Monkeypox is a rare infection caused by a virus that circulates in some animals in forested areas of Central andWest Africa, but cases recently have been reported in people in multiple countries.

How Does Monkeypox Spread?

The monkeypox virus is closely related to the smallpox virus, which was declared eliminated from the world in 1980. Monkeypox can spread by close contact with an animal or person infected with the monkeypox virus. Human-to-human spread often involves skin-to-skin contactwith a person who has a monkeypox rash, sores, or scabs. Monkeypox can also be spread through respiratory droplets or oral fluids during intimate sexual contact (kissing; oral, anal, or vaginal sex). Contact with fabrics, objects, or surfaces contaminated with the monkeypox virus (such as clothing, bedding, or towels) can also spread infection.

Signs and Symptoms of Monkeypox

Common symptoms of monkeypox are fever, headache, swollen lymph nodes (in the neck, armpits, or groin), back and muscle aches, and fa- tigue, although not all patients with monkeypox experience these flu- like symptoms. Typically, within 1 to 3 daysafter fever occurs, patients develop arash that often appears on the face first, then spreads to other parts of the body and may involve the mouth, vagina, and anus. The rash starts as flat red spots, which become firm, fluid-filled, raised bumps and then turn into scabs that heal over several weeks.

What Is Known About Monkeypox Outbreaks?

Human monkeypox infections are rare. Prior to May 2022, monkey- pox infections that occurred in people living in countries outside of Africa were associated with travel to places with circulating monkeypox (endemic areas) or with exposure to infected animals. However, between May 13 and May 26, 2022, the World Health Or- ganization reported 257 laboratory-confirmed cases of monkey- pox and approximately 120 suspected cases in 23 countries that do not have endemic monkeypox. These monkeypox infections have most commonly occurred in people who self-identified as men who have sex with men. As of June 7, 2022, there have been 35 con- firmed cases of human monkeypox infection across the US.

When to Seek Medical Care

The Centers for Disease Control and Prevention (CDC) recom- mends that individuals with symptoms concerning for monkeypox should seek medical care. This includes anyone who (1) traveled to Central or West African countries or other countries with con- firmed cases of monkeypox during the month prior to onset of their symptoms; (2) has had contact with a person with confirmed or suspected monkeypox; or (3) is a man who regularly has close or in- timate contact with other men.

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How Is Monkeypox Infection Treated?

There are currently no specific treatments for monkeypox infec- tions. Individuals diagnosed with monkeypox infection should iso- late at home and avoid intimate contactuntil all of their skin lesions have healed. In consultation with the CDC, patients with severe mon- keypox infection or those who are immunosuppressed, pregnant, breastfeeding, or younger than 8 years may be candidates for an an- tiviral medication or antibody treatment (intravenous vaccinia im- mune globulin).

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Prevention of Monkeypox Infection

Monkeypox infection can be prevented by avoiding contact with in- fected animals or people or materials used by animals or people infected with monkeypox. There is avaccine that provides some pro- tection against monkeypox; however, it is not currently available for general use.

Frequently Asked Questions

How does monkeypox spread?

Monkeypox is spread via close and intimate contact. The virus can be spread from a pregnant mother to her fetus through the placenta, and via infected animals. More information may be found at the following:

How can I prevent monkeypox?

Monkeypox is not considered a sexually transmitted disease. It is often spread through close, sustained physical contact, which includes sexual contact. To lower your risk during sex, vaccination is one important tool. Consider reducing or avoiding behavior that increases exposure between your first and second doses of the vaccine.

More information can be found at the following:

How is monkeypox treated?

If you have monkeypox symptoms, stay at home or your residence hall, and isolate until the rash has healed and a new layer of skin has formed.

Isolate and do not leave your home or residence hall and use a separate bathroom.

Wash your hands frequently.

Avoid sharing things with others (clothing, utensils, linens, dishes, etc.).

Avoid contact with pets.

If you are sick with monkeypox, please follow the guidelines by the Centers for Disease Control and Prevention:

How do I manage my symptoms?

Do not scratch or touch rashes. Use oral antihistamines or topical creams, take a warm soaking bath, or sitz bath.

Cover your rash with gauze and bandages to limit spreading to others or the environment.

Wash your hands often with soap and water or use an alcohol-based hand sanitizer; if lesions are on your hand be careful to avoid irritating the rash.

Keep skin rashes/lesions clean and dry outside of bathing and showering.

You may take over the counter pain relievers or fevers reduces (Tylenol or Ibuprofen).

If you have a rash in your mouth you may rinse with warm salt water four times a day or contact your health care provider for a prescription mouth wash.

You may use an oral antiseptic such as chlorhexidine mouthwash to clean your mouth.

More information may be found at the following:

Am I eligible to receive the monkeypox vaccine?

Those eligible for the vaccine have a known exposure to someone infected with Monkeypox virus; the CDC recommends the JYNNEOS vaccine be given within 4 days from the date of exposure to prevent the onset of the disease. To obtain a vaccine contact your local health department. Norfolk Public Health Department may be reached at 757-683-2800.

What is the status of cases in Virginia?

What is the status of monkeypox in the United States?

See the Centers for Disease Control and Prevention summary:

Does Â鶹´«Ã½ have a response plan?

Yes, the University has a plan developed along with campus leadership in the following areas: Student Health Services, Emergency Management, Risk Management, Housing & Residence Life, Campus Life Services, Environmental Health, Academics, IT Services, and Â鶹´«Ã½ Police.

What should I do if I have symptoms of monkeypox or am concerned about possible monkeypox exposure?

If you are an Â鶹´«Ã½ student and are concerned about symptoms of monkeypox or a possible exposure, please isolate at home or your residence hall and immediately call your local healthcare provider or Â鶹´«Ã½ Student Health Services at 757-683-3132. You will be asked to complete a screening form and an appointment via telehealth or in person will be scheduled. Faculty and staff should contact their supervisor or Human Resources at 757-683-3042.

Authors: Kristin Walter, MD, MS; Preeti N. Malani, MD, MSJ

Published Online: June 9, 2022. doi:10.1001/jama.2022.10259

Author Affiliations: Senior Editor, JAMA (Walter); Associate Editor, JAMA (Malani); Division of Infectious Diseases, University of Michigan Health System, Ann Arbor (Malani).

Conflict of Interest Disclosures: None reported.

Sources: Harris E. What to know about monkeypox. JAMA. Published online May 27, 2022. doi:10.1001/jama.2022.9499

World Health Organization. https:// item/2022-DON388

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be downloaded or photocopied noncommercially by physicians and other health care professionals to share with patients.

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