How it spreads

Close or intimate contact

There are two types of monkeypox: clade I and clade II.

Both classes can be spread through:

• Close contact (including intimate or sexual contact) with a person with monkeypox
• Contact with contaminated materials used by a person with monkeypox
• Direct contact with live or dead infected wild animals in some parts of West and Central Africa where monkeypox occurs regularly

A person can spread monkeypox from the time symptoms start until the rash has completely healed and a new layer of skin has formed. Data from 2022 suggests that some people can spread monkeypox from 1 to 4 days before showing symptoms, but no evidence suggests that people who never have symptoms can spread the virus to someone else. The CDC continues to study how monkeypox is spread.

Close or intimate contact

Monkeypox can be spread to anyone through close, personal contact, including:

• Direct skin-to-skin contact with monkeypox rash or scabs from a person with monkeypox
• Contact with saliva, upper respiratory secretions (snot, mucus) and body fluids or lesions around the anus, rectum or vagina from a person with monkeypox
• Pregnant women with monkeypox can transmit the virus to the fetus during pregnancy or to the newborn during and after birth.

Direct contact can occur during intimate contact, including:

• Oral, anal or vaginal sex or touching the genitals (penis, testicles, labia and vagina) or anus
• Hugs, massages and kisses

Touching objects

The virus that causes monkeypox can be spread through contact with objects, substances, and surfaces that have not been disinfected after use by a person with monkeypox. This includes items such as clothing, bedding, towels, dishes, utensils, fetish equipment or sex toys.

Infected animals

Monkeypox can spread from animals to humans in several ways:

• Through small wild animals in West and Central Africa, where monkeypox is endemic (found regularly).
• During activities such as hunting, trapping or treating infected wild animals in areas where monkeypox is endemic.
• Direct close contact with an infected animal or their fluids or waste, or being bitten or scratched.

People are less likely to get monkeypox from a pet or livestock, or vice versa, but it is possible.

To reduce the risk of spreading monkeypox between animals and humans:

• Avoid close contact with an animal that may have monkeypox, including petting, petting, hugging, kissing, licking, and sharing sleeping quarters or food.

• Avoid contact with animals, including pets, if you have monkeypox.

How monkeypox doesn’t spread

Through the air

The disease is not known to spread in settings where only respiratory spread is possible, such as across rooms, in markets or classrooms, in offices or during travel. Some studies suggest that the virus can be found in respiratory droplets, and spread has been shown to sometimes occur between animals in a laboratory that are housed separately but very close together for long periods of time. However, data from real outbreaks suggest it is not likely to spread from person to person through the air. Currently, the CDC recommends that people with monkeypox wear a mask when they are around others, including when they are receiving care. The CDC also recommends that people caring for someone with monkeypox use appropriate personal protective equipment to avoid getting the disease

Hot tubs or pools

No studies have found a clear link between monkeypox and water in pools, hot tubs or splash pads. The monkeypox virus is killed in water at the chlorine levels recommended for disinfection in recreational water sites by the CDC and required by US jurisdictions.