Monkeypox
Section NavigationU.S. Outbreak 2022: Situation Summary
Updated July 28, 2022
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What You Need to Know
CDC is tracking an outbreak of monkeypox that has spread across several countries that don't normally report monkeypox, including the United States.
The monkeypox virus is spreading mostly through close, intimate contact with someone who has monkeypox.
You can take steps to prevent getting monkeypox and lower your risk during sex.
CDC recommends vaccination for people who have been exposed to monkeypox and people who are at higher risk of being exposed to monkeypox.
If you have any symptoms of monkeypox, talk to your healthcare provider, even if you don't think you had contact with someone who has monkeypox.
CDC is urging healthcare providers in the United States to be alert for patients who have rash illnesses consistent with monkeypox.
Updated July 27, 2022
CDC has experience responding to monkeypox. We have the tools to effectively respond to this outbreak and are working in several areas to help stop the spread of the virus and end the outbreak.
Case identification and contact tracing
Through Health Alert Network (HAN) advisories, Clinician Outreach and Communication Activity (COCA) calls, and other outreach to the clinical community, CDC has urged healthcare providers to be vigilant and lookout for the rash associated with monkeypox. CDC has also shared detailed information about how to identify and test for potential infections through these channels.
CDC provides advice to U.S. state, tribal, local, and territorial health departments on tracking potential cases, contact tracing, and responding to additional identified cases.
CDC works with these health officials to identify people potentially exposed to the virus and inform them about how to monitor their health and seek care if symptoms appear.
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Testing and case confirmation
CDC supports diagnostic testing at Laboratory Response Network labs, which conduct tests for orthopoxviruses, including the monkeypox virus.
CDC uses its own labs to conduct viral characterization testing specifically for monkeypox.
CDC has expanded access to its orthopoxvirus test for use in commercial labs, increasing testing capacity and making it more convenient for providers and patients to access tests. The five largest U.S. commercial laboratories are now conducting orthopoxvirus tests, bringing total U.S. testing capacity to 80,000 per week.
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Investigating to better understand the outbreak and inform response efforts
CDC researchers are collaborating with partners to learn:
How long the virus has been circulating.
How the virus was introduced into some of the current clusters of cases.
The clinical course of illness.
Whether the virus is being spread through contact with semen or vaginal fluids.
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Global coordination
With cases of monkeypox being reported in several countries around the world, CDC is collaborating and consulting with other countries experiencing monkeypox.
This includes partnering with Nigeria Centers for Disease Control on testing and sequencing to better understand the evolution of the virus in Nigeria and the current global outbreak.
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Outreach to clinicians
CDC has been distributing detailed information on monkeypox to clinicians to help them identify potential infections and order testing for patients.
Much of that information shared through interactive partner calls that include:
Hosting Clinician Outreach and Communication Activity (COCA) calls that shared information with more than 17,000 participants.
Disseminating news of new commercial laboratory testing options to more than 64,000 subscribers of its COCA Now email updates.
Distributing Health Alert Network notices to inform thousands of clinicians about updated and expanded case definitions to encourage testing for monkeypox in people with a rash and who may be at risk for developing the virus.
Sharing weekly updates with more than 90 partner organizations, including state, tribal, local, and territorial agencies, public health organizations, and clinical, community, and LGBTQ+ organizations that forward information to their members.
Conducting ongoing consultations through a Clinician Call Center that was promptly set up to respond to individual providers and state and local health officials.
CDC works with our partners to learn how long the virus has been circulating; how it was introduced into some of the current clusters of cases; the clinical course of illness; and how the virus is being spread.
CDC helps clinicians get access to vaccines and therapeutics for people who may have been exposed to monkeypox.
CDC provides technical assistance and responds to inquiries and information requests from state, tribal, local, and territorial health departments and partner organizations.
CDC also holds weekly partner calls and distributes a weekly partner resource email that is widely distributed across a wide cross-section of partners.
CDC held a monkeypox webinar for the American Medical Association.
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Raising awareness among partners, disproportionately affected communities, and the public
Many—though not all—of the reported monkeypox cases have been among gay, bisexual, and other men who have sex with men. Because of this, CDC has emphasized the need to identify and use specific channels to promote messages that directly reach gay and bisexual men (across racial, ethnic, socioeconomic, and geographic backgrounds).
CDC provides information to a wider audience about symptoms and the behaviors that can lead to the spread of monkeypox.
CDC's webpage Reducing Stigma in Monkeypox Communication and Community Engagement offers tips for creating and sharing informational and prevention messages in a way that reduces the chances of stigmatizing people infected with (or potentially exposed to) monkeypox virus.
CDC is raising awareness of the current situation with multiple partners to reach disproportionately affected communities, including by working with our partners at Building Healthy Online Communities to build awareness via social media.
CDC works with community health organizations, including multiple partners in the LGBTQIA+ community, to raise awareness of the outbreak and share accurate information about what people can do to protect their health and the health of others.
CDC developed informational materials for consumers, including fact sheets for sexually active people and for social gatherings [119 KB, 2 pages] where sex or other prolonged, close contact may occur.
CDC responds to questions from the media and questions received via CDC INFO.
Infection prevention and control
CDC updated its website on infection prevention and control in healthcare settings to provide more detail on waste management. Sections about visitation and the management of healthcare personnel and patients exposed to monkeypox were also added.
CDC posted additional considerations for infection prevention and control in non-healthcare settings, including homes and congregate settings like dormitories, homeless shelters, and correctional facilities.
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Improving access to effective vaccines and therapeutics
CDC supports the federal government's National Strategy to vaccinate and protect communities disproportionately affected by this outbreak by:
Prioritizing vaccines for areas with the highest numbers of cases.
Providing guidance to state, tribal, local, and territorial health officials to aid their planning and response efforts.
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Page last reviewed: July 27, 2022
U.S. monkeypox cases are very rare. Monkeypox does not occur naturally in the United States, but cases have happened that were associated with international travel or importing animals from areas where the disease is more common.
2022 U.S. Monkeypox Outbreak
CDC is closely tracking cases of monkeypox recently detected in the United States. CDC urges healthcare providers in the U.S. to be alert for patients who have rash illnesses consistent with monkeypox.
2022 U.S. Outbreak
November 2021 Travel-Associated Case
The Centers for Disease Control and Prevention (CDC) and the Maryland Department of Health confirmed on November 16, 2021 a case of monkeypox in a U.S. resident who recently returned from Nigeria to the United States. CDC is supporting state and local health officials, airline and travel industry partners, and other stakeholders to identify people who had possible contact with the patient. Because it can take up to 21 days for symptoms to develop after infection, contacts are being asked to monitor their health for that amount of time. CDC will continue to collaborate with partners to ensure the success of this investigation to help prevent additional cases of monkeypox in the United States.
July 2021 Travel-Associated Case
CDC and the Texas Department of State Health Services confirmed on July 15, 2021 a case of human monkeypox in a U.S. citizen who traveled from Nigeria to the United States on two commercial flights. CDC supported state and local health officials to identify more than 200 people who had possible contact with the patient. Contacts were asked to monitor their health for 21 days. In early September, 21 days had passed without additional cases identified, and the monitoring period for the remaining contacts ended. Strong collaboration between CDC, state and local health departments, airline and airport partners, and other stakeholders involved in this investigation helped to prevent additional cases of monkeypox in the U.S. related to this case.
2003 Outbreak from Imported Mammals
In 2003, forty-seven confirmed and probable cases of monkeypox were reported from six states—Illinois, Indiana, Kansas, Missouri, Ohio, and Wisconsin. All people infected with monkeypox in this outbreak became ill after having contact with pet prairie dogs. The pets were infected after being housed near imported small mammals from Ghana. This was the first time that human monkeypox was reported outside of Africa.
What caused the 2003 U.S. outbreak?
Investigators determined that a shipment of animals from Ghana, imported to Texas in April 2003, introduced monkeypox virus into the United States. The shipment contained approximately 800 small mammals representing nine different species, including six types of rodents. These rodents included rope squirrels, tree squirrels, African giant pouched rats, brush-tailed porcupines, dormice, and striped mice. CDC laboratory testing showed that two African giant pouched rats, nine dormice, and three rope squirrels were infected with monkeypox virus. After importation into the United States, some of the infected animals were housed near prairie dogs at the facilities of an Illinois animal vendor. These prairie dogs were sold as pets before they developed signs of infection.
All people infected with monkeypox became ill after having contact with infected pet prairie dogs. A study conducted after the outbreak suggested that certain activities associated with animals were more likely to lead to monkeypox infection. These activities included touching a sick animal or receiving a bite or scratch that broke the skin. Another important factor was cleaning the cage or touching the bedding of a sick animal. No instances of monkeypox infection were attributed exclusively to person-to-person contact.
How was the outbreak contained?
CDC and the public health departments in the affected states, together with the U.S. Department of Agriculture, the Food and Drug Administration, and other agencies, participated in a variety of activities that prevented further spread of monkeypox. This included extensive laboratory testing; deployment of smallpox vaccine and treatments; development of guidance for patients, healthcare providers, veterinarians, and other animal handlers; tracking potentially infected animals; and investigation into possible human cases. Partners in the response issued an immediate embargo and prohibition on the importation, interstate transportation, sale, and release into the environment of certain species of rodents including prairie dogs. FDA later rescinded the part of the order that restricted the capture, sale, and interstate movement of prairie dogs or domestically-bred African rodents, but CDC's restriction on the importation of African rodents remains in place.
Monkeypox spreads in a few ways.
Monkeypox can spread to anyone through close, personal, often skin-to-skin contact, including:
Direct contact with monkeypox rash, scabs, or body fluids from a person with monkeypox.
Touching objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with monkeypox.
Contact with respiratory secretions.
This direct contact can happen during intimate contact, including:
Oral, anal, and vaginal sex or touching the genitals (penis, testicles, labia, and vagina) or anus (butthole) of a person with monkeypox.
Hugging, massage, and kissing.
Prolonged face-to-face contact.
Touching fabrics and objects during sex that were used by a person with monkeypox and that have not been disinfected, such as bedding, towels, fetish gear, and sex toys.
A pregnant person can spread the virus to their fetus through the placenta.
It's also possible for people to get monkeypox from infected animals, either by being scratched or bitten by the animal or by preparing or eating meat or using products from an infected animal.
A person with monkeypox can spread it to others from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. The illness typically lasts 2-4 weeks.
Scientists are still researching:
If the virus can be spread when someone has no symptoms
How often monkeypox is spread through respiratory secretions, or when a person with monkeypox symptoms might be more likely to spread the virus through respiratory secretions.
Whether monkeypox can be spread through semen, vaginal fluids, urine, or feces.
Monkeypox symptoms
People with monkeypox get a rash that may be located on or near the genitals (penis, testicles, labia, and vagina) or anus (butthole) and could be on other areas like the hands, feet, chest, face, or mouth.
The rash will go through several stages, including scabs, before healing.
The rash can initially look like pimples or blisters and may be painful or itchy.
Other symptoms of monkeypox can include:
Fever
Chills
Swollen lymph nodes
Exhaustion
Muscle aches and backache
Headache
Respiratory symptoms (e.g. sore throat, nasal congestion, or cough)
You may experience all or only a few symptoms
Sometimes, people have flu-like symptoms before the rash.
Some people get a rash first, followed by other symptoms.
Others only experience a rash.
How long do monkeypox symptoms last?
Monkeypox symptoms usually start within 3 weeks of exposure to the virus. If someone has flu-like symptoms, they will usually develop a rash 1-4 days later.
Monkeypox can be spread from the time symptoms start until the rash has healed, all scabs have fallen off, and a fresh layer of skin has formed. The illness typically lasts 2-4 weeks.
If You Have a New or Unexplained Rash or Other Symptoms...
Avoid close contact, including sex or being intimate with anyone, until you have been checked out by a healthcare provider.
If you don't have a provider or health insurance, visit a public health clinic near you.
When you see a healthcare provider, wear a mask, and remind them that this virus is circulating in the area.
illustration of doctor with note pad
Monkeypox Rash Photos
Photo of Monkey Pox rash
Photo Credit: NHS England High Consequence Infectious Diseases Network
Photo of Monkey Pox rash
Photo credit: UK Health Security Agency
Photo of Monkey Pox rash
Photo credit: UK Health Security Agency
Photo of Monkey Pox rash
Photo credit: UK Health Security Agency
Photo of Monkey Pox rash
Photo credit: UK Health Security Agency
Photo of Monkey Pox rash
Photo credit: UK Health Security Agency
Photo of Monkey Pox rash
Photo credit: UK Health Security Agency
Photo of Monkey Pox rash
Photo Credit: NHS England High Consequence Infectious Diseases Network
Photo of Monkey Pox rash
Photo Credit: NHS England High Consequence Infectious Diseases Network
Photo of Monkey Pox rash
Photo Credit: NHS England High Consequence Infectious Diseases Network
Photo of Monkey Pox rash
Photo Credit: NHS England High Consequence Infectious Diseases Network
Photo of Monkey Pox rash
Photo credit: UK Health Security Agency
Photo of Monkey Pox rash
Photo credit: UK Health Security Agency
Photo of Monkey Pox rash
Photo credit: UK Health Security Agency
Photo of Monkey Pox rash
Photo credit: UK Health Security Agency
Photo of Monkey Pox rash
Photo credit: UK Health Security Agency
Photo of Monkey Pox rash
Photo credit: UK Health Security Agency
Photo of Monkey Pox rash
Photo Credit: NHS England High Consequence Infectious Diseases Network
Photo of Monkey Pox rash
Photo Credit: NHS England High Consequence Infectious Diseases Network
Photo of Monkey Pox rash
Photo Credit: NHS England High Consequence Infectious Diseases Network
Photo of Monkey Pox rash
Photo Credit: NHS England High Consequence Infectious Diseases Network
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Related Pages
Prevention
Treatment
How It Spreads
2022 U.S. Monkeypox Outbreak
There are no treatments specifically for monkeypox virus infections. However, monkeypox and smallpox viruses are genetically similar, which means that antiviral drugs and vaccines developed to protect against smallpox may be used to prevent and treat monkeypox virus infections.
Antivirals, such as tecovirimat (TPOXX), may be recommended for people who are more likely to get severely ill, like patients with weakened immune systems.
If you have symptoms of monkeypox, you should talk to your healthcare provider, even if you don't think you had contact with someone who has monkeypox.
For Healthcare Professionals
Please see Interim Clinical Guidance for the Treatment of Monkeypox.