As monkeypox has spread so has misinformation about the illness, causing confusion and fear. If you’re unclear about how worried you should be about monkeypox and want to make sure you’re following the latest recommendations, we’re here for you. Below, experts clear up misconceptions and provide the facts.
Misconception No. 1: Monkeypox is a new disease, just like COVID-19 is.
Although most Americans have only heard of monkeypox recently, “We’ve known about it since the late 1950s,” says Jessica Justman, MD, associate professor of medicine in epidemiology at Columbia Mailman School of Public Health in New York City. The virus originated in Africa, where it was first detected in a colony of monkeys kept for research purposes. (The World Health Organization, or WHO, has stated its intent to create a new, less stigmatizing name for the disease.) The current outbreak has some unique features. In the past, monkeypox generally spread from animals (primarily rodents) to humans, but now transmission primarily occurs between people. A study published in July in The New England Journal of Medicine (NEJM) analyzed 528 cases of monkeypox in 16 countries. Overall, 98 percent of those infected were gay or bisexual men and other men who have sex with men.
Misconception No. 2: You can get monkeypox by shaking hands, trying on used clothes at a thrift shop, or sharing exercise equipment.
A person who has monkeypox will develop a rash or scabs that can spread the virus when touched, but handshakes don’t present a major risk. A handshake only lasts a matter of seconds, and in this outbreak, transmission typically involves intimate, prolonged skin-to-skin contact, says Amesh A. Adalja MD, senior scholar at the Johns Hopkins Center for Health Security in Baltimore. “It’s usually not something that’s transmitted casually.” Likewise, people don’t need to worry about monkeypox when shopping at thrift stores, even though the CDC says that the virus can spread through soiled linens, said Peter Chin-Hong, MD, professor of medicine and infectious disease expert at the University of California in San Francisco, in an interview with Ryan Seacrest. “It’s not really out in the general population, and we’re talking prolonged contact, skin-to-skin — that’s the main thing,” said Dr. Chin-Hong.
Misconception No. 3: Monkeypox is as contagious as COVID-19.
Monkeypox is not nearly as infectious as COVID-19. “COVID is highly transmissible in a way that monkeypox is not,” says Shireesha Dhanireddy, MD, a professor of medicine and infectious disease specialist at the University of Washington School of Medicine in Seattle. COVID-19 spreads through respiratory droplets such as saliva and very small particles, called aerosols, that float in the air. “For COVID, you go to a public event, chatting at a restaurant, eating at a restaurant — those are exposures,” says Dr. Dhanireddy. “That’s not the type of exposure we’re talking about with monkeypox.” Although respiratory spread of monkeypox is possible, it’s not at all easy, said Chin-Hong. In an interview with CBS News, Chin-Hong estimated that someone would have to spend three to six hours face-to-face “up close and personal” with an infected person not showing any visible lesions for the virus to spread through respiratory secretions. While it may be possible to contract monkeypox from a contaminated object, “It is extremely unlikely to catch monkeypox from something like a door handle or exercise equipment,” Dr. Adalja says. In this current outbreak, only about 0.2 percent — 2 people out of 1,000 — have caught the virus from a contaminated surface, according to WHO data reported by NPR.
Misconception No. 4: Cuddling with someone who has monkeypox is okay as long as you don’t have sexual contact.
The July NEJM study looking at people infected with monkeypox found that in 95 percent of the cases, the person most likely caught the virus through sexual contact. But sexual contact does not have to occur for the disease to be passed from person to person, says Adalja. Even long sessions of kissing or cuddling can result in virus transmission. “If a person with monkeypox had lesions on their skin and their skin rubs against someone else’s skin, that can transmit the disease. The closer the contact and the longer the duration of the contact, the more likely that transmission would occur,” says Adalja.
Misconception No. 5: Monkeypox poses a threat to children and can spread easily in schools and daycare centers.
Very few children have had confirmed cases of monkeypox, and their infection risk is low, according to the American Academy of Pediatrics (AAP). As of August 21, there have been 17 cases in the United States in children 0 to 15 years old and 134 cases in adolescents and young adults 16 to 20. NBC reported on August 5 that an Illinois man with monkeypox may have exposed children at the daycare center where he worked. In an exemption to eligibility rules, federal officials granted those children access to the monkeypox vaccine. If a child has a suspicious rash and has a history of close, personal contact with someone who has a confirmed or probable case of monkeypox, or a history of travel that puts them at risk, they should be tested for monkeypox, according to AAP.
Misconception No. 6: People with monkeypox can’t spread it to their pets.
It is possible for people infected with monkeypox to pass the disease along to their pets. A 4-year-old Italian greyhound developed lesions and tested positive for monkeypox 12 days after its owners first experienced symptoms, according to a case study published in the journal The Lancet. The owners slept together with their dog, suggesting that it may be possible for the virus to be passed from humans to their pets by way of snuggling or sharing a bed, according to the study authors. The CDC now advises people with monkeypox to avoid close contact with their pets.
Misconception No. 7: Most people with monkeypox require prescription medications or hospitalization.
While a monkeypox rash can be extremely painful and cause fever, aches, and exhaustion, patients usually recover without prescription drugs or serious medical interventions. Dr. Justman says that most people with healthy immune systems will eventually clear the monkeypox virus on their own. There are things they can do to feel better in the meantime, such as drinking extra fluids; taking pain relievers such as acetaminophen and ibuprofen; using calamine and other lotions for itching; and rinsing the mouth with salt water to improve oral sores. About 1 in 9 people with monkeypox needed hospitalization in the NEJM study referenced above, mostly commonly for pain and bacterial superinfection. Most cases were “mild and self-limited” and there were no deaths. For people who are hospitalized with monkeypox or are at a higher risk of complications due to certain health conditions, treatment might involve an antiviral medication called tecovirimat (TPOXX), says Justman.
Misconception No. 8: Everyone who is sexually active should get a monkeypox vaccine.
Currently, the CDC is not encouraging mass vaccination for the general public or for all sexually active people. During this outbreak, people who are sexually active aren’t considered to be at risk for monkeypox unless their sexual partners have monkeypox or they have had multiple sexual partners within the past two weeks in areas where monkeypox cases have been reported, according to the CDC. The U.S. Department of Health and Human Services announced vaccine priority will be given to the following individuals:
Those who had close physical contact with someone diagnosed with monkeypoxThose who know their sexual partner was diagnosed with monkeypoxMen who have sex with men who have recently had multiple sex partners in a venue where there was known to be monkeypox or in areas where monkeypox is spreadingThose who also have preexisting conditions, like HIV
Misconception No. 9: The monkeypox vaccine is new.
There are two vaccines used for monkeypox, Jynneos and ACAM2000, says Justman. “Both were developed for smallpox and both use a live virus that is a cousin of the smallpox vaccine,” she says. Jynneos is the preferred vaccine against monkeypox, per the CDC. because unlike ACAM2000 it consists of a virus that is not able to replicate; this makes it safer for people with immune conditions like HIV. “Supplies, however, are very limited at this stage,” Justman says. The White House has announced efforts to ramp up distribution to the vaccine to every state, but there are reports that demand is outpacing supply. According to the U.S. Food and Drug Administration, new strategies are in place to better distribute the vaccine, including dividing a dose into fifths and administering the shot under the top layer of skin rather than into the layer of fat between skin and muscle. If you think you are eligible for the vaccine because of your risk factors or a recent exposure, contact your healthcare provider or your local health department right away.
Misconception No. 10: If you’ve been exposed to monkeypox, you’ve missed your chance to be vaccinated.
Vaccination within four days of a known or presumed exposure to someone with monkeypox can prevent infection, according to the CDC. Getting vaccinated later — between 4 and 14 days following an exposure — may not keep you from getting monkeypox, but symptoms are likely to be less severe.
