses, because Jynneos was approved mainly on the basis of animal data. But the evidence so far suggests that two doses are better than one, said Dr. Peter Marks, the Food and Drug Administration’s top vaccine regulator.

“Having two doses of Jynneos was the correct way to go here, and the fact that the intradermal route allowed us to have a sufficient number of doses to move forward in that direction, I think, was a smart idea,” he said.

“We’re working in a public health emergency,” he added. “I think we’re doing our best with the data that we have in hand, and the data that we trust, and the data as it emerges.”

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There is some evidence that a third shot given a year after the first two doses provokes a vigorous immune response. If that turns out to be true, a three-dose regimen may be ideal to manage monkeypox infections in the long term. Dr. Marks said federal scientists are still debating whether to test third doses.

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A new trial led by the National Institutes of Health, which began earlier this month, will enroll 200 adults and compare the standard dose with intradermal delivery of one-fifth and one-tenth doses.

If the fractional doses prove to be comparably effective, the dose-splitting approach would greatly expand world supply, including in countries where the vaccine is currently unavailable.

Researchers will collect information on antibody levels in the immunized participants. But they will not be tracking other immune cells that may be equally important for protection from the virus, according to Dr. John Beigel, the N.I.H. researcher leading the trial.

“This was a decision for expediency,” he said.

A separate N.I.H. trial aims will test how well tecovirimat, also called Tpoxx, works in 500 adults and children infected with monkeypox.

Tecovirimat is the only drug used to treat monkeypox in the United States, as the alternatives can have toxic side effects. The drug was approved in 2018 on the basis of animal studies, and has never been tested rigorously in people.

Small clinical studies, as well as recent anecdotal observations of patients, suggest that the drug works well. A small percentage of patients experience minor side effects, such as headache and nausea.

Given the early data, the Biden administration has been sharply criticized for making it too difficult for clinicians to prescribe the drug. And the C.D.C. has urged clinicians to reserve tecovirimat for patients who are severely immunocompromised, pregnant or breastfeeding, or who have lesions in certain sensitive areas, as well as for children under 8.

The decision to limit access is rooted in the fear that indiscriminate use could lead to Tpoxx-resistant monkeypox, federal officials said. Several studies suggest that even small genetic changes could leave the virus resistant, according to the F.D.A.

The new trial should offer a clearer picture of the risk. “We want to make it much easier, and with much more confidence, to make Tpoxx available for people who are infected,” Dr. Fauci said.

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FAQs

How long does it take to get rid of monkeypox? ›

Most people with monkeypox recover fully within 2 to 4 weeks without the need for medical treatment. Learn more about taking care of yourself.

What is the prevention of monkeypox? ›

Some smallpox vaccines can prevent monkeypox, including the ACAM2000 and Jynneos vaccines. These vaccines can be used to prevent monkeypox because smallpox and monkeypox are caused by related viruses. Health care providers may suggest that people who have been exposed to monkeypox get vaccinated.

How long does monkeypox virus last? ›

If someone has flu-like symptoms, they will usually develop a rash 1-4 days later. Monkeypox can be spread from the time symptoms start until the rash has healed, all scabs have fallen off, and a fresh layer of skin has formed. The illness typically lasts 2-4 weeks.

What is the prevalence of monkeypox? ›

As of August 28, 2022 CDC is tracking 47,206 confirmed cases of monkeypox in 92 non-endemic countries, territories, and areas associated with the 2022 multinational outbreak (Figure 6). This count may include confirmed cases not yet reported in World Health Organization (WHO) official counts.

Can you get monkeypox from a toilet seat? ›

CLAIM: An Irish news site published a headline claiming, “Monkeypox can live on door handles and toilet seats for 120 years and can infect anyone from 5 miles away.” AP'S ASSESSMENT: False. No such headline was published.

Will Benadryl help monkeypox? ›

Oral antihistamines such as Benadryl and topical creams such as calamine lotion or petroleum jelly may help with itching. Soaking in a warm bath (using oatmeal or other over-the-counter bath products for itchy skin) may offer some relief to the dry, itchy sensations that can come with the rash.

What disinfectant kills monkeypox? ›

Monkeypox can survive on clothing, surfaces, and linens for weeks, but it's easy to kill using common household disinfectants and cleaning products. Using hot water and regular detergent is enough to kill the virus on linens and clothing.

How do you treat monkeypox at home? ›

Most cases of monkeypox are mild. Rest and home remedies including sitz baths, topical Vaseline, antihistamines (Benadryl) for itching, and pain medications, such as acetaminophen (Tylenol) or ibuprofen (Advil), may be all you need to recover.

Is there a vaccine for monkeypox? ›

Monkeypox Vaccines

The JYNNEOS vaccine is approved for prevention of smallpox and monkeypox. It is the primary vaccine being used during this outbreak in the U.S. The ACAM2000 vaccine is an alternative to JYNNEOS. It is also approved to help protect against smallpox and monkeypox.

What are the stages of monkeypox? ›

The evolution of lesions progresses through four stages—macular, papular, vesicular, to pustular—before scabbing over and desquamation. The incubation period is 3-17 days. During this time, a person does not have symptoms and may feel fine. The illness typically lasts 2-4 weeks.

How long does it take to see monkeypox after exposure? ›

Incubation Period: Infection with monkeypox virus begins with an incubation period where the person does not have symptoms and may feel fine. The incubation period is roughly 1-2 weeks. A person is not contagious during this period. Physicians are currently recommended to monitor patients up to 21 days.

Where does monkeypox rash start? ›

What does the monkeypox rash look like? "During this particular outbreak, we're seeing that the rash may start in the groin, genital region, or around the anus – and sometimes stay in the spot that it started instead of spreading," says Dr. Freeman. People may have only 1 or 2 bumps on their skin.

Who should get monkeypox vaccine? ›

Currently, the CDC recommends the vaccine to people who are a close contact of someone who has monkeypox; people who know a sexual partner was diagnosed in the past two weeks; and gay or bisexual men who had multiple sexual partners in the last two weeks in an area with known virus spread.

Which age group is affected by monkeypox? ›

Human infection with monkeypox virus occurs most frequently in the 5-9-year-old age group, particularly in small villages where the children hunt and eat squirrels and other small mammals.

What to do if you think you have monkeypox? ›

What should I do if I have symptoms? See a healthcare provider if you notice a new or unexplained rash or other monkeypox symptoms. Remind the healthcare provider that monkeypox is present in the United States. Avoid close contact (including intimate physical contact) with others until you see a healthcare provider.

What kills monkeypox on surfaces? ›

But, he and the CDC both say these viruses are sensitive to many disinfectants. “This virus is easily killed, so common disinfectants that we use, such as alcohol wipes or Lysol wipes, very easily kill the monkeypox virus,” Roberts said.

Can monkeypox be in food? ›

However, based on the available data, the Agency has indicated that the risk of transmission of the monkeypox virus to humans via food cannot be excluded. Food can be contaminated directly by a person who is ill, especially if the person handles food while he or she has lesions or scabs on their skin.

Can dogs get monkeypox? ›

Monkeypox virus can infect a wide range of mammal species, including monkeys, anteaters, hedgehogs, prairie dogs, squirrels, shrews and dogs.

Can Vaseline help monkeypox? ›

If you have a monkeypox rash and don't need to take a prescription antiviral, but you're still looking for a way to deal with the painful or itchy rash, there are a few over-the-counter (OTC) treatments that might help: Topical steroid creams or gels. Ointments (like Vaseline or Aquaphor)

Can I shower if I have monkeypox? ›

After isolation:

wash bed linen, towels and clothes in a washing machine at a minimum of 60 °C and with normal detergent. Dirty laundry should not be shaken, but carefully gathered before washing. take a shower and change into clean clothes before making contact with others after isolation.

Does calamine lotion help monkey pox? ›

It is important to keep to the recommended dosage and interval per medicine. o Antihistamines (such as Benadryl), calamine lotion, petroleum jelly and cooling lotions (such as menthol and camphor lotions) can provide temporary itch relief. o Warm oatmeal baths can reduce itching and pain.

Can you wash monkeypox off your hands? ›

Wash your hands with soap and water or use an alcohol-based hand rub after touching sores, clothing, linens, or surfaces that may have had contact with sores. warm water and detergent; bleach may be added but is not necessary. washed in a dishwasher or by hand with warm water and soap.

Are Clorox wipes effective against monkeypox? ›

These CloroxPro and Clorox Healthcare products have demonstrated effectiveness against viruses similar to the monkeypox virus on hard, nonporous surfaces and can be used against the monkeypox virus when used in accordance with the directions for use against the virus listed for each product in the table on hard, non- ...

Does washing clothes get rid of monkeypox? ›

Regular laundry detergents and dry-cleaning solvents can be used to clean clothing and remove the monkeypox virus. Steam cleaning for specialized items, such as costumes, can be used. Once laundry is properly cleaned, there is no longer a risk of spreading the virus by the laundry.

Can I go to work with monkeypox? ›

Activity restriction during monitoring. Individuals exposed to monkeypox virus can continue their routine daily activities (e.g., go to work or school) as long as they do not have signs or symptoms consistent with monkeypox.

Should you bandage monkeypox? ›

People with monkeypox should avoid scratching their skin and take care of their rash by cleaning their hands before and after touching sores and keeping skin dry and uncovered (unless they are unavoidably in a room with someone else, in which case they should cover it with clothing or a bandage until they are able to ...

Does monkeypox pop like pimples? ›

A new monkeypox bump isn't poppable at first. If you can pop any bumps that have appeared on your skin within four days, they're likely not monkeypox, Christine Ko, MD, a professor of dermatology and pathology at Yale School of Medicine, told Verywell. Ko doesn't recommend that people scratch at new bumps and blisters.

Does the monkeypox vaccine cost money? ›

The monkeypox vaccines are free. However, you could be charged an administration fee in certain medical settings. Providers must give you the vaccine regardless of your ability to pay the administration fee.

How many cases of monkeypox are there in the US? ›

In total, the U.S. has reported more than 24,000 cases since the beginning of May. The total worldwide exceeds 64,000.

Where has monkeypox spread in the US? ›

Datatable showing data for the United States Map figure.
...
2022 U.S. Map & Case Count.
LocationCases
Alaska5
Arizona446
Arkansas57
California4,886
48 more rows
5 days ago

Are monkeypox painful? ›

Besides the usual signs, new monkeypox symptoms may include: Painful rash that may start out on your pubic area, genitals, or around your anus. Fewer bumps (one to two bumps)

What do monkeypox sores look like? ›

What Does a Monkeypox Rash Look Like? Chicago's top doctor said the rashes "can look like a blister, like a pimple and can be very painful." "These sores can look like pimples and may be painful or itchy.

What does monkeypox feel like? ›

With monkeypox, people usually experience viral symptoms like fever, tiredness, headaches, and general achiness. Some people have these symptoms before developing a rash, while others experience them after the rash appears. Like other viral illnesses (think flu or COVID-19), symptoms vary from person to person.

How long do you quarantine if you have monkey pox? ›

Ideally, people with monkeypox would remain in isolation for the duration of illness, which typically lasts two to four weeks.

Do I need to quarantine if I have monkeypox? ›

Do I have to quarantine if I have been exposed to monkeypox? monkeypox, they should immediately self-isolate and contact the local health department or healthcare provider.

Does monkey pox start off itchy? ›

Monkeypox lesions are typically described as more painful than itchy in the beginning, said Roberts, adding that patients have reported itching towards the end when the sores are crusting and scabbing over.

How do they test for monkeypox? ›

To get a specimen to test, the healthcare provider will use a swab to rub vigorously across lesions of your rash. They will take swabs from more than one lesion. This swabbing may be uncomfortable but is necessary to get enough material to detect the monkeypox virus from the specimens.

Does monkey pox itch like mosquito bites? ›

Myth: It's easy to tell if you have monkeypox.

The monkeypox rash can look different from person to person. “It may initially look like a bug bite and itch like a bug bite,” Dr. Riveria says. But then the rash goes a different route: Bug bites tend to swell at first and then flatten as they heal.

Is monkeypox like chickenpox? ›

Monkeypox symptoms are similar to smallpox symptoms, but milder, and monkeypox is rarely fatal. Monkeypox is not related to chickenpox. Monkeypox was discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research.

How many monkeypox vaccines do you need? ›

The JYNNEOS vaccine is a two-dose vaccine, with at least four weeks between doses.

Can you get monkeypox if you had the smallpox vaccine as a child? ›

The answer is that a previous vaccination against smallpox may lessen the severity of monkeypox, but there's no guarantee. “We don't believe that the previous vaccine will prevent you from getting the infection,” says Dr. Esper.

Does the small pox vaccine prevent monkeypox? ›

The oft-cited assessment that smallpox vaccines are 85% effective against monkeypox infection was based on a 1988 study in Zaire, where smallpox vaccination ended in 1980.

How do I protect my child from monkeypox? ›

The Centers for Disease Control and Prevention recommends vaccination for some people who may have been exposed to someone with monkeypox, including children and teens. The vaccine also may be given to people who work in a laboratory with the virus or provide medical care to infected patients.

How do you avoid getting monkeypox? ›

Avoid handling clothes, sheets, blankets or other materials that have been in contact with an infected animal or person. Isolate people who have monkeypox from healthy people. Wash your hands well with soap and water after any contact with an infected person or animal. Avoid animals that may carry the virus.

How many kids in the US have monkeypox? ›

At least 17 children in the U.S. have been diagnosed with monkeypox.

Can you get monkeypox vaccine after exposure? ›

Following exposure of a confirmed monkeypox case, the CDC recommends that the vaccine be given as soon as possible after exposure, preferably within 4 days.

What are the early symptoms of monkeypox? ›

Monkeypox symptoms include swollen lymph nodes, fever, and a rash that may initially be mistaken for chickenpox or a sexually transmitted disease if in the genital or anal region. While monkeypox cases spreading globally in 2022 can cause severe disease, the infection most often clears up on its own.

What are the stages of monkeypox? ›

The evolution of lesions progresses through four stages—macular, papular, vesicular, to pustular—before scabbing over and desquamation. The incubation period is 3-17 days. During this time, a person does not have symptoms and may feel fine. The illness typically lasts 2-4 weeks.

How do you treat monkeypox at home? ›

Most cases of monkeypox are mild. Rest and home remedies including sitz baths, topical Vaseline, antihistamines (Benadryl) for itching, and pain medications, such as acetaminophen (Tylenol) or ibuprofen (Advil), may be all you need to recover.

How long does it take to see monkeypox after exposure? ›

Incubation Period: Infection with monkeypox virus begins with an incubation period where the person does not have symptoms and may feel fine. The incubation period is roughly 1-2 weeks. A person is not contagious during this period. Physicians are currently recommended to monitor patients up to 21 days.

Does monkey pox start off itchy? ›

Monkeypox lesions are typically described as more painful than itchy in the beginning, said Roberts, adding that patients have reported itching towards the end when the sores are crusting and scabbing over.

What disinfectant kills monkeypox? ›

Monkeypox can survive on clothing, surfaces, and linens for weeks, but it's easy to kill using common household disinfectants and cleaning products. Using hot water and regular detergent is enough to kill the virus on linens and clothing.

What can I put on a monkeypox rash? ›

Care and Treatment for Monkeypox

There is no specific treatment approved for monkeypox. However, an antiviral called tecovirimat (TPOXX), approved to treat smallpox, can be used for people who are at high risk for severe illness or have severe symptoms from monkeypox.

Where do monkeypox rashes start? ›

Usually the first lesions will be inside the mouth or on the tongue. This first sign of a rash marks when a person becomes contagious. These flat-based lesions typically begin on the face before spreading across the body—to the arms and legs, then the hands and feet—within 24 hours. The stage lasts one to two days.

Is there a vaccine for monkeypox? ›

Monkeypox Vaccines

The JYNNEOS vaccine is approved for prevention of smallpox and monkeypox. It is the primary vaccine being used during this outbreak in the U.S. The ACAM2000 vaccine is an alternative to JYNNEOS. It is also approved to help protect against smallpox and monkeypox.

Can Vaseline help monkeypox? ›

If you have a monkeypox rash and don't need to take a prescription antiviral, but you're still looking for a way to deal with the painful or itchy rash, there are a few over-the-counter (OTC) treatments that might help: Topical steroid creams or gels. Ointments (like Vaseline or Aquaphor)

Can I go to work with monkeypox? ›

Activity restriction during monitoring. Individuals exposed to monkeypox virus can continue their routine daily activities (e.g., go to work or school) as long as they do not have signs or symptoms consistent with monkeypox.

How long do you quarantine if you have monkey pox? ›

Ideally, people with monkeypox would remain in isolation for the duration of illness, which typically lasts two to four weeks.

Do I need to quarantine if I have monkeypox? ›

Do I have to quarantine if I have been exposed to monkeypox? monkeypox, they should immediately self-isolate and contact the local health department or healthcare provider.

What should I do if I've been exposed to monkeypox? ›

Stay away from other people and avoid sharing things you have used or touched until you have been seen by a healthcare provider. Before you are seen by a healthcare provider, cover all parts of the rash with clothing, gloves, or bandages, wear a mask and let them know you may have monkeypox.

What does the first stage of monkey pox look like? ›

Discolored portions of the skin that are flat—called macules—are often the first stage of a monkeypox lesion. Before this stage, sometimes an enanthem or enanthema—a rash on the mucous membrane of the mouth—can form. Macules can last up to two days.

How do you know if a rash is monkeypox? ›

Besides the usual signs, new monkeypox symptoms may include: Painful rash that may start out on your pubic area, genitals, or around your anus. Fewer bumps (one to two bumps) Bumps that look like blisters, pus-filled bumps, or open sores.

Are monkeypox like mosquito bites? ›

Myth: It's easy to tell if you have monkeypox.

It may initially look like a bug bite and itch like a bug bite,” Dr. Riveria says. But then the rash goes a different route: Bug bites tend to swell at first and then flatten as they heal.

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