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Monkeypox treatment information available online today

Monkeypox and smallpox viruses are genetically similar, which means that antiviral drugs and vaccines developed to protect against smallpox may be used to prevent and treat monkeypox virus infections. Consult with one of our board-certified doctors online today to discuss monkeypox treatment plans.*

Avoid contact with the monkeypox rashes, scabs, or bodily fluids Symptoms begin within 3 weeks of exposure Be aware of animal to human transmission

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Learn about monkeypox

Monkeypox is a viral infection that occurs primarily in central and western Africa. The monkeypox virus is closely related to the human smallpox virus and shares many of the same symptoms. In May 2022, an outbreak of monkeypox in numerous countries was reported, including the United States. Most cases are due to human to human transmission, and have occurred in men likely due to close contact with infectious skin lesions during sexual contact. Due to the multi-country monkeypox outbreak, the World Health Organization has declared monkeypox a global health emergency. The monkeypox illness typically lasts two to four weeks, during any time in this time frame, the infected person can pass the monkeypox virus infection.

Monkeypox causes

Monkeypox virus is from the same family of viruses that causes smallpox. According to the World Health Organization, the main natural source of the monkeypox virus has yet to be identified. The Centers for Disease Control and Prevention (CDC) states that there are two main ways the human monkeypox infection can spread:

Animal to human transmission

A human can get the monkeypox virus from infected wild animals in the following manners:

Scratched/bitten by the infected animal
Close contact with the infected animals
Consuming meat of the infected animals

Human to human transmission

Monkeypox human to human infection can happen via direct or indirect contacts. For transmission through close contact, the virus can pass from an infected person to the next person by directly coming into contact with the monkeypox rash, scabs, or bodily fluids. Such close physical contact can take place during:

Hugging, massage, and kissing
Oral, anal, and vaginal sex or touching the genitals
Breathing in the respiratory droplets of the infected person (when the person coughs or sneezes)
Touching/sharing the same objects, fabrics (clothing, towels) as the infected person
According to the Centers for Disease Control and Prevention (CDC), a pregnant person can spread the virus to their baby.

Monkeypox symptoms

Monkeypox symptoms begin within 3 weeks of exposure to the monkeypox virus. The symptom progression may vary from person to person. Some people get a rash first, followed by other symptoms, while others only get the rash. The typical initial symptoms of monkeypox are flu like symptoms, including:

Fever
Chills
Headache
Swollen lymph nodes
Exhaustion
Muscle aches and backaches
Respiratory symptoms (e.g. nasal congestion, or cough)

These early symptoms are then followed by the characteristic rash that may be located on or near.

Genitals (penis, testicles, labia, and vagina) or anus (butthole)
Extremities such as hands and feet
Chest
Face or mouth

The rash can then develop into skin lesions, mucosal lesions, scabs, before healing.

How to treat monkeypox

There are currently no specific treatments for the virus. Most patients have a mild self-limited disease and can get better within 2 to 4 weeks by themselves. According to the CDC, some antiviral treatments (eg, tecovirimat (TPOXX), cidofovir) maybe effective against monkeypox. Vaccinia Immune Globulin Intravenous (VIGIV) can also be considered in patients with compromised/weak immune systems.

In addition, post-exposure prophylaxis can also be considered after exposure (within four days and up to 14 days after exposure). When you seek medical care with PlushCare, our online medical team will first consult the appropriate state health department (State Contacts) or CDC through the CDC Emergency Operations Center (770-488-7100) as soon as monkeypox is suspected. If you meet the probable or confirmed case definition, we will ask you to please contact the CDC Monkeypox Call Center at poxvirus@cdc.gov to report the case and obtain the case report form. Our online medical team will also interact with public health authorities regarding monkeypox prophylaxis (eg, PrEP, PEP) and antiviral treatment.

Monkeypox medication

Currently, due to unknown efficacy, there is no treatment approved specifically for monkeypox virus infections. Most available data from in-vitro or animal studies was with orthopoxviruses or extrapolated from prior human use in smallpox. However, antivirals developed for use in patients with smallpox may prove beneficial against monkeypox. According to CDC, some available options are:

Tecovirimat (TPOXX, ST-246)

TPOXX is an FDA approved antiviral medication that treats smallpox in adults and children. Tecovirimat is available as a pill or an injection.

Vaccinia Immune Globulin Intravenous (VIGIV)

VIGIV is used to treat complications due to vaccinia vaccination including eczema vaccinatum, progressive vaccinia, etc. According to CDC, VIGIV may be used as treatment of orthopoxviruses (including monkeypox) in an outbreak. VIGIV can also be used as PEP in immunocompromised when Jynneos/ACAM200 is contraindicated.

Cidofovir (Vistide)

Vistide is an FDA approved antiviral medication for treating cytomegalovirus (CMV) retinitis in patients with Acquired Immunodeficiency Syndrome (AIDS). However, it has shown to be effective against orthopoxviruses in studies. Vistide is administered via a one-hour IV infusion weekly, for two consecutive weeks. Vistide has been used in pediatric and adult populations. It is limited by nephrotoxicity and risk of neutropenia, as well as carcinogenic, teratogenic and hypospermia risk profile. Vistide is stockpiled and available from the federal government to dispense to states.

Brincidofovir (CMX001 or Tembexa)

CMX001 is an FDA approved antiviral medication treating human smallpox CMX001 is a two-dose oral antiviral FDA approved for smallpox treatment for all ages (neonate to adult). It is dosed weekly for two consecutive weeks. CMX001 is not yet available in the US from the Strategic National Stockpile (SNS).

How to avoid monkeypox

Some ways to avoid monkeypox include:

Avoid close contact with people who have a rash that looks like monkeypox.
Avoid handling clothes, sheets, blankets or other materials that have been in contact with an infected animal or person.
Isolate people who have monkeypox from healthy people.
Wash your hands well with soap and water after any contact with an infected person or animal.

There are currently no specific monkeypox vaccines. However, smallpox vaccination has been shown to be effective in preventing monkeypox infections. Additional details of smallpox vaccination can be found on the CDC website. JYNNEOS and ACAM2000 are the two vaccines available for preventing monkeypox infection in the United States. Currently these prevention measures are typically for people who are at risk for monkeypox infection (e.g. healthcare professionals, research/clinical lab personnel working on monkeypox virus).

When to see a doctor for monkeypox virus infection

Contact our online healthcare team today if you:

Feel sick with fever, aches or swollen lymph nodes.
Have a new rash or sores.
Have been in close contact with a person who is infected.

Note: The CDC recommends that all individuals should immediately self-isolate and contact the health department if symptoms onset. If you are experiencing these symptoms, you should go to the ER:

Trouble breathing.
New or worsening chest pain.
Stiff neck.
Difficulty speaking or moving.
Loss of consciousness.
Seizures.

When you seek medical care with PlushCare, our online medical team will first consult the appropriate state health department (State Contacts) or CDC through the CDC Emergency Operations Center (770-488-7100) as soon as monkeypox is suspected. If you meet the probable or confirmed case definition, we will ask you to please contact the CDC Monkeypox Call Center at poxvirus@cdc.gov to report the case and obtain the case report form.

Monkeypox treatment FAQs

What is monkeypox?

Monkeypox is a rare viral infection that primarily occurs in central and western Africa. The monkeypox virus is closely related to the human smallpox virus and shares many of the same symptoms. Monkeypox is characterized by a rash that starts out as small red bumps and eventually turns into large blisters. The virus can also cause fever, headache, muscle aches, and fatigue. In severe cases, monkeypox can lead to pneumonia or death.

How is monkeypox transmitted?

The monkeypox virus can spread from person-to-person through:

Direct contact with the monkeypox sores, skin lesions or body fluids
Breathing in respiratory droplets of infected person
Touching items (eg, clothing) or surfaces that had previously come into contact with the infectious rash/skin lesion/body fluids
Pregnant mothers can pass the virus to their baby

A human can get the monkeypox virus from infected wild animals in the following manners:

Scratched/bitten by the infected animal
Close contact with the infected animals
Consuming meat of the infected animal

What are you supposed to do if you think you were exposed to monkeypox?

If you think you were exposed to monkeypox, CDC recommends that you visit a healthcare provider that can help decide if you need to be tested for monkeypox. The healthcare provider can also collect the appropriate biological samples for laboratory testing and provide a formal diagnosis of monkeypox. Our online medical team will first consult the appropriate state health department (State Contacts) or CDC through the CDC Emergency Operations Center (770-488-7100) as soon as monkeypox is suspected. If you meet the probable or confirmed case definition, we will ask you to please contact the CDC Monkeypox Call Center at poxvirus@cdc.gov to report the case and obtain the case report form.

What does monkeypox look like?

Patients with monkeypox infections can get a characteristic rash. The rash look like pimples or blisters and may be found on or near the genitals (penis, testicles, labia, and vagina) or anus. The rash can also show up on the hands, feet, chest, face, or mouth. The rash maybe itchy or painful for some patients.

What are the symptoms of monkeypox?

Monkeypox symptoms begin within 3 weeks of exposure to the monkeypox virus. The typical initial symptoms of monkeypox are flu like symptoms, including:

Fever
Chills
Headache
Swollen lymph nodes
Exhaustion
Muscle aches and backache
Respiratory symptoms (e.g. nasal congestion, or cough)

These early symptoms are then followed by the characteristic rash may be located on or near:

Genitals (penis, testicles, labia, and vagina) or anus
Extremities such as hands and feet
Chest
Face or mouth

How contagious is monkeypox?

Risk factors for human monkeypox virus infection include:

Travel to an affected region
Exposure to infected individuals
Occupational exposure (e.g. healthcare professionals)

The monkeypox virus can pass from an infected person to the next person by directly coming into contact with the monkeypox rash, scabs, or bodily fluids during:

Hugging, massage, and kissing
Oral, anal, and vaginal sex or touching of the genitals

In addition, the virus can also spread in the following manner:

Breathing in the respiratory droplets of the infected person (when the person coughs or sneezes)
Touching/sharing the same objects, fabrics (clothing, towels) as the infected person

Step 1

Book a monkeypox consultation appointment.

Book a same day appointment from anywhere.

Step 2

Talk to your medical provider regarding your monkeypox symptoms.

Visit with a doctor on your smartphone or computer.

Step 3

If prescribed, pick up a prescription to treat your monkeypox.

We can send prescriptions to any local pharmacy.

Related conditions to monkeypox

Other conditions may appear with symptoms that look very similar to the rashes caused by Monkeypox. These other rash illnesses include:

Smallpox - a highly contagious disease that is caused by the variola virus

Chickenpox - a milder form of the same virus that causes shingles

Both of these diseases can be prevented with vaccines. (The smallpox vaccine is no longer given in the United States because the disease has been eradicated.)

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