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Mpox: Symptoms, testing, care and treatment

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Symptoms

Mpox (previously known as monkeypox) is a viral infection with a rash that may be painful. Most people recover without treatment after a few weeks.

In rare cases, people can become very sick and die.

People usually develop symptoms 7 to 10 days after being exposed to the mpox virus. However, the time it takes to develop symptoms can range from 3 to 21 days after being exposed.

The rash can be painful and can affect any part of the body, such as the:

The rash usually lasts for 2 to 4 weeks and changes through different stages. Finally, scabs form and later fall off. The rash can be accompanied by symptoms such as:

Sometimes people don’t notice a rash, but may have a sore throat or rectal pain.

You’re contagious from the onset of first symptoms until the scabs have fallen off on their own and the skin is healed. You may also be contagious up to 4 days before symptoms begin, but we don't yet know:

If you have symptoms, you should immediately:

Learn more about:

Getting tested

Contact your health care provider to get assessed and tested for mpox.

You can get tested based on a combination of factors, such as:

Symptoms can appear similar to those of other infectious diseases, such as:

This is why it's important to speak to a health care provider and be tested.

Treatment

Treatment for mpox symptoms mainly involves:

There‘s limited data on the clinical effectiveness of specific antiviral treatments for mpox infections in people. These antivirals were first developed to treat smallpox. They may also help treat some cases of mpox. Talk to your health care provider for advice on the best mpox treatment for you.

Vaccines

Health Canada authorized the Imvamune® vaccine for immunization against:

The vaccine is authorized for adults 18 years of age and older at high risk of exposure. The National Advisory Committee on Immunization (NACI) recommends offering the Imvamune® vaccine as a 2-dose primary series to people at high-risk of mpox.

You’re considered to be at high risk if you:

You’re also at high risk of mpox, regardless of your gender, sex or sexual orientation, if you:

If you‘ve only had your first dose of Imvamune®, and it was more than 28 days ago, you should get your second dose.

NACI also recommends offering the vaccine to people:

If you’ve recently been exposed to mpox, consult your local public health office as soon as possible. Post-exposure vaccination is best within 4 days of exposure. However, you can still benefit if you get vaccinated within 14 days after you were last exposed.

Emerging evidence on the effectiveness of Imvamune® shows that:

As with other vaccines, the benefits take full effect a couple of weeks after completing your primary vaccine series.

Provinces and territories base their immunization programs on their needs and circumstances. Contact your local public health authority to learn more:

Vaccination for travellers

Currently, the mpox vaccine is not routinely recommended for travellers, unless they:

If you have mpox

If you have mpox, your local public health authority may tell you to isolate to prevent further spread. You can isolate at home or elsewhere, depending on your circumstances. On this page, we'll use "home" to refer to the place where you isolate.

Follow your local public health authority's advice on isolation, including the length of time they recommend. While isolating, take measures to limit the spread of mpox to others in your household, including pets.

Isolation requirements and recommendations may vary across the country and may change as the situation in Canada evolves.

Learn more about:

When isolating in your home

Stay at home and follow instructions on isolation

Follow the advice of your local public health authority.

Stay in isolation until they tell you that you no longer have to isolate.

This usually occurs once your:

  • scabs have fallen off on their own, and
  • skin is healing and has a light pink or shiny pearl appearance

Do not leave your home unless you need urgent medical care or for other emergencies. Have necessities, such as medication and groceries, delivered to your home. Tell your health care provider about your infection before an in-person appointment, if possible.

If you have no choice but to leave your home, you should:

  • cover your lesions well with clothing or bandages
  • wear a well-fitting medical mask
  • avoid contact with others
  • clean your hands regularly
  • avoid public transportation

Avoid contact with people

Avoid directly touching other people, even if they're fully vaccinated against mpox. This includes avoiding sexual contact.

Where possible, avoid all contact with people who are at risk of more severe disease, such as:

  • young children, including infants
  • people who are pregnant
  • people who are immunocompromised (including those with advanced or uncontrolled HIV)

Limit contact with others from outside the home. This includes not having visitors inside your home, except health care providers or other trained professionals if needed.

If you live with others, isolate in a separate space. For example, use a private room for sleeping and use a separate washroom if possible, especially if you have:

  • weeping lesions
  • lesions that are hard to cover, such as on the face, neck and hands
  • respiratory symptoms such as a cough or sneeze (due to any illness or health condition) particularly if there are lesions in your mouth or throat

If a private room for sleeping isn't available, separate your bed as far away as possible from others.

If a separate washroom isn't available:

  • do not share used towels with other people
  • immediately remove and wash used towels, if possible
  • clean and disinfect all surfaces and objects that you touch

Avoid areas that you share with others in the household.

Learn more about:

Cover your lesions and wear a mask

Cover all your lesions with clothing or bandages as much as possible. This includes when you:

  • have no choice but to interact with others
  • use a shared space, even if nobody else is currently in it

Wear a well-fitting medical mask when around others, such as in a shared space or when receiving care. When this isn't possible, other household members should wear a well-fitting medical mask when they’re with you.

Avoid contact with animals

It's possible for humans to spread mpox to animals.

Avoid all contact with pets, livestock and wildlife. Have someone in your household care for these animals until you are no longer contagious. If this isn't possible, then when caring for your animals you should always:

  • cover all your lesions with clothing or bandages
  • wear a well-fitting medical mask and gloves when near the animals, their food, bedding or other items
  • avoid close contact, like:
    • petting
    • kissing
    • cuddling
    • sharing sleeping areas
    • sharing food
  • clean your hands regularly and cover your coughs and sneezes
  • clean and disinfect high-touch surfaces and objects frequently

This will help limit the potential risk of introducing mpox into animal populations in Canada.

If you've had close contact with an animal during your isolation period, the person caring for the animal should monitor them for symptoms for 21 days after the exposure.

Symptoms in animals may include:

  • fever
  • depression
  • not eating
  • respiratory signs
  • diarrhea
  • oral ulcers
  • skin lesions

If symptoms develop within the monitoring period, contact a veterinarian for advice. Be sure to tell them the animal has been exposed to mpox.

Learn more about:

Avoid sharing items that may be contaminated

Do not share items that may be contaminated with the virus from lesions or body fluids, including:

  • razors
  • clothes
  • utensils
  • needles
  • sex toys
  • toothbrushes
  • linens, towels and bedding
  • children’s toys

Clean your hands

Clean your hands properly and frequently by washing them with soap and water for at least 20 seconds.

  • if soap and water aren’t available, use a hand sanitizer containing at least 60% alcohol

Cover your coughs and sneezes

If you have respiratory symptoms, it's especially important to cover your coughs and sneezes. You should:

  • cough or sneeze into a tissue or your elbow, not your hand
  • throw any tissues you've used into a plastic-lined waste container as soon as possible
  • clean your hands immediately afterwards

Keep your environment clean

Clean and disinfect all surfaces and objects that you've had contact with.

Handle and wash your own clothes, bedding, towels and other laundry, unless you can’t.

Handle your own used utensils and dishes, unless you can’t.

Learn more about:

Postpone non-urgent appointments

Postpone all non-urgent medical visits and procedures, like elective dental visits or blood tests.

Do not donate body fluids or tissues, including blood and sperm.

If you're in close contact with young children

Ask your health care provider for advice if you're in close contact with young children, including infants. For example, if you're providing care to a young child or breastfeeding.

Seeking medical care

If you're feeling unwell, contact your health care provider immediately.

If you call an ambulance, tell the dispatcher that you have or may have mpox. Follow any directions they provide.

If you use a private vehicle to access medical care, call ahead to let them know that you have or may have mpox. Do not use public transportation unless you have no other choice.

While travelling in a private vehicle or on public transportation, use personal protective measures to lower the risk of transmission:

  • cover all lesions with clothing or bandages
  • wear a well-fitting medical mask
    • If you can't wear a mask, all other passengers should do so
  • keep the number of passengers in the vehicle as low as possible
  • keep as far away from others as possible

After travelling in a private vehicle, properly clean and disinfect any surfaces or objects in the vehicle that you may have touched, such as:

  • door handles
  • seats
  • seatbelts

Risk reduction after recovering from mpox

We're still learning about how mpox spreads, including possible risks after a person recovers. Live mpox virus has been found in the bodily fluids, including semen, of some people several weeks after their recovery.

Because of this, you should use barrier protection like condoms and dental dams during sexual activity after you’ve recovered. This may help lower the risk of spreading mpox through genital fluids, and lower your partners’ risk of being exposed.

At this time, the World Health Organization suggests using condoms for 12 weeks after recovering from mpox. This also helps prevent the spread of other sexually transmitted infections.

Learn more about:

Providing care at home to someone with mpox

Ideally, only one person should care for someone who has mpox. This will help reduce the risk of spreading mpox to others.

The caregiver should not be someone who is at risk of more severe disease from mpox, including someone who is:

If you're caring for someone with mpox, contact your local public health authority about getting vaccinated against mpox. Continue to watch for signs or symptoms of mpox for 21 days after your last exposure to the person. If signs or symptoms develop, immediately isolate, contact your local public health authority and follow their instructions.

To lower your risk of getting mpox from the person you’re caring for:

You should also:

If you can't avoid close contact with someone you're caring for:

Learn more about:

If you've been exposed

If you know you've been exposed to someone with mpox, contact your local public health authority immediately. Your local public health authority may also tell you that you've been exposed to someone with mpox. They will instruct you on what to do and how to lower the risk of further spread.

You can still get mpox even if you've been fully vaccinated.

Instructions depend on your exposure risk level, which may range from lower (a short social interaction with a case) to higher risk (a household member has mpox). If you've had a high-risk exposure, you may be advised to refrain from sexual contact with others.

In some cases, you may be instructed to:

Watch for symptoms, even mild ones, for 21 days after exposure. Avoid taking medications that are known to lower fever, such as acetaminophen, ibuprofen and acetylsalicylic acid. They can mask an early symptom of mpox.

If you develop symptoms, isolate immediately and contact your local public health authority or health care provider. Tell your health care provider that you've been exposed before going to an in-person appointment, when possible.

Hand and environmental hygiene

Proper hand and environmental hygiene can lower the risk of getting or spreading mpox.

Hand hygiene

Wash hands regularly with soap and water for at least 20 seconds. If soap and water aren’t available, use hand sanitizer containing at least 60% alcohol. When hands are visibly dirty, you should wash them with soap and water instead of using hand sanitizer.

If you have mpox, clean your hands before touching common surfaces and objects.

If you're a caregiver or household member of someone with mpox, clean your hands:

Avoid touching your eyes, nose or mouth with unclean hands.

Disposable gloves

Always clean your hands before and after using gloves.

If gloves become soiled or torn:

To remove gloves safely:

Learn more:

Handling laundry

If you have mpox, you should handle your own laundry if possible, including clothes, towels and bed linens.

Remove any potentially contaminated laundry and bedding from the room. Then clean and disinfect surfaces and objects to lower the risk of contamination.

Wash your contaminated laundry in a washing machine using hot water (70 °C) and detergent. Your laundry must be completely dried using a clothes dryer.

If you don't have access to a washing machine and dryer, contact your local public health authority. They may be able to help you.

If you're handling the laundry of someone with mpox:

Learn more about:

Cleaning and disinfecting surfaces and objects

Cleaning and disinfecting is especially important for high-touch surfaces, such as:

If you have mpox, frequently clean and disinfect surfaces and objects that you may have come into contact with.

If you don’t have mpox but you're cleaning and disinfecting surfaces or objects that someone with mpox has come into contact with, you should wear:

If a surface or object is visibly dirty, clean it first with regular cleaning products, then use a disinfectant. Always follow product label directions. If you're using household bleach, follow instructions on how to properly dilute it.

Learn more:

When cleaning hard surfaces and flooring, use a wet mop or cloth with disinfectant instead of dry sweeping and dusting. Dry methods of cleaning may disturb dust and spread infectious particles.

We recommend using single-use disposable cleaning products, such as disposable towels. If they aren't available:

Discard the cleaning products after use if you can't wash or disinfect them.

After you've recovered from mpox, clean and disinfect all the spaces you accessed in the home. Someone else can do this for you, if needed. Thorough cleaning and disinfecting will lower the potential risk of transmission to other household members or visitors.

Learn more about:

Cleaning furniture and carpets

Cover upholstered furniture that can't be easily washed or cleaned. Use a covering that you can wash frequently, such as a sheet or blanket. If upholstered furniture and carpets become visibly dirty from weeping lesions or body fluids, use commercial cleaning products. Ask your local public health authority for advice if furniture is very dirty.

If you have mpox and are isolating in a home with other people, avoid vacuuming your upholstered furniture and carpet floors. Vacuuming could spread infectious particles to others. If you're isolating at home alone, use a vacuum with a high-efficiency particulate air (HEPA) filter, if available.

After you have recovered from mpox, vacuum your home thoroughly. Do this without others present, especially if they're at risk of more severe disease from mpox. Follow these steps:

Ventilating your home will help remove any potentially infectious particles and lower the risk of transmission to others who enter your home.

Cleaning dishes and utensils

If you have mpox, you should handle and wash your own used dishes and utensils. Do not share your dishes and other eating utensils.

Utensils should be properly washed between uses, which you can do by:

If you can't clean them yourself, your caregiver should make sure they are properly washed.

Waste management

Examples of contaminated waste from the person with mpox or their caregiver include:

When disposing of contaminated waste, ensure that it can't be accessed by people, pets or wild animals, especially rodents. To do this:

Immediately after handling contaminated waste, wash your hands with soap and water. If these are not available, use hand sanitizer containing at least 60% alcohol.

Supplies

When you’re isolating at home, you’ll need:

Recommended hygiene products include:

Read and follow manufacturer's instructions for safe use of cleaning and disinfection products.

Reach out to family, friends or neighbours if you can't get these supplies. You can also contact your local public health authority or a community organization for advice, support and resources.

If you're isolating or providing care, do so where you have access to running water, if possible. This will make it easier to wash your hands, clean, disinfect and do laundry.

Learn more about:

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