MPX (Monkeypox) Frequently Asked Questions

Last updated: 7/26/22

What is Monkeypox (MPX)?

Monkeypox is a disease that is caused by the monkeypox virus.  It typically involves flu-like symptoms and a rash that includes bumps that are initially filled with fluid and then scab over. MPX can be confused with infections like syphilis, herpes, or chickenpox.

What are the symptoms of MPX?

Symptoms typically appear 1-2 weeks after infection.  This can range from 5-21 days. Early symptoms may include fever, headache, muscle aches, backache, swollen lymph nodes, chills, and fatigue.

The MPX rash can look like pimples or blisters that appear on the face, inside the mouth, and on other parts of the body like hands, feet, chest, genitals, or anus.

Sometimes people get a rash first or only develop a rash and no other symptoms.  Some individuals in the current US outbreak have experienced rashes only in the genital region or other body parts.

How is MPX spread?

MPX is spread in different ways:

• MPX virus is most often spread through direct contact with a rash or sores of someone who has MPX
• It can also spread through contact with clothing, bedding, or other items used by a person with MPX
• It can also spread through respiratory droplets passed through prolonged face-to-face contact including kissing, cuddling, or sex

MPX is not limited to any sexual orientation or group of people. Anyone who has been in close contact with someone who has MPX is at risk.

Can I get MPX from having sex?

Even though it is not considered a sexually transmitted infection, MPX can spread during intimate physical contact. This can happen when you have sex including:

• Oral, anal, and vaginal sex, or touching the genitals or anus of a person with MPX
• Hugging, massaging, kissing, or talking closely
• Touching fabrics, objects like bedding, towels, and sex toys that were used by a person with MPX

How can individuals prevent getting MPX?

• Avoid close skin-to-skin contact with people who have a rash that looks like MPX
  • Do not touch the rash or scabs of a person with MPX
  • Do not kiss, hug, cuddle or have sex with someone with MPX while they remain infectious
  • Do not share eating utensils or cups with a person with MPX while they remain infectious
  • Do not share skin care products, such as make-up or moisturizer
• Do not touch bedding, towels, clothing, fetish gear, or sex toys of a person with MPX
• Avoid prolonged face-to-face contact with someone with MPX
• Wear a mask when in crowded locations, such as in indoor public venues or crowded outdoor events
• Wash your hands often with soap and water or use an alcohol-based sanitizer
• CDC recommends vaccination for people who have been exposed to MPX and people who are at higher risk of being exposed to MPX. If given after exposure to MPX, the vaccine is most effective if given within 4 days after being exposed, but can be given up to 14 days after exposure

How can a person lower the chance of getting MPX at raves, parties, and clubs?

• Consider how much close, personal, skin-to-skin contact is likely to occur at the event
• If you feel sick or have a rash, do not attend the gathering and see a healthcare provider
• Events, where attendees are fully clothed and unlikely to share skin-to-skin contact, are safer. However, activities like kissing might spread monkeypox.
• Events where there is minimal clothing and direct, personal, skin-to-skin contact have some risks; consider minimizing skin-to-skin contact.
• Enclosed spaces, like back rooms, saunas, sex clubs, or private and public sex parties where intimate sexual contact with multiple partners occurs may have a higher likelihood of spreading MPX

How can I lower my risk during sex?

• Talk to your partner about any recent illness and be aware of new or unexplained rash on your body or your partner’s body, including the genitals and anus
• If you or your partner have recently been sick, currently feel sick, or have a new or unexplained rash, do not have sex and see a healthcare provider
• Consider the following ways to reduce the spreading of MPX
  • Have virtual sex with no in-person contact
  • Masturbate together at a distance of at least 6 feet, without touching each other
  • Consider having sex with your clothes on or covering areas where the rash is present. If there is a rash near the genitals or anus, condoms may help but are likely not enough to prevent MPX
  • Wash your hands, fetish gear, sex toys, and any fabrics (bedding, towels, clothing) after having sex
  • Avoid touching the rash. Touching the rash can spread it to other parts of the body and may delay healing

What should I do if I have symptoms?

Contact your healthcare provider if you are concerned you may have MPX.

How long does MPX last?

The illness usually lasts 2-4 weeks. Individuals are infectious until they no longer have a rash. The health department will work with individuals to determine when they are no longer infectious.

Can MPX be treated?

There are no FDA-approved medications for treating MPX specifically. Some medications that are used to treat other viruses may be used to treat MPX.

Questions about the vaccine for MPX

JYNNEOS Vaccine for Monkeypox (MPX): Frequently Asked Questions

The JYNNEOS vaccine is recommended for people who are at high risk for monkeypox (MPX) infection.

Why are vaccines being given intradermally now?

• The FDA has now authorized the JYNNEOS vaccine as an intradermal (within the skin) vaccine for people 18 years old and older. This is a smaller volume injection, provides similar protection, and allows more people to be vaccinated.
• All patients 18 years and older will now be receiving intradermal vaccines. If patients have a history of keloids (scarring) a subcutaneous (under the skin) vaccine will be offered.
• The FDA has authorized giving a 2^nd dose intradermally, even if the patient received their 1^st dose subcutaneously.
• If you do not want the intradermal vaccine, you will need to wait until more vaccine is available.

Will the vaccination site be visible on my body?

• The preferred intradermal administration site is the volar (inner) side of the forearm. There may be a noticeable small elevation of the skin (wheal) after administration, and the wheal may be covered by a band-aid temporarily.
• However, it is acceptable to use sites other than the volar forearm, for example, if the patient has privacy concerns or anatomic limitations. Intradermal administration of vaccine may also be performed at the upper back below the scapula or at the deltoid.

How many doses do I need?

• JYNNEOS vaccine is currently approved as a two-dose vaccine. You should receive the second dose at least 4 weeks after the first dose. This applies for both subcutaneous and intradermal vaccines. You should be given a follow up appointment at the clinic where you received your first vaccine.
• Public health guidance about the number of recommended doses may be subject to change. If this change affects your follow up appointment, you will be contacted.

What are side effects of the vaccine?

• Side effects are common but usually mild. Most people have redness, swelling, and pain where they got the shot. Tiredness, headache and muscle pain can also occur after vaccination.
• If you receive an intradermal vaccine, you may have itching, swelling, or redness at the injection site. This can be present for a few days or potentially longer.  There is also a small risk of temporary skin discoloration. This may last for weeks to months and is a normal, expected reaction.  Speak with your health care provider if you have concerns.

What should I do if I have a serious health problem after vaccination?

• Signs of severe allergic reaction include hives, swelling of the face and throat, difficulty breathing, fast heartbeat, chest pain, dizziness and weakness. If you think you are having a severe allergic reaction, call 911 or go to the nearest hospital.
• Your provider is required to report serious adverse reactions to the Vaccine Adverse Event Reporting System (VAERS), but you can also report to VAERS at vaers.hhs.gov or by calling 800-822-7967. VAERS staff members do not give medical advice.

Can I get the MPX vaccine at the same time as other vaccines?

• JYNNEOS can be administered at the same time as most other vaccines, but at different anatomic sites if possible.
• However, there are additional considerations if administering a COVID-19 vaccine, especially to adolescent or young adult males – if clinically appropriate, providers might counsel waiting 4 weeks after JYNNEOS vaccination before receiving a Moderna, Novavax, or Pfizer-BioNTech COVID-19 vaccine, because of the observed risk for myocarditis and/or pericarditis after receipt of ACAM2000, another vaccine for Monkeypox. The risk of myocarditis and/or pericarditis after JYNNEOS administration is unknown.

Am I still at risk for MPX, even if I’ve been vaccinated?

• The vaccine takes maximum effect 2 weeks after the second dose of vaccine
• Early data released by the CDC at the end of September 2022 suggests that people who receive JYNNEOS are more protected against MPX compared to people who are unvaccinated. We will know more in the coming months about how effective the JYNNEOS vaccine is in the 2022 MPX outbreak.
• The vaccine may not be 100% effective. It is important to continue other prevention measures such as avoiding sex and other close physical contact with people who have symptoms of MPX.

How can individuals avoid getting MPX, whether or not they have been vaccinated?

• Avoid close skin-to-skin contact with people who have a rash that looks like MPX.
  • Do not touch the rash or scabs of a person with MPX.
  • Do not kiss, hug, or cuddle or have sex with someone with monkeypox while they remain infectious.
  • Do not share eating utensils or cups with a person with monkeypox while they remain infectious.
  • Do not share skin care products, such as make-up or moisturizer.
• Close skin-to-skin contact can occur during intimate contact including:
  • Oral, anal, and vaginal sex or touching the genitals or anus of a person with MPX
• Do not touch bedding, towels, clothing, fetish gear, or sex toys of a person with MPX
• Avoid prolonged face-to-face contact with someone with MPX
• Wear a mask when in crowded locations, such as in indoor public venues or crowded outdoor events
• Wash your hands often with soap and water or use an alcohol-based sanitizer

If you think you might have monkeypox, contact your medical provider for your testing. Baltimore City Health Department Sexual Health Clinics also offer MPX testing at the two clinic locations: 1200 E Fayette Street (410-396-9410) and 1515 W North Avenue (410-396-0176).