What is mpox?

Mpox, formerly known as monkeypox, is a rare viral disease characterized by rashes and flu-like symptoms. Similar to the smallpox virus, it belongs to the Orthopoxvirus genus. The virus is transmitted through close contact with an infected person or animal.

There are two recognized strains (clades) of the mpox virus: Clade I, which originated in Central Africa, and Clade II, which originated in West Africa. The recent global outbreak (2022-2023) is attributed to Clade IIb, a subtype of the less severe West African strain.

How common is mpox?

Mpox is rare, but cases are on the rise in Africa and in areas that have not previously experienced these infections.

Where is mpox found?

For many years, mpox was primarily observed in Africa, though it occasionally appeared in other countries, including the United States.

In the summer of 2021, a case of mpox was detected in a U.S. resident who had traveled from Nigeria. In 2022, outbreaks occurred in regions outside of Africa, including Europe, the Americas, and Australia.

Who does mpox affect?

Anyone can get mpox. In Africa, most cases are among children under 15 years old. Outside of Africa, the disease appears to be more common in men who have sex with men (MSM), but there are numerous cases in people who don’t fall into that category.

Policy Symptoms and Causes

Mpox rashes begin as flat, red spots that evolve into raised bumps, eventually filling with fluid and pus, before crusting over and falling off. These rashes can be painful and undergo changes over time before they scab and heal.

What are the signs and symptoms of mpox?

After exposure to the virus, it can take several days to a few weeks for symptoms to appear.

Common signs of mpox include:

Fever

Rash

Swollen lymph nodes

Chills

Headache

Muscle aches

Fatigue

The rash typically starts as flat, red bumps that can be painful. These bumps develop into blisters filled with pus, which eventually crust over and fall off. The entire process can last two to four weeks. The rash can appear on the mouth, face, hands, feet, genital area, or anus.

Not everyone with mpox will experience all symptoms. You may experience:

1.Only a rash (with other symptoms appearing later or not at all).

2.Flu-like symptoms followed by a rash, or no rash at all.

3.A widespread rash, or just a few bumps or blisters.

You may have mpox without realizing it, as mild symptoms or a lack of noticeable signs do not prevent the virus from being transmitted to others through prolonged close contact. How do you catch mpox?

Mpox spreads when you come into contact with an animal or a person infected with the virus.

Person-to-person spread (transmission) occurs when you come in contact with the sores, scabs, respiratory droplets or oral fluids of a person who’s infected, usually through close, intimate situations like cuddling, kissing or sex. Research is ongoing, but experts aren’t sure if the virus is transmitted through semen or vaginal fluids.

Animal-to-person transmission occurs through broken skin, like from bites or scratches, or through direct contact with an infected animal’s blood, bodily fluids or pox lesions (sores).

You can also get mpox by coming into contact with recently contaminated materials like clothing, bedding and other linens used by a person or animal who’s infected.

Diagnosis and Tests How is mpox diagnosed?

Because mpox is rare, a healthcare provider may first suspect other rash illnesses, such as measles or chickenpox. But swollen lymph nodes usually distinguish mpox from other poxes. To diagnose mpox, your healthcare provider takes a tissue sample from an open sore (lesion). Then, they send it to a lab for polymerase chain reaction (PCR) testing (genetic fingerprinting). You may also need to give a blood sample to check for the mpox virus or antibodies your immune system makes.

Management and Treatment Is mpox curable?

Mpox is usually a self-limited disease (gets better without treatment) with symptoms lasting from two to four weeks. Following diagnosis, your healthcare provider will monitor your condition and try to relieve your symptoms, prevent dehydration and give you antibiotics to treat secondary bacterial infections if they develop.

Is mpox fatal?

While rare, mpox can sometimes be fatal. It may also lead to serious complications, such as pneumonia or infections in the brain (encephalitis) or eyes, which can be life-threatening.

Living With Mpox

How can I take care of myself?

If you have symptoms of mpox, there are over-the-counter (OTC) medications that can help alleviate discomfort, including:

Pain relievers and fever reducers: Medications like ibuprofen (Advil®, Motrin®) and acetaminophen (Tylenol®) can help reduce pain and fever.

Oatmeal baths: Soaking in a warm bath with colloidal oatmeal can soothe the dry, itchy feeling associated with skin rashes. Isolate yourself if infected: Avoid contact with others until all lesions have scabbed over.

Cover single or localized ulcers or sores: Use gauze or bandages to minimize the risk of spreading the infection to others and the environment.

Take care of yourself: Rest at home, wear a mask around others, and stay hydrated by drinking plenty of fluids.

Avoid contact with pets (especially rodents).

When should I see my healthcare provider?

Contact your healthcare provider if you:

1.Feel unwell with symptoms like fever, aches, or swollen lymph nodes.

2.Develop a new rash or sores.

3.Have been in close contact with someone who is infected.

When should I go to the ER?

Seek emergency medical attention if you experience:

1.Difficulty breathing.

2.New or worsening chest pain.

3.A stiff neck.

4.Confusion or trouble thinking clearly.

5.Difficulty speaking or moving.

6.Loss of consciousness.

7.Seizures.

Additional Common Questions

Why is it no longer called monkeypox? Who changed the name? The name "monkeypox" carried stigmas, including those related to race. In November 2022, the World Health Organization (WHO) renamed the disease "mpox."

What’s the difference?

Mpox vs. Chickenpox:

Although both diseases cause skin rashes, they are caused by different viruses. Mpox is an orthopoxvirus, while chickenpox is caused by a herpes virus. Both viruses can spread through skin-to-skin or prolonged face-to-face contact, but chickenpox is much more contagious and spreads more easily than mpox. People with mpox are more likely to experience swollen lymph nodes compared to those with chickenpox.

The rashes also behave differently. Chickenpox rashes can appear in waves, while mpox sores develop simultaneously. Chickenpox symptoms, including the rash, usually improve within two weeks, whereas mpox can take two to four weeks to resolve.

Mpox vs. Smallpox:

Mpox and smallpox belong to the same Orthopoxvirus genus, meaning they are caused by similar but distinct viruses. Smallpox, thanks to effective vaccines, was eradicated by 1980 and no longer circulates. It was more contagious and spread more easily than mpox. While mpox symptoms resemble those of smallpox, they tend to be milder.

A Note from Cleveland Clinic

The past few years have been incredibly challenging due to the COVID-19 pandemic, which drastically changed how we live and work. Now, just as we're starting to return to normalcy, mpox has emerged as a new concern. However, mpox is a rare disease that spreads through close contact, such as kissing or sexual activity. We're still learning about how it transmits between humans.

To protect yourself, get vaccinated if you're at high risk, avoid contact with infected individuals, wash your hands frequently, and wear a face mask in crowded indoor spaces. Early mpox symptoms are flu-like, including fever, chills, and body aches. After a few days, a rash will appear. If you develop symptoms, consult a healthcare provider.