What is monkeypox?

Monkeypox is a rare disease caused by infection with the monkeypox virus. Cases have been reported in the United States–where it isn’t usually found. Monkeypox infection can make you sick, often with flu-like symptoms and a rash that can look like pimples or blisters. Monkeypox is rarely fatal. For the general public, the current risk of getting monkeypox is low.

What are the symptoms of monkeypox?

Monkeypox typically begins with symptoms like fever, headache, muscle aches, and exhaustion which appear 5 to 21 days after the individual was infected. Often within 1 to 3 days of the onset of fever, infected individuals develop a rash that can look like pimples, sores, or blisters. The rash may appear on the face before spreading to other parts of the body, including the hands, feet, and genitals.

How does monkeypox spread?

Monkeypox can spread to anyone through close, personal, or skin-to-skin contact. This includes:

• Direct skin-to-skin contact with monkeypox rash, sores, or scabs
• Contact with materials like clothing, bedding, or towels that have been used by someone with monkeypox
• By kissing or other face-to-face contact through saliva or respiratory droplets
• A pregnant person can spread the virus to their fetus through the placenta
• The virus can spread through fluid or pus from monkeypox sores, though we don’t know if the virus can be present in semen or vaginal fluids. Monkeypox has not been shown to be spread through casual contact, such as being in the same area, having casual conversation, or briefly touching shared items like doorknobs. People who do not have monkeypox symptoms cannot spread the virus to others.

Am I at risk of getting monkeypox?

For the general public, the current risk of getting monkeypox is low. Recent cases have been reported more frequently among gay, bisexual, and other men who have sex with men (GBMSM) and who may have multiple or unknown sexual partners. However, monkeypox can spread to anyone through close, personal, or skin-to-skin contact.

What should I do if I have symptoms of monkeypox?

If you have a new or unexplained rash, sores, or other symptoms of monkeypox, you should talk to your healthcare provider. If you don’t have a healthcare provider or health insurance, please call the County’s Dennis Avenue Call Center at 240-777-2982.When you talk to the healthcare provider, remind them that the monkeypox virus may be circulating in the community. Avoid close contact with anyone, including intimate physical contact and sex, until you have talked to a healthcare provider and while you wait for test results.

What should I do if I have monkeypox?

If a healthcare provider tells you that you have monkeypox, follow the treatment and prevention recommendations from the provider. Avoid close contact with anyone, including intimate physical contact and sex, until all sores have healed, and you have a fresh layer of skin formed. You may be asked about the people you have had close, personal, or sexual contact with within the last 21 days. This is to help stop the spread of monkeypox. Can monkeypox make my pet sick? Monkeypox can spread between people and animals. However, the current risk to pets is believed to be low. People with monkeypox should avoid interacting with animals and find someone to care for their pets while they recover. You can find information about pets and monkeypox on the CDC website.

What can be done to prevent monkeypox?

There are several ways to help prevent monkeypox infection.

• Avoid contact with any materials, such as bedding and towels, that have been in contact with a person or animal with monkeypox.
• Wash your hands or use an alcohol-based sanitizer after contact with a person or animal with monkeypox.
• Avoid contact with animals that may carry the virus, including animals that are sick or that have been found dead, especially in areas where human monkeypox typically occurs.
• Use appropriate personal protective equipment (PPE) when caring for a person with MPX.

Is Monkeypox a sexually transmitted infection (STI). Do condoms help stop the spread?

There is a lot of discussion in the scientific community about whether monkeypox is an STI. We do not know if monkeypox is found in semen, vaginal fluid, or feces. Condoms can provide protection against sexually transmitted infection (STI) but may not prevent the spread of monkeypox.

How does testing work? Does someone have to have symptoms?

No testing is currently available until a person has symptoms. Testing involves swabbing lesions (two swabs per lesion to get best sample). Swabbing can be uncomfortable for the patient because the provider may apply pressure to get an adequate sample. Those samples are securely sent to a lab for testing. Result times vary by laboratory.

Is there a blood antibody test available to check if I was exposed in the past and developed antibodies (protection) against monkeypox?

Antibody testing is currently not being done. It would not be able to tell the difference between vaccination and prior infection.

How do I isolate with monkeypox?

Cover body parts and wear well-fitting masks; common disinfectants can be used to disinfect surfaces. Isolate in your own home if possible until all lesions have crusted over and until the scab has fallen off.

What treatments are available for monkeypox?

There are no treatments specifically for monkeypox virus infection. However, since the monkeypox virus is a part of the same family of viruses as smallpox, antiviral drugs and vaccines developed to protect against smallpox may be used to prevent and treat monkeypox virus infections. A healthcare provider may recommend an antiviral, such as tecovirimat (TPOXX), for a patient who is more likely to get seriously ill–like a patient with a weakened immune system.

What vaccines are available for monkeypox?

The US Food and Drug Administration (FDA) has licensed two vaccines for use in preventing monkeypox - ACAM2000 and Jynneos. ACAM2000 is not recommended for some people. The supply of Jynneos is more limited. The federal government is managing how much vaccine is available to cities and states based on the number of monkeypox cases and other factors. A limited number of vaccine doses are available to individuals at highest risk in some U.S. jurisdictions, including Maryland. Authorized healthcare providers will offer the vaccine to eligible highest-risk individuals who meet certain criteria. This information will change as more vaccine becomes available.

How can providers get TPOXX (treatment) for their patients?

Per the CDC, there is no treatment approved specifically for monkeypox virus infections. However, there is evidence that antivirals developed for use in patients with smallpox may help patients with monkeypox. Tecovirimat (known as TPOXX) is currently available through the US Strategic National Stockpile (SNS) a treatment option for some monkeypox patients. Healthcare providers hoping to obtain TPOXX for a patient diagnosed with monkeypox should visit CDC’s Obtaining and Using TPOXX webpage and follow the instructions there for accessing this medication.

How long does immunity last from both a case of monkey pox and the vaccine?

We don’t know exactly how long immunity lasts. As we learn more, we will share this information with Montgomery County residents.

Where can a person in a high-risk group get vaccinated in Montgomery County?

Montgomery County currently offers MPX vaccine at our Dennis Avenue Health Center (2000 Dennis Avenue Silver Spring MD 20901) STI Program by appointment. There is no cost for the MPX vaccination. To make an appointment please call 240-777-1760.  There is no cost for the MPX vaccination. 

If you have specific questions related to MPX you may email MPXinfo@MontgomeryCountyMD.gov or call 240-777-1760.

Vaccine Administration

Montgomery County is following federal and state guidance for vaccine administration. A two-dose regime of JYNNEOS (given 28 days apart) will be given intradermally (under the top layer of skin).

When will private healthcare providers, pharmacies or others be authorized to offer this vaccine?

We believe that private providers will eventually have access to vaccine as national supply increases. There is no timeline for rollout of vaccine to private providers in Montgomery County or elsewhere in Maryland.

If someone received a first dose of the Jynneos vaccine and is then infected by monkeypox, are their symptoms lessened? If I get monkeypox between my first dose of the vaccine and second, should I still get the second dose?

Having the first dose will reduce the extent of infection and how bad symptoms are; for the average person there is no benefit to getting a second vaccine.

If you have had a smallpox vaccine when you were younger, do you have any protection from monkey pox virus?

We don’t know the answer to that question. There is probably a small degree of protection but not sufficient to prevent disease.

What if someone starts developing early symptoms while waiting for the vaccine, or finds out that they were recently exposed, would they get priority for vaccinations? How do they update their current request for the vaccine?

Montgomery County is prioritizing vaccination for people without symptoms who have been exposed to monkeypox, as vaccination 4-14 days after exposure can lessen symptoms and prevent illness. At this time, vaccination is not recommended for individuals experiencing symptoms consistent with monkeypox infection. If an individual is experiencing symptoms consistent with monkeypox infection or has had a confirmed case of monkeypox, they are no longer eligible for vaccination as the vaccine is not believed to have any additional benefits. If you believe that you may have monkeypox, we encourage you to contact either your primary care physician or one of the County’s emergency or urgent care centers for testing. For additional information concerning vaccination in special populations, please refer to the CDC.

To update a request for vaccination, email MPXinfo@montgomerycountymd.gov and let us know of any changes to the original registration. Individuals may also let us know if they are no longer interested in receiving a vaccine from Montgomery County.

If spread continues, will there be a consideration to offer vaccine to front line health care providers? They were prioritized for COVID-19 vaccination.

Currently, vaccination is being offered to health care providers who have been exposed. As we receive more supply, healthcare providers who are likely to be exposed to MPX may receive pre-exposure prophylaxis vaccination.