What Are the Symptoms of Mpox?

monkeypox symptoms

Verywell Health / Ellen Lindner

On November 28, 2022, the World Health Organization (WHO) recommended using the term “mpox” instead of “monkeypox” in order to avoid racist and stigmatizing language when discussing the disease. Both terms will be used for the next year as WHO phases out usage of “monkeypox.”

Key Takeaways

  • Mpox is a rare disease that is related to smallpox.
  • The disease usually causes flu-like symptoms and swelling of lymph nodes. Rashes, pustules, ulcers, and other lesions tend to appear a few days later.
  • Researchers are still trying to understand precisely how the disease is transmitted, and how symptoms appear in different people.

Unusual cases of mpox (formerly known as monkeypox) are cropping up around the world. The World Health Organization (WHO) has documented more than 550 cases in 30 nations, including those where the disease does not usually appear.

The Centers for Disease Control and Prevention (CDC) is investigating 19 cases of mpox in U.S. patients. The disease remains rare and is much less severe than its cousin, smallpox.

Health officials are working to make sense of where and how the virus is spreading in the current outbreaks. They can turn to the research and experience of experts in Africa who have worked to minimize the spread of mpox for decades to better understand how the viral infection behaves.

Though mpox has been well-studied, many people in the U.S. are unfamiliar with the virus given its extreme rarity in the country.

Here are the signs to look out for if you suspect you might have been exposed to mpox.

Understanding Monkeypox Symptoms

According to the CDC, mpox begins with:

  • Fever
  • Headache
  • Muscle aches
  • Backache
  • Swollen lymph nodes
  • Chills
  • Exhaustion

After one to three days, the patient develops a rash, often beginning on the face and then spreading to other parts of the body.

Mpox typically begins with flu-like symptoms, including fever, headache, muscle aches, and exhaustion. Different from smallpox, a key feature of mpox is that it also causes the lymph nodes to swell, according to the CDC.

Within one to three days, a rash will likely appear. It tends to start in the face and then spread to other parts of the body. Mpox causes skin abnormalities, called lesions, across the body, including on the soles of the feet and palms of the hands.

The lesions will progress through four stages—from flat spots to raised bumps to blisters and lesions filled with pus. The lesions will usually be the same size and stage of development on any given part of the body. As the body heals from the disease, the lesions will turn into scabs and eventually fall off.

In some cases, patients appear to have rashes that look like those from mpox, without first developing fever, Erica S. Shenoy, MD, PhD, a medical director at Massachusetts General Hospital and fellow at the Infectious Disease Society of America, said in a press call. As with all diseases, individuals can express symptoms in many ways.  

Confusing Symptoms

A doctor told NPR that some mpox patients have rashes that look much more like a crater or ulcer than the raised, pus-filled lesions that are often associated with mpox. And in some current cases, the rashes started in the genital area, and either stayed localized or spread to other areas of the body.

The WHO said mpox lesions may be confused with skin rashes from other conditions. Viral testing is important to help health providers accurately diagnose mpox.

There are many common infections that could cause symptoms reminiscent of mpox. Lesions could form due to allergic reactions, for instance, and lymph nodes may swell in response to several infections. When assessing a patient with such symptoms, the CDC said health providers should rule out other causes first, but consider mpox as a potential diagnosis.

Symptoms may not emerge until five to 21 days after infection with mpox. People who are exposed to someone sick with mpox should isolate from others for the full 21 days to avoid spreading it to others, Shenoy said.

The illness typically lasts for two to four weeks. So far, there are no documented deaths due to mpox among people outside Africa.

Mpox Is Spread Through Close Contact

So far, there’s no evidence that the disease is sexually transmitted, and health officials emphasize that all people are vulnerable to mpox.

If you suspect you may have been exposed to mpox, speak with a healthcare provider about how to track your symptoms and avoid spreading it to others.

“Contact tracing is essential at this time to be able to understand transmission networks and ensure that people get the care that they need, should they develop symptoms,” Shenoy said.

Who Is at Risk of Getting Mpox?

Anyone who has close contact with an infected person has a chance of getting sick with mpox. But it’s not as highly contagious as COVID-19, which spreads much more easily without direct contact with a sick individual.

Mpox is most often transmitted through skin-to-skin contact. It can also be passed through body fluids, respiratory droplets produced by coughing and sneezing, and contaminated materials like bedding.

In prior mpox outbreaks, researchers found that the likelihood of spreading mpox is higher for people living in the same household.

In the U.S. and other countries, there is a disproportionately high number of cases “in communities of gay, bisexual, and other men who have sex with men,” according to the WHO. Some of these cases were identified at sexual health clinics.

So far, there’s no evidence that the disease is sexually transmitted, and health officials emphasize that all people are vulnerable to mpox.

“What we know right now is that it's spread through close contact,” Shenoy said. “I don't think there's any reason to think that, at least at this point, there's anything different about that than just being a close contact.”

In an interview with STAT, Maria Van Kerkhove, PhD, an infectious disease expert at the WHO, said that there may be a higher number of cases emerging from “amplification events.” These are events—like social gatherings and sexual networks—where people are more likely to have skin-to-skin contact with others.

When talking about mpox, it’s important not to stigmatize the disease based on its current associations with the communities of men who have sex with men and its prevalence in certain parts of Africa, said Daniel Lucey, MD, MPH, FIDSA, FACP, a professor of medicine at Dartmouth Geisel School of Medicine and a fellow at the Infectious Diseases Society of America.

“We have lots of examples of how not to do it from the HIV pandemic and from the Ebola epidemic,” Lucey said. “It's very difficult, but it can and must be done.”

What Scientists Hope to Learn

Mpox is a zoonotic virus, meaning it can pass from animals to humans. Scientists know that rodents and some other animals may carry the virus and pass it along to humans, but they’re not yet sure if the same is true for household animals.

“That would be a very big concern if dogs or cats were susceptible and actually infected and then if they could infect humans or other dogs or cats,” Lucey said. “But there's no evidence of that yet.”

Though the symptoms of mpox are relatively well defined, testing for the disease is limited to public health laboratories and the CDC. Shenoy emphasized the need to develop testing strategies to more quickly and effectively diagnose a mpox case.

“Not many people have diagnosed monkeypox in the United States and so we need rapid learning in terms of what to look for, what to ask the patient, and what to do in terms of next steps,” Shenoy said.

At a WHO meeting this week, a panel of experts from around the world outlined some of the outstanding questions about mpox, such as whether it’s possible to have an asymptomatic infection, how easily the virus spreads through respiratory droplets, and whether the disease can be transmitted through semen and vaginal fluids.

While scientists find the best ways to address the mpox outbreaks, some experts urged the scientific community to learn from the COVID-19 response and be sure that resources are shared with communities globally.  

“We can’t just solve the problem for high-income countries,” said Helen Rees, MB BChir, a medical researcher in South Africa who moderated the 2022 WHO conference. “We need to be sure that what we come up with in terms of solutions have an equitable impact.”

What This Means For You

If you have been exposed to mpox or develop a rash or other signs of the disease, isolate yourself from others and speak with a healthcare provider about your symptoms.

You can also minimize your exposure by avoiding skin-to-skin contact, including sexual contact, practicing good hygiene, and wearing a face mask around sick individuals.

9 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.
  1. World Health Organization. WHO Director-General's opening remarks at the COVID-19 media briefing– 1 June 2022.

  2. Centers for Disease Control and Prevention. U.S. monkeypox 2022: Situation summary.

  3. Centers for Disease Control and Prevention. Monkeypox - Signs and symptoms.

  4. Centers for Disease Control and Prevention. Monkeypox.

  5. Centers for Disease Control and Prevention. Monkeypox: Clinical recognition.

  6. Harris E. What to know about monkeypoxJAMA. Published online May 27, 2022. doi:10.1001/jama.2022.9499

  7. Beer EM, Rao VB. A systematic review of the epidemiology of human monkeypox outbreaks and implications for outbreak strategy. PLOS Neglected Tropical Diseases. 2019;13(10). doi:10.1371/journal.pntd.0007791

  8. World Health Organization. Monkeypox: Public health advice for gay, bisexual and other men who have sex with men.

  9. Minhaj FS, Ogale YP, Whitehill F, et al. Monkeypox outbreak — nine states, May 2022MMWR Morb Mortal Wkly Rep. 2022;71. doi:10.15585/mmwr.mm7123e1

By Claire Bugos
Claire Bugos is a health and science reporter and writer and a 2020 National Association of Science Writers travel fellow.