The mpox virus is spreading mostly through close, intimate contact with someone who has mpox. The mpox virus can spread when a person comes into contact with the virus from a human, animal or from materials contaminated with the virus.

• Mpox can spread to anyone through close, personal, often skin-to-skin contact including:
  • Direct contact with mpox rash and scabs from a person with mpox, as well as contact with their saliva, upper respiratory secretions (snot, mucus), and areas around the anus, rectum, or vagina.
• This contact can happen during intimate sexual contact including:
  • Oral, anal, and vaginal sex or touching the genitals or anus of a person with mpox
  • Hugging, massage, and kissing
  • Prolonged face-to-face contact

The risk is considered low for getting mpox by touching objects, fabrics, and surfaces that have been used by someone with mpox and not disinfected, such as clothing, bedding, towels, fetish gear, or sex toys.

Other ways the mpox virus can spread include:

• A pregnant person can spread the virus to their fetus through the placenta.
• People can get mpox from infected animals, either by being scratched or bitten by the animal or by preparing or eating meat or using products from an infected animal.

Mpox does not spread from person to person through:

• Casual conversation with someone who is infected
• Walking by someone who is infected

A person with mpox can spread it to others from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. As of February 2023, new data show that some people can spread mpox to others from one to four days before their symptoms appear. It’s not clear how many people this has affected during the current outbreak. There is currently no evidence showing that people who never develop symptoms have spread the virus to someone else. 

Mpox symptoms usually start within 3 weeks of exposure to the virus. For most people, clear up within two to four weeks.   

The illness often begins with:

• Fever
• Headache
• Muscle aches
• Backache
• Swollen lymph nodes
• Chills
• Exhaustion
• Respiratory symptoms (e.g. sore throat, nasal congestion, or cough)
• A rash that may be located on or near the genitals or anus but could also 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 look like pimples or blisters and may be painful or itchy.

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.

If someone has flu-like symptoms, they will usually develop a rash 1-4 days later. The rash can look like pimples or blisters. It often begins on the genitals or anus, or in and around the mouth. In these situations, the mpox rash could be confused with a more common sexually transmitted infection (STI). The rash might develop on just one part of the body or can appear on many parts of the body. These lesions might be painful.

People with certain conditions may be more likely to develop severe illness. These include people with weakened immune systems, children under 8 years of age, people with a history of eczema, and people who are pregnant or breastfeeding.

Mpox Rash Photos

Photo credit: UK Health Security Agency, Source: CDC.

Take the following steps to prevent getting mpox:

• Avoid close, skin-to-skin contact with people who have a rash that looks like mpox.
  • Do not touch the rash or scabs of a person with mpox. The rash might appear on the genitals (penis, testicles, labia, vagina) or anus and could be on other areas like the hands, feet, chest, face, or mouth
  • Do not kiss, hug, cuddle or have sex with someone with mpox.
• Avoid contact with objects and materials that a person with mpox has used.
  • Do not share eating utensils or cups with a person with mpox.
  • Do not handle or touch the bedding, towels, or clothing of a person with mpox.
• Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially before eating or touching your face and after you use the bathroom.
• Wear a mask in situations where you may have lengthy or close face-to-face contact with people who may be infected.
• Get vaccinated. Learn more below
• If you are in Central or West Africa, avoid contact with animals that can spread mpox virus, usually rodents and primates.

Safer Sex and Social Gatherings

While public health works to contain the current outbreak, we want you to have information so you can make informed choices when you are in spaces or situations where mpox could be spread. Mpox is often transmitted through close, sustained physical contact, almost exclusively associated with sexual contact in the current outbreak.

Vaccination is an important tool in preventing the spread of mpox. If you are at risk for mpox but haven’t received your two-dose vaccine yet, temporarily changing some parts of your sex life might reduce the risk of exposure to the virus. This includes the time between your first and second shots of vaccine. See below to learn more about vaccination.

See CDC's Social Gatherings, Safer Sex, and Mpox to learn more about:

• How to lower your risk during sex.
• How to lower the chance of getting mpox at places like raves, parties, clubs, and festivals.
• What to do if you have a new or unexplained rash, sores, or other symptoms.

• Call your healthcare provider to schedule an appointment and arrange for testing.
• If you do not have a health care provider, some urgent care facilities are seeing patients with symptoms consistent with mpox and providing testing. Call before you go and let them know that you are concerned about mpox.
• If you do not have a health care provider and are unable to be seen at an urgent care facility, the health department may be able to assist, call 703-246-2433.

Your healthcare provider may take a specimen and send it to a lab for testing or they may send you to a lab for both specimen collection and testing.

Learn more about testing from the CDC. 

Please call ahead before going to a healthcare facility and let them know that you are concerned about mpox.

Isolate

If you have mpox, you are advised to stay at home (isolate) until your mpox rash has healed and a new layer of skin has formed. Staying away from other people and not sharing things you have touched with others will help prevent the spread of mpox. Mpox can also spread to animals, so staying away from pets, livestock and other animals is important.

Inform your contacts

It’s important to notify your close contacts that they may have been exposed to mpox as soon as possible, so they can watch for signs and symptoms, get tested and isolate if they have symptoms, and consider getting vaccinated.

The Health Department can help you confidentially notify your contacts and help them monitor their symptoms so that if they do get sick, they can get tested quickly.  

Self-care

As with many viral illnesses, treatment mainly involves supportive care and relief of symptoms. Learn how to take care of yourself and manage your symptoms.

There are no treatments specifically for mpox virus infections. However, mpox and smallpox viruses are genetically similar, which means that antiviral drugs and vaccines developed to protect against smallpox may be used to prevent and treat mpox virus infections.

Antivirals, such as tecovirimat (TPOXX), may be recommended for people who are more likely to get severely ill, like patients with weakened immune systems. Not everyone who has symptoms of mpox is recommended to take treatments.

See Patient’s Guide to Mpox Treatment with Tecovirimat (TPOXX) from the CDC.

The CDC is closely monitoring worldwide case counts and working to understand the cause of the current cases. 

Researchers are also investigating:

• How often mpox is spread through respiratory secretions, or when a person with mpox symptoms might be more likely to spread the virus through respiratory secretions.
• Whether mpox can be spread through semen, vaginal fluids, urine, or feces (poop).

Mpox Fact Sheet (Virginia Department of Health)

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Shareables and Communication Resources

VDH: Communication Resources

The first confirmed U.S. case in the outbreak was announced on May 18, 2022. The first case of Mpox in Northern Virginia was confirmed on May 27, 2022. Since that date additional cases have been identified in multiple states including in Virginia. On August 4, 2022, the U.S. Department of Health and Human Services declared a public health emergency in response to the mpox outbreak. The U.S. Public Health Emergency for mpox ended on January 31, 2023. However, mpox continues to be an important public health issue.

The Fairfax County Health Department is working with the Virginia Department of Health (VDH) and with other local public health agencies to respond to the current mpox outbreak. Key activities include: 

• Quickly identifying and responding to cases of mpox through testing and case and contact investigations and taking the appropriate public health action to reduce its spread.
• Administering mpox vaccines to eligible individuals directly and through partner organizations.
• Consultation with health care providers in the community to provide public health guidance and reach those most at risk in the community.
• Conducting communication and outreach through equity-focused engagement with organizations as well as the general public.

The mpox vaccine is recommended for individuals who have been exposed, or are at high risk of exposure, to the virus.

Two vaccines may be used for the prevention of mpox disease:

• JYNNEOS vaccine is approved for the prevention of mpox and smallpox disease.
• ACAM2000 vaccine is approved for immunization against smallpox disease and made available for use against mpoxunder an Expanded Access Investigational New Drug (EA-IND) protocol.

At this time, JYNNEOS is the primary vaccine used in Virginia for prevention of mpox.

People can be vaccinated after exposure to mpox virus to help prevent mpox. This is called "post-exposure prophylaxis." 

• FDA: Key Facts about Mpox Vaccine

People should take precautions to reduce their exposure to mpox until two weeks after receiving the second vaccine dose and immune protection from vaccines has reached its maximum.

The mpox vaccine is recommended for individuals who have been exposed, or are at high risk of exposure to the mpox virus. 

VDH updated its vaccine eligibility in February 2023. VDH and CDC recommends vaccination against mpox if you:

• Had known or suspected exposure to someone with mpox
• Had a sex partner in the past 2 weeks who was diagnosed with mpox
• Are a gay, bisexual, or other man who has sex with men or a transgender, nonbinary, or gender-diverse person who in the past 6 months has had any of the following:
  • A new diagnosis of one or more sexually transmitted diseases (e.g., chlamydia, gonorrhea, or syphilis)
  • More than one sex partner
• Have had any of the following in the past 6 months:
  • Sex at a commercial sex venue (like a sex club or bathhouse)
  • Sex related to a large commercial event or in a geographic area (city or county for example) where mpox virus transmission is occurring
  • Sex in exchange for money or other items
• Have a sex partner with any of the above risks
• Anticipate experiencing any of the above scenarios
• If you are traveling to a country with a clade I mpox outbreak and anticipate any of the following activities during travel, regardless of gender identity or sexual orientation:
  • Sex with a new partner
  • Sex at a commercial sex venue (e.g., a sex club or bathhouse)
  • Sex in exchange for money, goods, drugs, or other trade
  • Sex in association with a large public event (e.g., a rave, party, or festival)
• Have HIV or other causes of immune suppression and have had recent or anticipate future risk of mpox exposure from any of the above scenarios
• Work in settings where you may be exposed to mpox:
  • You work with orthopoxviruses in a laboratory

At this time, most clinicians and laboratorians in the United States are not advised to receive mpox vaccine pre-exposure prophylaxis (PrEP).

Non-residents of Virginia are now eligible to receive the JYNNEOS mpox vaccine. 

Learn more about mpox vaccination in Virginia.

An FDA emergency authorization enables a change in how the currently licensed JYNNEOS vaccine is administered. Research shows that giving the JYNNEOS vaccine intradermally is safe and causes a similar immune response against mpox while using a smaller dose. This will enable more people to be vaccinated better protecting our community.

On August 24, the health department began vaccinating individuals 18 years and older who are eligible for the JYNNEOS vaccine with an intradermal injection - a shot given between the layers of the skin (like a TB test), rather than below the skin (subcutaneous). Note: If you have a history of developing keloids, tell your provider. They may suggest getting the vaccine subcutaneously instead. 

Two doses of the vaccine are needed. People who received their first dose as a subcutaneous injection can get their second dose intradermally.

Learn more about how the vaccine is given intradermally and possible side effects from this VDH factsheet.  

For more information, see:

• FDA Intradermal JYNNEOS Monkeypox Vaccine Fast Facts
• FDA EUA Fact Sheet for Patients and Caregivers
• FDA Additional Vaccine Information

You should still continue to take precautions after vaccination.

The JYNNEOS vaccine is given in two-doses with 28 days between doses. You are considered protected 14 days after your second dose (about 6 weeks after your first dose). You should continue to take precautions against mpox between doses.

Mpox infections after vaccination are possible, although they may be milder and less likely to result in hospitalization. You can reduce your risk of infection by continuing to take preventative measures after being vaccinated. CDC offers more information about mpox infections after vaccination.

For more information about mpox vaccines and other prevention measures, please visit the CDC Prevention website.