What mpox (formerly monkeypox) is
Mpox (formerly known as monkeypox) is a viral infection in the same family as smallpox. Until recently, it was limited to small ongoing outbreaks in West and Central Africa.
Symptoms of mpox include a new rash or blisters, fever, chills, headache, sore throat, muscle aches and swollen lymph nodes. It usually resolves by itself in two to four weeks, but in severe cases it may need hospital treatment.
Vaccination can reduce the chance of getting mpox. It can also make the illness less severe if you get it.
Is there an mpox outbreak right now?
In 2022 there was a global outbreak of mpox. Outside of Africa, this affected mostly queer men. An organized effort by the community got this under control within a few months. This involved a quick rollout of the vaccine – more on that below! – and harm reduction tools like condoms.
There are two main types (or “clades”) of mpox. The mpox from the 2022 outbreak is a sub-group called clade 2b. In 2024 there has been a rise in 2b cases in Canada, but this is much lower than 2022.
In 2024 there was a new outbreak in West and Central Africa, known as clade 1. This type of mpox appears to be more severe and easier to transmit. There have been a handful of travel-related cases outside Africa in Germany, India, Sweden, Thailand, the United States and the United Kingdom.
The communities affected by mpox outside of Africa are mostly gay and bisexual men and people who are part of this sexual network.
How mpox is transmitted
Mpox is transmitted through close personal contact. This includes skin contact with sores and sharing bodily fluids like semen, saliva and blood. In other words, things like kissing, having sex or sharing a bed with someone who has mpox.
Mpox can also be transmitted indirectly by sharing items like bedsheets, towels, clothing, razors, toothbrushes or utensils. This is because the virus can live on these surfaces.
The only way to fully prevent mpox is to avoid sex or only have sex in a monogamous relationship. This isn’t realistic for everyone though! If you do have casual sex, then there are ways you can lower your risk.
Places where lots of people have sex – like bathhouses and sex parties – may present a higher risk. Some people may avoid these types of events or reduce their number of partners to lower their risk.
Condoms may help prevent getting mpox sores in certain places. Using condoms when you’re bottoming, for example, could help prevent rectal lesions – and these can be painful. However, condoms won’t completely prevent mpox because it can still transmit through kissing and body contact.
The best way to reduce your risk for mpox is getting vaccinated.
Mpox vaccine: The most effective form of prevention
The mpox vaccine is known as Jynneos or Immvamune. It was originally developed to prevent smallpox and is now used to prevent mpox as well, because they are related viruses. Research has shown that the vaccine is highly effective at preventing mpox. It can also reduce the length and severity of illness if you do get sick.
Who should get vaccinated
Mpox vaccination is recommended if you have had or plan to have casual sex or multiple partners and you are also a man who has sex with men or a 2-spirit, trans or non-binary person who identifies as part of this community. It is also recommended if you are a sex worker, no matter your gender.
Mpox vaccine dose
The vaccine is taken in two doses, 28 days apart. You can still take the second vaccine if it has been longer than 28 days since your first. Third vaccine doses are not recommended in Canada and the United States at this time.
How effective is the mpox vaccine?
A study from the UK mpox outbreak estimates that two doses are 80% effective at preventing infection.
Research from the CDC shows that one dose can provide some protection, but it is not as good as two doses. In 2024 in Canada, for example, there have been more mpox cases in people with one dose than two. Most cases are in people with no doses.
Where to get vaccinated
- Alberta - call HealthLink at 1-866-301-2668 for eligibility assessment and to book an appointment
- B.C. - click here to book an appointment with your local health authority
- Ontario - visit GMSH for information on vaccine clinics
- Manitoba - click here to contact your local public health office
- Quebec - click here to book a vaccine appointment
- Saskatchewan - call HealthLine at 811 or 1-877-800-0002 for vaccine assessment and referral
For all other regions, contact your local public health unit.
Mpox symptoms: How mpox affects the body
Mpox symptoms generally show up 7-10 days after being exposed. However, it can happen in as soon as 3 days or as long as 21 days. These symptoms include:
- Rash, lesions or sores
- Fever
- Chills
- Headache
- Nausea
- Sore throat
- Muscle pain
- Fatigue
- Rectal pain
Flu-like symptoms (e.g. fever, chills) may appear a few days before lesions appear. However, they can also happen during or after.
Mpox lesions are often painful. They can be anywhere on the body, but they are usually on the hands, feet, genitals, anus and face. They can also be inside the body, like inside your genitals, throat or rectum.
What to do if you’ve been exposed to mpox
If someone you’ve had sex with tells you they have mpox, your next steps depend on if you have symptoms or if you’ve been vaccinated.
If you have no symptoms and 1 or no vaccine doses
Get a vaccine. The vaccine can reduce the risk of getting mpox when taken after you have been exposed. The sooner you get vaccinated after exposure, the more effective it is. Estimates for the period you can be vaccinated after exposure range from two to three weeks.
If you have no symptoms and 2 vaccine doses
Look out for symptoms for 21 days from your exposure. After 3 weeks, you are in the clear.
If you have symptoms
If you have a new rash or blisters then get tested. See below for more information on testing.
Getting tested for mpox
You can get tested for mpox at most sexual health clinics. Call them in advance to confirm and let them know you have symptoms.
To test for mpox, a clinician will swab any lesions you may have. You should receive the result in a few days. You should also notify any recent partners and isolate while waiting for your appointment and your results.
If you test positive for mpox:
If you test positive for mpox, you will need to isolate at home for the duration of your illness. You can stop isolating when your lesions have healed.
The sores start as small flat marks and then become raised bumps filled with fluid. These will then become open sores that scab over. When the scabs naturally fall off and your new skin underneath is intact, you have recovered and can stop isolating.
If you live with other people or pets, then you will still need to isolate from them as much as you can to minimise transmission risk. This includes wearing masks, not sharing towels or utensils, cleaning surfaces regularly and sleeping in separate rooms where possible.
This guide from Health Canada has detailed information on how to isolate if you or someone in your household has tested positive for mpox.
Recovering at home
Mpox usually resolves by itself. However, it can be unpleasant. There are a few things you can do to make it easier.
It’s important to keep your sores clean and covered with bandages or clothing. Wash your hands before and after touching them. For more information on wound care, check out this guide from the American Academy of Dermatology.
Lesions can be painful, especially ones that are inside your body. If you have rectal lesions, then sitz baths may help. You can also use over-the-counter painkillers to reduce pain, but if these don’t work then contact your health provider about other pain relief options.
Dr. Caley Shukalek, Freddie’s medical director and a sexual health specialist, says that if regular painkillers aren’t enough “you can ask for a prescription for other oral medications like gabapentin or numbing lotions that contain lidocaine.” Lidocaine is also available in a mouthwash, which can help with oral lesions.
When to get help
In some cases, you might not be able to manage recovery on your own. Dr. Shukalek says “if you're not able to control the pain or you're feeling so unwell that you can't seem to manage at home, it's important to seek urgent medical help.” You should also seek medical attention if your rash gets worse, you have mild to moderate bleeding that won’t stop or your fever goes away and then comes back.
Call 911 if you have severe symptoms like chest pain, trouble breathing, heavy bleeding, or you lose consciousness. Let them know you have mpox.
If you test negative for mpox
If you test negative for mpox then follow your healthcare provider’s advice about your original symptoms. If your rash or sores get worse then seek medical care. Since you have tested negative for mpox you will not have to isolate, but you may require treatment for another health condition.
What’s the takeaway?
Even among communities affected by mpox, the current risk in North America is low. The best protection is getting both doses of the mpox vaccine – so it’s worth staying up to date on your shots, even if you think you’re not at risk right now.
The global situation with mpox is evolving, and you can rely on Freddie for the most up-to-date information when it comes to your sexual health. We’re here to support you in having a fun, healthy sex life and making whatever decisions work best for you!
