Causes and Risk Factors of Monkeypox

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Monkeypox is a viral infection. It comes from the same family as the smallpox virus and causes a similar rash. But monkeypox is not as contagious and generally causes milder symptoms than smallpox.

Classic symptoms of monkeypox are fever, body aches, fatigue, and headaches, followed by a rash that lasts anywhere from two to four weeks. Most people who contract monkeypox will have mild symptoms and recover without treatment.

Others, especially those with compromised immune systems, will need antiviral medicines. It is also possible to develop serious complications from the virus, such as severe scarring, vision problems, and pneumonia.

A person can be exposed to monkeypox through close contact with an infected animal or person. By July 25, 2022, researchers at the Centers for Disease Control and Prevention (CDC) were tracking 3,487 cases of monkeypox in the United States.

This article will cover the causes and risk factors for monkeypox. 

Two people in close physical contact

Klaus Vedfelt / Getty Images

Common Causes 

Most people who contract monkeypox have had close contact with an infected person. There are two ways in which monkeypox is transmitted from a person with the virus to someone else—by contact and by respiratory droplets. You can also acquire monkeypox after direct contact with an affected animal.

Contact With Body Fluids or Infection Skin Lesions

According to the CDC, the monkeypox virus is found in bodily fluids and skin lesions. You could acquire the virus if you have had physical contact with someone who is sick with the virus. 

Prolonged physical contact that could lead to monkeypox includes:

  • Skin-to-skin contact: This includes hugging, touching, playing, or face-to-face contact.
  • Contact with surfaces touched by a person with monkeypox: These include bedding, towels, and objects like eating utensils.
  • Sexual intercourse, including oral, anal, and vaginal: Monkeypox is not a sexually transmitted infection (STI) but can be transmitted through contact with infectious bodily fluids.

What Is an STI?

STIs are infections primarily transmitted from one person to another through sexual contact. Some STIs, like herpes and human papillomavirus (HPV), only need sexual skin-to-skin contact to spread.

STIs are caused by viruses, bacteria, and parasites and cause symptoms such as discharge, sores, itchiness, redness, and odor in intimate areas. Some people will not have symptoms and unknowingly transmit an STI to others.

If you are sexually active, talk to a healthcare provider about your risk for STIs and whether you need to be tested.

Respiratory Droplets 

Researchers also believe that monkeypox can spread through contact with respiratory droplets that land on the hands, objects, and surfaces when someone coughs, sneezes, or talks.

Respiratory droplets that transmit monkeypox are large, causing them to drop out of the air quickly. These droplets only travel a few feet from the affected person. That means to contract the virus from a person with monkeypox, you would have to have close contact with them for an extended time.

Contact With an Animal With Monkeypox

Humans can also contract monkeypox from animals with monkeypox. Before 2022, animal-to-person transmission was much more common, but most people, especially in the United States, are more likely to contract monkeypox after exposure to a person with the virus.

Animal-to-human transmission can occur after direct contact with the animal's body fluids or through a bite. According to the CDC, it is also possible to get monkeypox "by preparing or eating meat or using products from an infected animal," although this is not a likely occurrence in the United States.

Risk Factors 

Some groups of people might be at an increased risk of contracting monkeypox. 

People who might have a higher risk of monkeypox are:

  • International travelers: Anyone who travels to an endemic country (places where the virus has ongoing circulation) or places with outbreaks is at an increased risk for monkeypox. This risk is even higher if you participate in activities involving contact with people or animals with the virus.
  • Individuals who engage in anonymous sex: While monkeypox is not an STI since it can be passed on in other ways, it is transmitted through body fluids, close contact, and skin-to-skin contact. The 2022 multinational outbreak mainly passed from person to person through sexual contact.
  • People who have contact with animals with the virus: Animal-to-human transmission of monkeypox can occur when a person has contact with an animal (i.e., a squirrel, rat, or monkey) with monkeypox. This can occur if an animal with monkeypox bites or scratches you. Contact with lesions of an animal with monkeypox or its saliva can also transmit monkeypox. 
  • Healthcare workers: It is possible to contract monkeypox after caring for a person with the disease. In a healthcare setting, the virus can be transmitted through direct contact with a person's bodily fluids, lesions, or respiratory droplets. It might also occur through contact with bedding or clothing used by a person with the virus. 

Endemic Countries

According to the World Health Organization (WHO), endemic countries for monkeypox include "Benin, Cameroon, the Central African Republic, the Democratic Republic of the Congo, Gabon, Ghana, Ivory Coast, Liberia, Nigeria, the Republic of the Congo, Sierra Leone, and South Sudan."

Summary

Monkeypox is an infection that is caused by a virus similar to the one that causes smallpox. Symptoms of monkeypox are similar to smallpox symptoms but are typically milder. People can develop monkeypox if they have had direct contact with a person or animal that has the virus. In the United States, human-to-human contact is much more common. 

Prolonged direct contact has to have occurred for someone to acquire monkeypox. This contact can occur through kissing or sexual intercourse, contact with infected bedding or clothing, or respiratory droplets from a person with monkeypox.

Some people might be at a higher risk for monkeypox, including international travelers to endemic regions, people who engage in anonymous sex, people who are around animals with the virus, and healthcare workers treating individuals with monkeypox.

A Word From Verywell 

Most people do not need to worry about monkeypox. But it is a good idea to be mindful of how it spreads. 

If you know someone who has the virus, avoid direct skin contact with that person. You will also want to avoid sharing clothing, bedding, cups, or utensils. Take precautions when caring for someone who has monkeypox lesions on their body. 

If you develop symptoms of monkeypox, you should self-isolate to prevent spreading the virus. Early signs of monkeypox include fever, headache, muscle aches, and swollen lymph nodes. A rash typically follows within a few days. You should call a healthcare provider immediately if you think you were exposed to the virus and start to experience symptoms. 

Frequently Asked Questions

  • Can I get monkeypox from a friend or family member?

    Monkeypox is transmitted by close contact. If your friend or family member has the virus, you should avoid sharing clothes, towels, or eating utensils. You should also take precautions when caring for a loved one with monkeypox lesions on their body.

    You and the affected person should wear masks to contain respiratory droplets and avoid touching any lesions on the affected person. Wear gloves and long-sleeved clothing if you need to assist in the other person's care.

  • Is monkeypox a sexually transmitted infection?

    Because monkeypox is a contagious virus, it can spread during sex. But that does not make it a sexually transmitted infection. Monkeypox can occur after direct contact, including touching the infected person's lesions, interactions with objects they may have used, and through respiratory secretion contract. This means that while virus transmission can occur during sexual contact, it can also happen during nonsexual contact.

  • Is monkeypox a new illness?

    Monkeypox was first identified in West Africa and Central Africa in the 1950s, and sporadic cases worldwide are not uncommon. While monkeypox is not a new illness, the way it is spreading is (through human contact instead of animal to human). Fortunately, vaccines and treatments are already available to lessen its impact.

13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Lana Barhum
Lana Barhum has been a freelance medical writer since 2009. She shares advice on living well with chronic disease.