Monkeypox FAQs

Monkeypox is a rash illness, caused by the monkeypox virus, which can be spread from person-to-person or animal-to-person, or from contact with contaminated materials.

The disease typically begins with early symptoms of fever, headache, muscle aches, and exhaustion followed a few days later by a rash. In some of the recent cases, the early symptoms were not noted before rash appearance. Lesions may be all over the body, including the palms of the hands, soles of the feet, and head, or located only on the genitals or around the buttocks. The rash goes through four stages – flat (macular), to raised (papular), to fluid-filled (vesicular), to pus filled (pustular) – before scabbing over and resolving. This happens over a period of 2-4 weeks. Lymph nodes may swell in the neck, armpits, or groin, on one or both sides of the body.

The monkeypox virus may be transmitted person-to-person (saliva, lesion fluid, and respiratory droplets), animal-to-person, or from contact with materials contaminated with the virus. The virus enters the body through broken skin, or mucus membranes such as the eyes, nose, or mouth. The incubation period is usually 7−14 days but can range from 5−21 days.

Additional symptoms are provided here.

Contact a healthcare provider if you have a rash and have had close contact (including sexual contact) with individuals who have a similar appearing rash, or people who have received a diagnosis of confirmed or suspected monkeypox. Your doctor will evaluate the rash and may contact the public health department for testing at the North Carolina State Lab of Public Health (NCSLPH). If a poxvirus is confirmed, a sample will be sent to the Centers for Disease Control and Prevention to confirm a diagnosis of monkeypox.

Monkeypox is spread among people through close physical contact such as skin-to-skin contact or prolonged unmasked face-to-face contact, but is currently not considered a sexually-transmitted infection. It is important to know that anyone can get monkeypox, and the virus does not spread exclusively through any one gender, sexual, or social network.

There is no specific treatment for monkeypox, although antivirals developed for treatment of smallpox may prove beneficial. Your healthcare provider will conduct an assessment to determine the best treatment option for you.

Yes, isolation, usually at home, is required until the skin lesions have completely healed.

Please click here for current infection control and isolation recommendations.

Current risk to the public appears low. However, anyone who has had close physical contact with an infected person, contact with fluids or contaminated materials, or who has prolonged face-to-face exposure to someone with the virus may be at risk. While anyone can get monkeypox, at this point in time men who have sex with men, or transgender individuals, who have had multiple or anonymous sex partners in the last 14 days in either a venue where monkeypox was present or in an area where the virus is spreading have been disproportionately affected by the current international outbreak and may be at an increased risk of exposure to the infection.

Monkeypox is usually a self-limited disease with the symptoms lasting from 2 to 4 weeks, though severe cases can occur. Some infections may require hospitalization or other medical care for treatment. People who have immunocompromised states and children are at risk for more severe monkeypox illnesses.

To prevent infection, individuals should:

• Ensure infected individuals isolate from others until skin lesions have completely healed.
• Wear personal protective equipment when caring for infected people. https://www.cdc.gov/poxvirus/monkeypox/prevention.html
• Practice proper hand hygiene after contact with infected people or animals, washing hands with soap and water for at least 20 seconds, or for as long as it takes to sing “Happy Birthday” twice. Where soap and water are not available hand sanitizer that contains at least 60% alcohol should be used to cover all surfaces of the hands, then hands rubbed together until they feel dry.
• Avoid sex or skin-to-skin contact with someone who has a rash or other monkeypox-related symptoms.
• Talk to your sexual partner(s) about any recent illness and be aware of new or unexplained sores or rashes on your body or partner’s body, including genitals and anus.
• Avoid contact with materials that may be contaminated with the virus.
• Seek evaluation from your healthcare provider if you have been exposed to monkeypox. For some people who have been exposed to monkeypox, physicians and public health officials may recommend vaccination to prevent illness or decrease illness severity.

No, at this time we are not requiring people who have been exposed to monkeypox to quarantine. However, people who are exposed should self-monitor for symptoms for 21 days from their last exposure to someone with symptoms or unhealed lesions and check their temperature twice a day. If they develop any symptoms of monkeypox, they should immediately self-isolate and contact the local health department or healthcare provider. Contacts who remain asymptomatic can be permitted to continue routine daily activities (e.g., go to work, school), as long as their typical activities allow them to self-isolate if symptoms develop. Contacts should not donate blood, cells, tissue, breast milk, semen, or organs while they are under symptom surveillance.

The ACAM2000 or JYNNEOS vaccines can prevent illness or lead to less severe symptoms if given within two weeks after someone is exposed to monkeypox. For more information, see the CDC monkeypox and smallpox vaccine guidance: https://www.cdc.gov/poxvirus/monkeypox/clinicians/smallpox-vaccine.html

Vaccines are available in limited supply, at no cost, for individuals with known or suspected exposure to monkeypox. This includes:

• People who have been in close physical contact with someone diagnosed with monkeypox in the last 14 days (PEP)
•  Men who have sex with men, or transgender individuals, who report any of the following in the last 90 days:
  • Having multiple or anonymous sex partners
  • Being diagnosed with a sexually transmitted infection
  • Receiving HIV pre-exposure prophylaxis (PrEP)
•  Available for certain healthcare workers and public health response team members designated by public health authorities

Individuals who meet the current criteria can call their local health department to make an appointment to receive the vaccine, or they can call one of the seven local health departments that have already received vaccines as part of the phase 2b allocation of Jynneos vaccine:

Monkeypox vaccines are free and are based on availability of vaccine, which is in limited quantities currently.

This is an evolving situation, and new information may result in rapid changes to public health communications and recommendations. Current information on monkeypox can be obtained here.