Monkeypox symptoms

People with monkeypox get a rash that may be located on or near the genitals (penis, testicles, labia, and vagina) or anus (butthole) and could be on other areas like the hands, feet, chest, face, or mouth.

  • The rash will go through several stages, including scabs, before healing.
  • The rash can initially look like pimples or blisters and may be painful or itchy.

Other symptoms of monkeypox can include:

  • Fever
  • Chills
  • Swollen lymph nodes
  • Exhaustion
  • Muscle aches and backache
  • Headache
  • Respiratory symptoms (e.g. sore throat, nasal congestion, or cough)

You may experience all or only a few symptoms

  • Sometimes, people have flu-like symptoms before the rash.
  • Some people get a rash first, followed by other symptoms.
  • Others only experience a rash.

How long do monkeypox symptoms last?

Monkeypox symptoms usually start within 3 weeks of exposure to the virus. 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.

If You Have a New or Unexplained Rash or Other Symptoms…
  • Avoid close contact, including sex or being intimate with anyone, until you have been checked out by a healthcare provider.
  • If you don’t have a provider or health insurance, visit a public health clinic near you.
  • When you see a healthcare provider, wear a mask, and remind them that this virus is circulating in the area.

What to Do If You Are Sick

Updated August 11, 2022
There is no treatment specifically for monkeypox. Because the viruses that cause monkeypox and smallpox are closely related, drugs and vaccines developed to treat and protect against smallpox may be effective for monkeypox.

However, the type of treatment for a person with monkeypox will depend on how sick someone gets or whether they’re likely to get severely ill. Most people with monkeypox recover fully within 2 to 4 weeks without the need for medical treatment.

Some people, like those with a weakened immune system or genital or rectal rashes, may need treatment. Drugs used to treat monkeypox require a prescription and must be requested by a healthcare provider through the local or state health department.

Taking Care of Yourself

  • Use gauze or bandages to cover the rash to limit spread to others and to the environment.
  • Don’t lance (pop) or scratch lesions from the rash. This does not speed up recovery and can spread the virus to other parts of the body, increase the chance of spreading the virus to others, and possibly cause the open lesions to become infected by bacteria.
  • Do not shave the area with the rash until the scabs have fallen off and a new layer of skin has formed. Shaving can spread the virus and cause more lesions.
  • Keep skin lesions/rash clean and dry when not showering or bathing.
  • Wash hands often with soap and water or use an alcohol-based hand sanitizer, especially after direct contact with the rash.
    • If you have rash on your hands, be careful when washing or using sanitizer so as not to irritate the rash.
  • If you have rash on your hands, wear gloves that are non-irritating when handling common objects or touching surfaces in shared spaces. If you can, use disposable gloves that can be discarded after each use (e.g., latex, polyurethane, or nitrile gloves). Reusable gloves should be washed with soap and water between use.
  • Wear a well-fitting mask around other people until the rash and all other symptoms have resolved.
  • Eat healthy and get plenty of rest to allow your body to heal.

Managing Your Symptoms

Medicines like ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) can help you feel better. Your healthcare provider may prescribe stronger pain relievers as well.

For rash in the mouth, rinse with salt water at least four times a day. Prescription mouthwashes, sometimes called miracle or magic mouthwash, or local anesthetics like viscous lidocaine can be used to manage pain. Oral antiseptics like chlorhexidine mouthwash can be used to help keep the mouth clean.

Contact your healthcare provider if pain becomes severe and unmanageable at home.

Rash Relief

The most important thing is to try to not touch or scratch the rash. This can spread the rash to other parts of the body, increase the chance of spreading the virus to others, and possibly cause open lesions to become infected by bacteria. If you do accidentally touch the rash, wash your hands with soap and water and avoid touching sensitive areas like your eyes, nose, mouth, genitals and rectum (butthole).

Topical benzocaine/lidocaine gels can be used for temporary relief. 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.

People who have the rash in or around their anus (butthole) or genitals (penis, testicles, labia, vagina), or perineum (taint) may also benefit from a sitz-bath. A sitz bath is a round, shallow basin that can be purchased online or at a pharmacy. Most fit over the rim of a toilet but can also be placed in a bathtub. There is also the option to sit in a bathtub with shallow water. Your healthcare provider may prescribe medication like povidone-iodine or other products to be added to the water in a sitz bath. Adding Epsom salt, vinegar, or baking soda to the water can be soothing.

Monkeypox Information & Updates

Vaccines are available through the NYC Department of Health, Suffolk County and Nassau County, though supply is limited. LGBT Network does not have access to the vaccine at this time. We know many of you have requested the vaccine be available at our centers, and we are advocating through public and health officials to bring the vaccine to our community centers.

People who meet all of the following conditions are eligible to be vaccinated:

  • Gay, bisexual, or other man who has sex with men, and/or transgender, gender non-conforming, or gender non-binary

  • Age 18 or older

  • Have had multiple or anonymous sex partners in the last 14 days

People who have been informed by the Health Department that they are a close contact of someone with monkeypox should also get vaccinated.

If you are eligible to be vaccinated, you should especially consider getting vaccinated if:

  • Your partners are showing symptoms of monkeypox, such as a rash or sores.

  • You met recent partners through apps or social media platforms (such as Grindr, Tinder or Scruff), or at clubs, raves, sex parties, saunas or other large gatherings.

  • You have a condition that may increase your risk for severe disease if infected with monkeypox virus, such as HIV or another condition that weakens your immune system, or you have a history of atopic dermatitis or eczema.

What is Monkeypox (MPV)?

Beginning in early May, the Centers for Disease Control and Prevention have been tracking several clusters of Monkeypox in countries that don’t typically have Monkeypox (MPV) activity, including in the UK and North America.

Although Monkeypox (MPV) can affect anyone regardless of sex, gender, or sexual orientation, recent clusters have disproportionately occurred in gay and bisexual men.

The Monkeypox Virus (MPV) is in the same family as smallpox. According to the CDC, the symptoms of monkeypox are similar to but milder than the symptoms of smallpox. Symptoms of Monkeypox include a painful rash or sores, fever, headache, muscle aches, tiredness, and swollen lymph nodes. People with monkeypox may experience all or only a few of these symptoms. Some people have reported developing the rash or sores before (or without) the flu-like symptoms.

In the recent outbreak, the rash or sores is often seen in the genital/groin area as well as in and around the anal area but can occur all over the body as well as on the palms of the hands and soles of feet. Some have also reported anal symptoms like bleeding and pain.

How is Monkeypox (MPV) transmitted?

Monkeypox (MPV) is spread through: 

  • Direct skin-to-skin contact with a rash, scabs, or body fluids 

  • Respiratory secretions during prolonged, face-to-face (unmasked) contact, or during intimate physical contact, such as kissing, cuddling, or sex 

  • Touching porous items (such as clothing or linens) that previously touched the infectious rash or body fluids 

Monkeypox (MPV) is NOT spread through: 

  • Brief conversations/interactions 

  • Brushing by someone with monkeypox 

  • Touching items like doorknobs or elevator buttons 

Reduce the risk of Monkeypox (MPV) infection by:

Help reduce the risk of Monkeypox (MPV) infection by: 

  • Talking to your sexual partner(s) about any recent illness, and being aware of new or unexplained sores or rashes on you or your partner’s body, including on the genitals and anus  

  • Avoiding intimate physical contact, including kissing, cuddling, and sex with someone with an unexplained rash or sore  

  • Seeking medical advice if you’ve had contact with someone who has tested positive or, if you have developed a new or unexplained rash or sore 

  • Regularly washing hands  

If you have Monkeypox (MPV), or have a new unexplained rash or sore, reduce the risk of transmitting it to others by: 

  • Keeping your rash covered when coming into contact with others 

  • Avoiding intimate contact  

  • Being open and honest with your partners 

Reduce the Stigma: 

Help reduce the stigma of Monkeypox (MPV): 

  • Although currently 97-98% of monkeypox cases are gay and bisexual men, anyone can get Monkeypox (MPV), regardless of gender identity and sexual orientation. 

  • Have open conversations with sexual partners about your status, and theirs. Lead with empathy! We are all going through a scary time, but we are in this together. Do not blame or shame anyone – including yourself. 

  • Don’t panic, and seek medical attention if you have a new or unexplained rash. You can get tested, and find ways to keep you, your partners, and other close contacts safe. 

How is Monkeypox (MPV) treated?

In most cases, Monkeypox (MPV) will resolve on its own.  There are also antiviral medications such as tecovirimat (TPOXX), that may be recommended for people with severe symptoms, or people who are more likely to get severely ill, like patients with weakened immune systems.

If you have symptoms of monkeypox, you should talk to your healthcare provider, even if you don’t think you had contact with someone who has monkeypox.

For more information, check out this CDC Fact Sheet.

What is the vaccine?

Eligible New Yorkers can get the JYNNEOSTM vaccine. This vaccine has been approved by the FDA for the prevention of monkeypox in people ages 18 and older.

Getting vaccinated after a recent exposure reduces the chance of you getting monkeypox, and it can reduce symptoms if you do get it. You must take two doses of the vaccine, approximately four weeks apart.

Interim Clinical Guidance for the Treatment of Monkeypox

Many people infected with monkeypox virus have a mild, self-limiting disease course in the absence of specific therapy. However, the prognosis for monkeypox depends on multiple factors, such as previous vaccination status, initial health status, concurrent illnesses, and comorbidities among others. Patients who should be considered for treatment following consultation with CDC might include:

    • People with severe disease (e.g., hemorrhagic disease, confluent lesions, sepsis, encephalitis, or other conditions requiring hospitalization)
    • People who may be at high risk of severe disease:
      • People with immunocompromise (e.g., human immunodeficiency virus/acquired immune deficiency syndrome infection, leukemia, lymphoma, generalized malignancy, solid organ transplantation, therapy with alkylating agents, antimetabolites, radiation, tumor necrosis factor inhibitors, high-dose corticosteroids, being a recipient with hematopoietic stem cell transplant <24 months post-transplant or ≥24 months but with graft-versus-host disease or disease relapse, or having autoimmune disease with immunodeficiency as a clinical component)1
      • Pediatric populations, particularly patients younger than 8 years of age2
      • People with a history or presence of atopic dermatitis, persons with other active exfoliative skin conditions (e.g., eczema, burns, impetigo, varicella zoster virus infection, herpes simplex virus infection, severe acne, severe diaper dermatitis with extensive areas of denuded skin, psoriasis, or Darier disease [keratosis follicularis])
      • Pregnant or breastfeeding women3
      • People with one or more complications (e.g., secondary bacterial skin infection; gastroenteritis with severe nausea/vomiting, diarrhea, or dehydration; bronchopneumonia; concurrent disease or other comorbidities)4
    • People with monkeypox virus aberrant infections that include accidental implantation in eyes, mouth, or other anatomical areas where monkeypox virus infection might constitute a special hazard (e.g., the genitals or anus)

Medical Countermeasures Available for the Treatment of Monkeypox

Currently there is no treatment approved specifically for monkeypox virus infections. However, antivirals developed for use in patients with smallpox may prove beneficial against monkeypox. The following medical countermeasures are currently available from the Strategic National Stockpile (SNS) as options for the treatment of monkeypox:

Tecovirimat (also known as TPOXX, ST-246)

TPOXX is an antiviral medication that is approved by the United States Food and Drug Administration (FDA) [PDF – 24 pages] for the treatment of smallpox in adults and children. Data are not available on the effectiveness of tecovirimat in treating monkeypox infections in people, but studies using a variety of animal species have shown that tecovirimat is effective in treating disease caused by orthopoxviruses. Clinical trials in people showed the drug was safe and had only minor side effects. CDC holds an expanded access protocol (sometimes called “compassionate use”) that allows for the use of stockpiled tecovirimat to treat monkeypox during an outbreak. Tecovirimat is available as a pill or an injection. For children who weigh less than 28.6 pounds, the capsule can be opened, and medicine mixed with semi-solid food.

Vaccinia Immune Globulin Intravenous (VIGIV)

VIGIV is licensed by FDA [PDF – 18 pages] for the treatment of complications due to vaccinia vaccination including eczema vaccinatum, progressive vaccinia, severe generalized vaccinia, vaccinia infections in individuals who have skin conditions, and aberrant infections induced by vaccinia virus (except in cases of isolated keratitis). CDC holds an expanded access protocol that allows the use of VIGIV for the treatment of orthopoxviruses (including monkeypox) in an outbreak.

Data are not available on the effectiveness of VIG in treatment of monkeypox virus infection. Use of VIG has no proven benefit in the treatment of monkeypox and it is unknown whether a person with severe monkeypox infection will benefit from treatment with VIG. However, healthcare providers may consider its use in severe cases.

VIG can be considered for prophylactic use in an exposed person with severe immunodeficiency in T-cell function for which smallpox vaccination following exposure to monkeypox virus is contraindicated.

Cidofovir (also known as Vistide)

Cidofovir is an antiviral medication that is approved by the FDA [PDF – 6 pages] for the treatment of cytomegalovirus (CMV) retinitis in patients with Acquired Immunodeficiency Syndrome (AIDS). Data is not available on the effectiveness of Cidofovir in treating human cases of monkeypox.  However, it has shown to be effective against orthopoxviruses in in vitro and animal studies. CDC holds an expanded access protocol that allows for the use of stockpiled Cidofovir for the treatment of orthopoxviruses (including monkeypox) in an outbreak. It is unknown whether or not a person with severe monkeypox infection will benefit from treatment with Cidofovir, although its use may be considered in such instances. Brincidofovir may have an improved safety profile over Cidofovir.  Serious renal toxicity or other adverse events have not been observed during treatment of cytomegalovirus infections with Brincidofovir as compared to treatment using Cidofovir.

Brincidofovir (also known as CMX001 or Tembexa)

Brincidofovir is an antiviral medication that was approved by the FDA [PDF – 21 pages] on June 4, 2021 for the treatment of human smallpox disease in adult and pediatric patients, including neonates. Data is not available on the effectiveness of Brincidofovir in treating cases of monkeypox in people.  However, it has shown to be effective against orthopoxviruses in in vitro and animal studies. CDC is currently developing an EA-IND to help facilitate use of Brincidofovir as a treatment for monkeypox. However, Brincidofovir is not currently available from the SNS.

State and territorial health authorities can direct their requests for medical countermeasures for the treatment of monkeypox to the CDC Emergency Operations Center (770-488-7100).