Monkeypox – What Should I Know?



With over 17,000 people in the United States now having been infected, overall case counts are starting to decrease over the last few weeks.  While monkeypox can affect anyone, the risk of contracting monkeypox in the general public remains incredibly low.  Among U.S. monkeypox cases with available data, 99% of cases occurred in men, 94% of whom reported recent male-to-male sexual or close intimate contact.  

Transmission: The California Department of Public Health reports that, to date, there has been no evidence that monkeypox has been spread by attending an outdoor event with fully clothed people, trying on clothes or shoes at a store, traveling in an airport, on a plane or on other public transit, swimming in a pool or body of water, or through casual contact with other people.  Monkeypox is spread through direct skin-to-skin contact with the sores, scabs or body fluids (e.g. drainage from skin sores or saliva that was in contact with mouth sores) of people with monkeypox, prolonged face-to-face or intimate contact, such as kissing, cuddling, or sex with people with monkeypox, or touching items that previously touched the sores or body fluids of people with monkeypox.

Symptoms: Monkeypox often starts with symptoms like the flu, with fever, low energy, swollen lymph nodes, and general body aches.  Usually within 1-3 days after fever a rash or sores develop.  The sores appear like pimples or blisters, may be painful and itchy, and go through several stages, including scabs, before healing.  Some people develop rash without the other symptoms, but far fewer people develop symptoms without a rash (this would be uncommon).  Though they are related, monkeypox is less contagious than smallpox and causes less severe illness. Rates of severe disease are very low with modern medical treatment.

Vaccination: Monkeypox vaccine (JYNNEOS) is approved by the U.S. Food and Drug Administration (FDA) to prevent both monkeypox and smallpox. Vaccination helps protect against monkeypox when given before or shortly after an exposure.

JYNNEOS remains in very short supply, and we only recommend it for those at high-risk of contracting the disease, which the San Mateo County Health Department currently defines as:

  • Gay, bisexual, and other men or trans people who have sex with men, who have had more than 1 sexual partner in the past 14 days 
  • Sex workers of any sexual orientation or gender identity
  • Persons who have had close contact within the past 14 days with someone with suspected or confirmed monkeypox 
  • Persons who had close contact with others at a venue or event or within a social group in the past 14 days where a suspected or confirmed monkeypox case was identified. This includes persons who received notice from a venue or event of a potential exposure within the past 14 days
  • Laboratory workers who routinely perform monkeypox virus testing
  • Clinicians who have had a high-risk occupational exposure (e.g., examined monkeypox lesions or collected monkeypox specimens without using recommended personal protective equipment)

We are here for you: If you have a new or unexplained rash or other symptoms or if you think you are at high risk of having been exposed, please reach out to your Village Doctor to talk through your symptoms or concerns. 

Helpful sites with more information:

WHO Monkeypox Site

US Center for Disease Control Monkeypox Site

California Department of Public Health Monkeypox Site

San Mateo County Health Department Monkeypox Site

New England Journal of Medicine Monkeypox International Case Series Report

CDC Morbidity and Mortality Weekly Report (MMWR) on Use of JYNNEOS vaccine, June 3, 2022

CDC Morbidity and Mortality Weekly Report (MMWR) on Epidemiologic and Clinical Characteristics of Monkeypox Cases, August 12, 2022


Jennifer Abrams, MD, October 3, 2022