Monkeypox

Monkeypox is a rare viral illness that has not often been seen in the United States, although sporadic outbreaks have occurred in the past. It can cause a rash that looks like bumps, blisters, or ulcers. Some people have flu-like illness before the rash develops. Most people recover in 2–4 weeks, but the disease can be serious, especially for children and people who are immune compromised or pregnant.

How monkeypox is spread

Monkeypox can spread between people through close physical contact (skin-to-skin), including sexual contact, with a person who has monkeypox or contact with objects that have been used by a person with monkeypox.

Anyone can be infected with monkeypox if they have close physical contact with someone who has monkeypox, regardless of gender identity or sexual orientation. However, many of those affected in the current global outbreak are among gay and bisexual men, or other people assigned male at birth who have sex with men, including non-binary, genderqueer and/or transgender people.

Routes of transmission include:

• Direct physical contact with monkeypox rash, sores, or scabs from a person with monkeypox; CDC believes this is currently the most common way that monkeypox is spreading in the U.S.
• Kissing or other prolonged face-to-face contact due to respiratory droplets or oral fluids (i.e., saliva)
• During sex through skin-to-skin and other intimate sexual contact
• Contact with objects, fabrics (e.g., clothing, bedding, or towels), and surfaces that have been used by someone with monkeypox is possible

Signs and symptoms of monkeypox

The illness can begin with flu-like symptoms, including fever, headache, back and muscle aches, swollen lymph nodes, and general exhaustion, followed by a rash (usually painful) that can look like pimples or blisters.

• Symptoms usually start within 2 weeks of exposure to the virus but symptom onset can occur up to 3 weeks later.
• Within 1-3 days of symptoms beginning, people usually develop a rash or sores.
• The rash or sores may appear like a sexually transmitted infection, especially if the rash or sores are located around the genitals or anus. The rash or sores may appear on or near the genitals or anus, but sometimes appear in other areas, such as the hands, feet, chest, face, or in the mouth.
• Sores often go through several stages before healing, which takes about 3 weeks.
• An individual is considered contagious once symptoms appear; they remain contagious until all sores have healed, a new layer of skin is formed, and scabs have fallen off. 

Contact your healthcare provider immediately for an evaluation if you develop a new, unexplained, rash or lesions on any part of the body. They can help get you access to the appropriate testing, if needed. In addition:

• Avoid sex or other close, intimate contact with others until you have been evaluated.
• Cover any rashes you may have.
• Avoid gatherings until symptoms have resolved, especially if they involve close, personal, skin-to-skin contact or prolonged face-to-face contact.
• Talk to your partner(s) about any recent illness and be aware of new or unexplained sores or rashes on your body or your partner’s body, including on the genitals and anus.

If a healthcare provider suspects or confirms you have monkeypox

Isolate at home until the rash has fully resolved, the scabs have fallen off, and a fresh layer of intact skin has formed. This is when you are no longer contagious to others. Please note this may last between 2 and 4 weeks.

• Stay home and separate from other people and pets in your household. If you cannot fully separate from others in your household, wear a facemask and avoid physical contact.  
• Wear clothing that covers your lesions when in shared spaces. If you must leave home for essential needs or medical care, cover your rash/sores with clothing and wear a facemask.
• Do not share or let others touch your clothing, towels, bedding, or utensils. Do not share a bed. Handle and do your own laundry, if possible.
• Do not share dishes, food, drinks, or utensils. Wash dishes with warm water and soap or in a dishwasher.
• Wash your hands often. Household members should also wash their hands often, especially if they touch materials or surfaces that may have come in contact with your rash or sores.
• Clean and disinfect shared surfaces, such as countertops and doorknobs, frequently.
• Follow CDC monkeypox isolation guidelines. In addition, follow any additional guidelines provided by your healthcare provider.
• Follow the Monkeypox Infection Prevention and Isolation Guidelines for University Residence Halls and Shared Living Spaces if these apply to your living situation
• Ask your healthcare provider about treatment options.

Reporting

While most individuals in the UW community are not required to report a monkeypox infection to the University; please notify covidehc@uw.edu in the following scenarios:

• Students in University residence halls: If a healthcare provider suspects or confirms monkeypox infection, notify covidehc@uw.edu for isolation guidelines to limit spread.
• Exposure due to University workplace or instructional activities or at a University setting: If units, personnel, and students have questions or concerns about potential exposure to monkeypox in a University setting or due to University work or instructional activities, notify covidehc@uw.edu.  

Outside of these scenarios, reporting a suspected or confirmed infection to the University is not required.

Personnel with questions about leave and accommodations needed while they are isolating can contact their supervisor, or a human resources consultant or academic human resources business partner for assistance.

Students may choose to contact their instructors to make up coursework when isolating at home; however, students are not required to share personal health information with their instructors.

Visit the Washington state, King, Pierce, and Snohomish health department websites, the CDC U.S. Monkeypox Outbreak 2022 webpage, or the World Health Organization Monkeypox website for more information.

As this is a newer outbreak, public health entities nationally and internationally are still learning about the behaviors that may put people at increased risk and we will continue to share information with the community as we learn more.

Decreasing risk of stigma

The UW Advisory Committee on Communicable Diseases is committed to informing the UW community about health issues that may affect them. We recognize that there is risk for stigma or discrimination when communicating about a new disease outbreak. We all have a responsibility to call out any stigmatizing words or actions related to monkeypox virus and instead, share factual information so that people can make the best decisions for their own health and the health of our community.