Information and Advice – San Mateo County Health

About Monkeypox

Monkeypox is a rare disease caused by infection with the monkeypox virus. Most cases resolve on their own, although they can be serious. The illness often begins with flu-like symptoms before a rash appears and can last 2 to 4 weeks. While it is good to remain vigilant for any emerging public health outbreaks, the current risk of contracting monkeypox in the general public is very low.


Monkeypox can begin with flu-like symptoms, with fever, low energy, swollen lymph nodes and general body aches. Within 1 to 3 days (sometimes longer) after the onset of fever, the person may develop a rash or sores. The sores can look like pimples or blisters and can be painful and itchy.

People with monkeypox have a rash that may be located on or near the genitals (penis, testicles, labia, and vagina) or anus and may be on other areas such as the hands, feet, throat. chest, face or mouth.

  • The rash will go through several stages, including scabs, before it heals.
  • The rash may 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 pain and back pain
  • Headache
  • Respiratory symptoms (for example, sore throat, nasal congestion, or cough)
  • You may experience all of the symptoms or just some
  • Sometimes people have flu-like symptoms before the rash
  • Some people have a rash first, followed by other symptoms
  • Others only feel a rash


Monkeypox can be spread to anyone through close, personal, often skin-to-skin contact, including direct contact with infectious wounds, scabs, or bodily fluids, and during sexual intercourse, as well as activities such as kisses, hugs, massages and hugs. Monkeypox can be spread by touching materials used by someone with monkeypox that have not been cleaned, such as clothing and bedding. It can also be spread through respiratory secretions during prolonged, close, face-to-face contact.

Monkeypox can be transmitted by:

  • Direct skin-to-skin contact with rash lesions
  • Sexual/intimate contact, including kissing
  • Live in a house and share a bed with someone
  • Sharing towels or unwashed clothes
  • Respiratory secretions through prolonged face-to-face interactions (the type that occurs primarily when living with someone or caring for someone with monkeypox)

Monkeypox is NOT transmitted by:

  • Brief informal conversations
  • Walk next to someone who has monkey pox, like in a grocery store

A person with monkeypox can pass it on to others from the time symptoms appear until the rash has completely healed and a new layer of skin has formed. The illness usually lasts 2 to 4 weeks.


Unlike COVID-19 which spreads easily through the air, the risk of monkeypox to the general public is currently low unless they engage in high-risk behaviors. Having sex with multiple sex partners can increase a person’s risk of infection when monkeypox spreads in the community. For more information, visit Safer sex, Social Gathering, and Monkeypox from the Centers for Disease Control and Prevention (CDC).

There are several ways to prevent the spread of monkeypox, including:

  • Always tell your sexual partner about any recent illnesses and be aware of any new or unexplained sores or rashes on your or your partner’s body, including on the genitals and anus
  • Avoiding close contact, including sex, with people with symptoms such as sores or rashes
  • Practice good hand hygiene
  • Infected people should self-isolate until their symptoms improve or disappear completely. The rash should always be well covered until it is completely healed
  • Use appropriate personal protective equipment (PPE) (such as a mask, gown, and gloves) when caring for others with symptoms
  • Avoid contact with infected materials contaminated with the virus
  • Avoid contact with infected animals

How to protect others

If you have symptoms, especially a rash consistent with monkeypox, or if you have been in contact with someone who has been diagnosed with monkeypox:

  • Stay home if you feel sick
  • If you have a new or unexplained rash or other symptoms, see a doctor for further testing and evaluation
  • Contact a health care provider as soon as possible for an evaluation
  • Avoid skin-to-skin contact or close contact with other people, including sexual contact, until a medical evaluation has been completed
  • Inform your sexual partners of any symptoms you experience
  • Cover the rash with clean, dry, loose clothing
  • Wear a properly fitted mask
  • If you are contacted by public health officials, answer their confidential questions to help protect others who may have been exposed


There is no specific treatment for monkeypox virus infections. However, monkeypox and smallpox viruses are genetically similar, which means that antiviral drugs and vaccines developed to protect against smallpox can be used to prevent and treat monkeypox virus infections.

Antivirals, such as tecovirimat (TPOXX), may be recommended for people who are more likely to get seriously ill, such as patients with weakened immune systems.

If you have symptoms of monkeypox, you should tell your health care provider, even if you don’t think you’ve been in contact with someone with monkeypox. Your provider may be able to offer treatments that aren’t specific to monkeypox but can help reduce your symptoms, such as prescribed mouthwashes, stool softeners for people with rectal pain, or topical gels or creams.


The Centers for Disease Control and Prevention (CDC) and the California Department of Public Health (CDPH) recommend that people who have been exposed to monkeypox receive the vaccine to prevent them from developing the disease – this is called post-exposure prophylaxis or PEP . PEP can also be given to people who have no known exposure but are at risk of recent exposure to cases of monkeypox. Vaccines are not recommended for people with monkeypox. For more information and to see vaccine eligibility, please visit the vaccination application form page.

Further information

General information and questions and answers from the California Department of Public Health

Information on monkeypox from the Centers for Disease Control & Prevention (CDC)

Social Gatherings and CDC Safe Sex

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