Mpox (Monkeypox)

There’s a new method of transmission that hasn’t been observed before - it’s being transmitted from person to person. It’s a new way of spreading virus.

Some people say that climate change changes the way that animals behave and where they live, and that may have something to do with the way that some of these infections are spread, but at this point, we just don't know. However, people were smart enough to recognize there was a new way the virus was spreading, and it put us on alert. We’re looking for it, managing it, and trying to stop the spread, before it gets to be a much bigger problem.

Viruses like this are unpredictable, so we really don't know what's going to happen. The best course of action, for now, is to be on the alert. That's the advice that I would give to my patients, to my friends, and to my medical colleagues. Be on the lookout.

The big feature is a rash. And with this current outbreak, the rashes tend to be in the groin, around the rectum, on the trunk of the body, or on the hands and face. It’s either one small lesion or several of them together.

People also get sick. They have may have fevers, fatigue, muscle aches, and swollen glands on either the neck or the groin. It takes about two weeks for the infection to resolve. It’s what we call self-limiting - in other words, it takes care of itself. There really isn't any specific treatment for this virus, so patients wait it out.

I would consider it a serious condition if I had it because it can spread to others. You must isolate for about two weeks. We need to notify public health departments about new infections so we can stop the spread. It becomes disruptive.

So far we have not seen any hospitalizations or deaths as a result of these infections. Although people with HIV and AIDS may feel worse and be sick for longer, there isn't any difference, at least at this point, in terms of outcome. But one of the things we're going to learn is how immunosuppressed people react to this virus, and if there are any differences in people with immune suppression versus a normally functioning immune system. We'll learn about how this virus behaves in different populations of people.

We are seeing community spread. People have traveled to other places, acquired the virus at large events, traveled back to where they live, and spread the virus in their communities. It’s something that we want to try and mitigate, bring under control, and manage.

It spreads through close contact and skin-to-skin contact. The kind of contact you have when you have sex. There's a lot of rubbing of skin and lesions. The wet, early lesions (sores) have virus in them. So with skin-to-skin contact, it is spread to another person by close person-to-person, close contact.

I want to make the distinction between sexual contact and sexually transmitted infections. Mpox is transmitted through close contact, the kind of contact that happens during sex. So far, this virus is not behaving like the AIDS virus.that can be spread by semen or blood.

It's getting better now that testing method locally through hospitals and commercial labs. We can get answers faster, and we can prevent virus spread to others. Also, if you suspect somebody is has has the rash of monkey pox, they need to be isolated pending laboratory testing.

Be on alert, but not on edge. We’ve learned enough from past pandemics to be able to look at this intelligently and remember that not all of these viruses are transmitted in the same way.

While we are waiting for more vaccines, there are steps that you can take to protect yourself. According to the CDC:

Have virtual sex with no in-person contact.

Masturbate together at a distance of at least 6 feet, without touching each other and without touching any rash.

Consider having sex with your clothes on or covering areas where rash is present, reducing as much skin-to-skin contact as possible. 

If the rash is confined to the genitals or anus, condoms may help; however, condoms alone are likely not enough to prevent monkeypox.

Avoid kissing.

Remember to wash your hands, fetish gear, sex toys and any fabrics (bedding, towels, clothing) after having sex. Learn more about infection control.

Having multiple or anonymous sex partners may increase your chances of exposure to monkeypox. Limiting your number of sex partners may reduce the possibility of exposure.

Avoid touching the rash. Touching the rash can spread it to other parts of the body and may delay healing.

In addition, you should shower after sex.