Mpox (Monkeypox)

Mpox is a rare, but serious disease caused by the mpox virus. It can be spread from infected humans, animals, and materials contaminated with the virus. While generally less severe and much less infectious than smallpox, mpox can be a serious illness.

The risk to most Hawaii residents remains low. Anyone who has direct skin-to-skin or prolonged close contact with someone with mpox is at risk of infection—regardless of who they are, what they do, or if they are sexually active.

Nationwide and in Hawaii, mpox cases have been disproportionately reported among social networks of gay or bisexual men, or other men who have sex with men. While many of those affected in the current outbreaks identify as gay or bisexual, anyone who had direct skin to skin or prolonged close contact with someone with mpox is at risk of infection.

Infection begins with flu-like symptoms such as fever, headache, muscle aches, chills, exhaustion, and swollen lymph nodes. Infection progresses to a rash or sores, often on the hands, feet, chest, face, or genitals. Individuals generally become ill within 21 days of exposure. People may have all of the symptoms or only a few.

Yes, vaccines can prevent disease or reduce the severity of mpox disease. If administered after exposure to mpox , vaccines work best when administered within 4 days.

Yes, treatment is available, but it must be coordinated through your healthcare provider and DOH. If you think you’ve been exposed to mpox or have symptoms of mpox, call your healthcare provider and notify them of your situation. Read more here.

Mpox is diagnosed through laboratory testing. Your healthcare provider can order testing.

Mpox is primarily spread from person to person through close, prolonged physical contact. It is much harder to spread than COVID-19, colds, or the flu.

• Mpox can be spread through direct skin-to-skin or prolonged close contact with someone who has mpox. This can include sexual/intimate contact, cuddling, or kissing while a person is infected.
• Mpox can spread by sharing a bed with someone who is infected or by sharing items like towels or unwashed clothing.
• Mpox can spread through large respiratory droplets. These droplets generally cannot travel more than a few feet, so prolonged face-to-face contact is required.
• Mpox has not been proven to spread through touching items like doorknobs or by walking past someone who is infected.

A person with mpox is infectious from the time symptoms start to when the rash has fully healed and a new layer of skin has formed. Mpox typically lasts 2-4 weeks. People who do not have mpox symptoms cannot spread the virus to others.

There are a number of simple steps you can take to help prevent getting infected with mpox.

• Get vaccinated if you are at risk of mpox
• Reduce your risk of mpox during sex or social gatherings where there is direct, personal, skin-to-skin contact
• Avoid close, skin-to-skin contact with people who have a rash that looks like mpox and animals that carry the mpox virus
• Avoid contact with objects and materials that a person with mpox has used
• Wash your hands often

Mpox can spread through close contact (including intimate or sexual contact) with a person with mpox, through contact with contaminated materials, and through direct contact with infected wild animals. Mpox can spread during sex by:

• Oral, anal, and vaginal sex, or touching the genitals or anus of a person with mpox
• Hugging, massaging, kissing, or talking closely
• Touching fabrics, shared surfaces, and objects, such as bedding, towels, and sex toys, that were used by a person with mpox

Individuals who have symptoms consistent with mpox should contact their healthcare provider. Make sure to call ahead and mention that you may have been exposed to mpox.

Contact your healthcare provider and let them know that you are a close contact. Your healthcare provider can work with DOH to arrange testing and vaccination if appropriate.

Mpox can spread through direct, prolonged skin-to-skin contact with someone who has mpox symptoms.

Personal service providers should consider asking clients about any new or unexplained rash or sores and take precautions.

Nationwide and in Hawaii, mpox cases have been disproportionately reported among social networks of gay or bisexual men, or other men who have sex with men. While many of those affected in the current outbreaks identify as gay or bisexual, the risk of mpox is not limited to people who are sexually active or men who have sex with men.

Those who should consider getting vaccinated against mpox include individuals who meet the following criteria:

• Gay, bisexual, and other men who have sex with men, as well as transgender or nonbinary people who in the past 6 months have had one or more of the following:
  • A new diagnosis of 1 or more sexually transmitted infections
  • Multiple or casual sex partners (e.g., such as through dating apps)
• People who have a sex partner in any of the categories described above
• People who anticipate experiencing any of the above
• Anyone with close contact in the last 14 days to a person with known or suspected mpox infection
• Travelers to a country with a clade I mpox outbreak who anticipate any of the following activities during travel, regardless of gender identity or sexual orientation:
  • Sex with a new partner
  • Sex at a commercial sex venue (e.g., a sex club or bathhouse)
  • Sex in exchange for money, goods, drugs, or other trade
  • Sex in association with a large public event (e.g., a rave, party, or festival)
• Anyone in any of these categories who has only received one vaccine dose

Parental consent is required for vaccination of individuals under 18 years of age.

Workers in certain occupational groups are also eligible: Clinical laboratory personnel performing diagnostic testing for orthopoxviruses and research laboratory personnel who directly handle cultures or animals contaminated or infected with orthopoxviruses (see ACIP recommendations).

• Most people who get the JYNNEOS vaccine have minor reactions. These may include pain, redness, swelling, firmness, or itching where the shot was given, especially for intradermal injection (between layers of the skin). Some people have reported reactions lasting 2-4 weeks, or longer.
• You also may have muscle pain, headaches, nausea, chills, or may feel tired. There is a small chance of fever. As with any medicine, there is a very small chance of a vaccine causing a severe allergic reaction.

• If you have signs of a severe allergic reaction (such as hives, swelling of the face or throat, difficulty breathing, a fast heartbeat, or dizziness), call 911 immediately or go to the nearest hospital. For other concerns, contact a health care provider.
• Adverse reactions should be reported to the Vaccine Adverse Event Reporting System (VAERS). Your health care provider will usually file this report, or you can do it yourself. Visit the VAERS website or call 800-822-7967. VAERS is only for reporting reactions, and VAERS staff members do not give medical advice.
• You can visit the FDA website (PDF) to read the package insert for this vaccine. For more information on the vaccine, visit the CDC JYNNEOS Vaccine Statement (PDF) and the CDC’s Consideration on Mpox Vaccine site.