Anyone who thinks they have monkeypox or have had close personal contact with someone who has monkeypox should visit a healthcare provider to help them decide if they need to be tested.
Key Characteristics for Identifying Monkeypox
- Lesions are firm or rubbery, well-circumscribed, deep-seated, and often develop umbilication (resembles a dot on the top of the lesion)
- During the current global outbreak:
- Lesions often occur in the genital and anorectal areas or in the mouth
- Rash is not always disseminated across many sites on the body
- Rash may be confined to only a few lesions or only a single lesion
- Rash does not always appear on palms and soles
- Rectal symptoms (e.g., purulent or bloody stools, rectal pain, or rectal bleeding) have been frequently reported in the current outbreak
- Lesions are often described as painful until the healing phase when they become itchy (crusts)
- Fever and other prodromal symptoms (e.g., chills, lymphadenopathy, malaise, myalgias, or headache) can occur before rash but may occur after rash or not be present at all
- Respiratory symptoms (e.g. sore throat, nasal congestion, or cough) can occur
Lesions typically develop simultaneously and evolve together on any given part of the body. The evolution of lesions progresses through four stages—macular, papular, vesicular, to pustular—before scabbing over and desquamation.
The incubation period is 3-17 days. During this time, a person does not have symptoms and may feel fine.
The illness typically lasts 2-4 weeks.
The severity of illness can depend upon the initial health of the individual and the route of exposure. The West African virus genetic group, or clade, which is the clade involved in the current outbreak, is associated with milder disease and fewer deaths than the Congo Basin virus clade.
Epidemiologic Criteria
Within 21 days of illness onset:
- Reports having contact with a person or people with a similar appearing rash or who received a diagnosis of confirmed or probable monkeypox OR
- Had close or intimate in-person contact with individuals in a social network experiencing monkeypox activity, this includes men who have sex with men (MSM) who meet partners through an online website, digital application (“app”), or social event (e.g., a bar or party) OR
- Traveled outside the US to a country with confirmed cases of monkeypox or where Monkeypox virus is endemic OR
- Had contact with a dead or live wild animal or exotic pet that is an African endemic species or used a product derived from such animals (e.g., game meat, creams, lotions, powders, etc.)