What Are the Symptoms of Monkeypox? Find Out Now

Monkeypox (mpox) is a viral illness that can cause a range of concerning symptoms.1 According to the latest data, mpox symptoms can last 2–4 weeks and include a distinctive skin rash, fever, headache, muscle aches, back pain, low energy, and swollen lymph nodes.1 The rash can initially resemble pimples or blisters and may be painful or itchy, appearing on the hands, feet, chest, face, mouth, or near the genitals, anus, and rectum.1 The incubation period for mpox is 3-17 days, and a person can spread the virus from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed.1 It’s important to note that some individuals may experience all or only a few of these mpox symptoms.

Key Takeaways

  • Monkeypox symptoms can include a rash, fever, headache, muscle aches, back pain, low energy, and swollen lymph nodes.
  • The rash can appear on various parts of the body, including the hands, feet, face, and genital areas.
  • Mpox symptoms typically last 2-4 weeks, but can last longer in individuals with weakened immune systems.
  • Transmission of the virus can occur from the start of symptoms until the rash has fully healed.
  • While some people may experience all symptoms, others may only have a few.

Monkeypox Overview

Monkeypox (mpox) is a viral illness caused by the monkeypox virus, a species of the genus Orthopoxvirus.1 There are two main genetic clades of the virus – clade I and clade II.1

What is Monkeypox?

Monkeypox is a zoonotic disease, meaning it can be transmitted from animals to humans.2 The monkeypox virus was first discovered in 1958 during two outbreaks in colonies of monkeys kept for research, and the first reported human case was in a nine-month-old boy in the Democratic Republic of the Congo in 1970.2

History of Monkeypox

After the eradication of smallpox in 1980 and the end of smallpox vaccination worldwide, monkeypox steadily emerged in central, east, and west Africa.2 A global outbreak occurred in 2022-2023, primarily caused by the clade IIb strain.1

Common Monkeypox Symptoms

Monkeypox, a viral illness caused by the monkeypox virus, can manifest a variety of symptoms according to the first and third sources.1 One of the most distinctive signs is a rash or mucosal lesions that can last 2-4 weeks.1 Along with the rash, individuals may also experience fever, headache, muscle aches, back pain, low energy, and swollen lymph nodes.1

Rash and Lesions

The monkeypox rash typically begins as a flat sore that develops into a blister filled with liquid.1 These lesions can be itchy or painful, and as the rash heals, the blisters will dry up, crust over, and eventually fall off, revealing a new layer of skin.1 The number of skin lesions can vary greatly, with some people having only a few, while others may have hundreds or more, appearing on various parts of the body such as the palms of the hands, soles of the feet, face, mouth, throat, groin, genital areas, and anus.1

Fever and Chills

In addition to the rash, individuals with monkeypox often experience fever, chills, and other flu-like symptoms.1 This can include headaches, muscle aches, back pain, and feelings of low energy or fatigue.1

Swollen Lymph Nodes

One of the distinguishing features of monkeypox is the swelling of lymph nodes, which is not typically seen with other rash-causing illnesses like chickenpox.1 This swelling of the lymph nodes can occur in various parts of the body, such as the neck, armpits, or groin.1

Fatigue and Muscle Aches

Along with the rash, fever, and swollen lymph nodes, people with monkeypox may also experience feelings of fatigue and muscle aches.1 These symptoms, coupled with the other manifestations of the illness, can make it challenging for individuals to carry out their daily activities until the infection resolves.1

monkeypox rash

First Symptoms of Monkeypox

According to the first and third sources, the first symptoms of monkeypox typically appear within 1-21 days after exposure to the virus.1 For some people, the first symptom is the [first symptoms of monkeypox] rash, while others may experience different symptoms first, such as fever, headache, muscle aches, back pain, low energy, and swollen lymph nodes.1 The illness usually lasts 2-4 weeks, but it can last longer in individuals with weakened immune systems.1

Monkeypox [first symptoms of monkeypox] typically starts within a week of exposure and lasts 2–4 weeks, with symptoms like fever, muscle aches, sore throat, and swollen lymph nodes appearing first.1 The rash can present as flat sores developing into blisters filled with fluid that may be itchy or painful, and as the rash heals, the lesions dry up, crust over, and eventually fall off.1 Individuals may have varying numbers of skin lesions, ranging from a few to hundreds, appearing on different parts of the body such as the palms of hands, soles of feet, face, mouth, throat, groin, genital areas, and anus.1

Some of the first [first symptoms of monkeypox] symptoms can include painful swelling of the rectum and pain or difficulty urinating.1 Children, pregnant individuals, and those with weakened immune systems are at higher risk of complications from monkeypox.1

Progression of Monkeypox Rash

Stages of Rash Development

The monkeypox rash goes through a distinct progression, as described in the first and third sources.3 The rash begins as a flat sore that then develops into a blister filled with liquid. As the rash heals, the lesions dry up, crust over, and eventually fall off, revealing a new layer of skin underneath. This process can take 2-4 weeks, with the rash progressing from macules (flat spots) to papules (raised bumps) to vesicles (blisters) and finally to pustules (pus-filled bumps) before the scabs form and fall off.3

The monkeypox rash remains contagious until all skin lesions are healed with new skin replacing the scabs.3 This progression through the different stages of the rash can take up to four weeks from the onset of symptoms for patients to become non-contagious.3

It’s important to note that monkeypox can be challenging to diagnose in the early stages, and individuals in close contact with infected persons should seek medical advice for proper evaluation.3 Effective over-the-counter treatments for scar treatment after the monkeypox rash include silicone scar sheets and ointments, and virtual visits with dermatologists can provide guidance on skin concerns, including suspected cases of monkeypox rash.3

What are the symptoms of monkeypox?

According to the first and third sources, the early symptoms of monkeypox typically include fever, headache, muscle aches, back pain, low energy, and swollen lymph nodes.1 These symptoms usually appear within 1-21 days after exposure to the virus.1

Early Symptoms

The early symptoms of monkeypox can include fever, sore throat, headache, muscle aches, back pain, and low energy.1 Swollen lymph nodes are also a common early symptom.1

Later Symptoms

Later symptoms of monkeypox include the development of a rash, which can appear anywhere on the body, including the face, mouth, hands, feet, genital, and anal areas.1 The rash goes through several stages, starting as flat sores that develop into blisters filled with liquid, which then crust over and fall off as the skin heals.1 Overall, monkeypox symptoms can last 2-4 weeks, but may last longer in individuals with weakened immune systems.1

The rash can vary in severity, with some individuals having one or a few skin lesions, while others may have hundreds or more.1 Monkeypox patients are infectious until all sores have healed and a new layer of skin has formed.1

monkeypox symptoms

Monkeypox Lesion Locations

According to the first and third sources, monkeypox lesions can appear on various parts of the body, including the face, mouth, hands, feet, genital, and anal areas.1 The rash can start on the face and spread to other areas of the body.1 Lesions on the face, mouth, and throat can be painful and make it difficult to swallow.1 Lesions on the hands and feet can cause discomfort and impair mobility.1 Lesions in the genital and anal areas can be particularly painful and may lead to rectal pain, swelling, and difficulties urinating.1

Face and Mouth

Monkeypox lesions on the face and in the mouth can be particularly troublesome.1 The lesions in these areas can be painful and make it difficult for the individual to swallow, potentially leading to further complications.1

Hands and Feet

Lesions on the hands and feet can also be a significant issue for those with monkeypox.1 The lesions in these areas can cause discomfort and impair mobility, making everyday tasks more challenging.1

Genital and Anal Areas

Perhaps the most concerning locations for monkeypox lesions are the genital and anal areas.1 These lesions can be particularly painful and may lead to rectal pain, swelling, and difficulties urinating.1 Individuals with lesions in these sensitive areas may experience significant discomfort and disruption to their daily lives.1

Additional Monkeypox Symptoms

In addition to the common symptoms of monkeypox, such as fever, rash, and swollen lymph nodes, some individuals may experience additional concerning symptoms. According to the first and third sources, rectal pain and swelling, as well as urinary difficulties, can be observed in certain cases of monkeypox.1

Rectal Pain and Swelling

The development of lesions in the anal and genital areas can result in rectal pain and swelling for those affected by monkeypox. This can be particularly problematic and cause significant discomfort.1

Urinary Difficulties

Lesions in the genital and anal regions can also lead to difficulties with urination, causing pain or discomfort when trying to relieve oneself. This additional symptom can be quite concerning for those experiencing it.1

Duration of Monkeypox Symptoms

According to the first and third sources, the duration of monkeypox symptoms can vary, but typically lasts 2-4 weeks.1 However, the illness may last longer in individuals with weakened immune systems, such as those living with HIV or undergoing cancer treatment.1 Most people with monkeypox will recover within this 2-4 week timeframe, but it’s important to note that a person can spread the virus to others until all sores have healed and a new layer of skin has formed.1

The rash associated with monkeypox typically lasts between 2 to 4 weeks and progresses through different stages.4 Symptoms of monkeypox can include fever, chills, headache, exhaustion, swollen lymph nodes, back, joint, and muscle pain.4 People infected with monkeypox are contagious from the onset of symptoms until the scabs have fallen off and the skin is healed.4

It’s important to note that the duration of monkeypox symptoms can vary, and individuals with weakened immune systems may experience a longer illness.1 Proper care and self-isolation measures are crucial for recovering from monkeypox within the typical 2-4 week timeframe.1

Monkeypox Virus Transmission

According to the information provided in the second5 and third6 sources, the [monkeypox virus transmission] can occur through various means, including direct contact with infectious skin or other lesions, such as those in the mouth or on the genitals. Transmission can happen through face-to-face contact, skin-to-skin contact (including sexual activity), and even respiratory droplets or short-range aerosols from prolonged close contact.5 The virus can also be contracted from infected animals, such as during hunting, skinning, trapping, or consuming contaminated animals.5 Additionally, the virus can spread through contact with contaminated objects, such as clothing or linens, or in healthcare settings through sharps injuries.6

Monkeypox typically occurs in Central and West Africa,5 and recent outbreaks have been observed globally in 2022-2023, primarily driven by the Clade IIb strain.1 While the virus belongs to the genus Orthopoxvirus and has two main clades, Clade I and Clade II,1 the current outbreak has been linked to the Clade IIb strain.1 Importantly, person-to-person transmission of monkeypox can occur through direct contact with infectious skin or lesions, respiratory droplets, and close contact.1 Additionally, people can contract the virus from infected animals through activities like hunting, skinning, or cooking them.1

At-Risk Groups for Complications

While monkeypox (mpox) can affect anyone, certain groups face a higher risk of developing severe complications from the virus.

The first and third sources indicate that children, pregnant people, and individuals with weakened immune systems are particularly vulnerable to more serious illness from mpox.1

Children

Children may be more susceptible to severe mpox symptoms due to their developing immune systems.1 Their smaller body size and immature immune responses can make them more prone to complications like pneumonia, dehydration, and organ inflammation.

Pregnant People

Pregnant individuals face the additional risk of passing the mpox virus to their unborn babies, potentially leading to complications for both the parent and the fetus.1 Pregnant people are also more vulnerable to developing severe illness from mpox, which can endanger their own health and that of their pregnancy.

Immunocompromised

Those with weakened immune systems, such as people living with HIV or undergoing cancer treatment, are at greater risk of experiencing more severe symptoms and complications from monkeypox.1 Their compromised immune responses may make it harder for their bodies to fight off the virus, potentially leading to larger, more widespread lesions, secondary bacterial infections, and complications affecting vital organs.7

Potential Complications of Monkeypox

While most individuals with monkeypox recover within 2-4 weeks, the illness can potentially lead to several concerning complications.1 Some of the potential complications associated with monkeypox include severe bacterial skin infections, pneumonia, vision problems, dehydration and malnutrition, sepsis, and inflammation of various organs.

Bacterial Skin Infections

The skin lesions caused by monkeypox can become infected, leading to abscesses or other serious skin damage.7 These bacterial infections can require hospitalization, supportive care, and potentially antiviral medicines to manage.

Pneumonia

Monkeypox can cause inflammation of the lungs, leading to breathing difficulties and the development of pneumonia.7 Severe cases of monkeypox may require hospitalization and supportive care to address respiratory complications.

Vision Problems

Lesions on the cornea can result in scarring and vision loss for some patients with monkeypox.8 Corneal lesions can be a serious complication that requires prompt medical attention to prevent long-term eye damage.

Dehydration and Malnutrition

Severe vomiting, diarrhea, and difficulty swallowing associated with monkeypox can lead to dehydration and malnutrition.7 These complications may require hospitalization and IV fluids to prevent further health issues.

Sepsis

In some cases, the monkeypox infection can spread to the bloodstream, causing a potentially life-threatening whole-body inflammatory response known as sepsis.7 Sepsis is a medical emergency that requires immediate treatment.

Inflammation of Organs

Monkeypox can cause inflammation of various organs, including the heart, rectum, genital organs, and urinary passages.7 These complications can be serious and may require specialized medical care.

Individuals with weakened immune systems, such as those living with HIV or undergoing cancer treatment, are at a higher risk of experiencing more severe symptoms and complications from monkeypox.1 Engaging with at-risk communities and raising awareness is essential to protect those most vulnerable to the potential complications of this viral illness.

Monkeypox vs Chickenpox

While monkeypox and chickenpox both cause skin rashes, they are caused by different viruses and exhibit some key differences. As explained in the second source, the monkeypox rash develops all at once, while the chickenpox rash appears in waves.9 Additionally, monkeypox lesions tend to be deeper-seated, often appearing on the palms of the hands and soles of the feet, whereas chickenpox lesions are more superficial.10

Differences in Rashes

The monkeypox rash develops at the same time, in contrast to the chickenpox rash that appears in waves.10 Furthermore, monkeypox lesions are typically larger and deeper in the skin compared to chickenpox lesions.10

Differences in Symptoms

Monkeypox is more likely to cause swollen lymph nodes, a symptom not typically seen with chickenpox.9 Additionally, chickenpox symptoms, including the rash, usually resolve within two weeks, while monkeypox symptoms can last 2-4 weeks.10

Monkeypox vs Smallpox

While monkeypox and smallpox belong to the same Orthopoxvirus genus, they are distinct viruses.11 Smallpox was first documented in ancient Egyptian mummies and is suspected to have been around for at least 3,000 years.12 The variola virus, which causes smallpox, was declared eradicated in 1980 by the World Health Organization.13 However, monkeypox has continued to emerge, particularly in central and western Africa.

Relatedness of Viruses

Though the viruses are related, monkeypox is a different virus than the one that caused smallpox.11 Monkeypox was first discovered in 1958 in Denmark, and the first human case was recorded in 1970 in the Democratic Republic of Congo.11 While smallpox was eradicated, monkeypox has steadily emerged in areas where it is endemic, such as central and western Africa.11

Severity Differences

13 Monkeypox has a lower fatality rate than smallpox and is less contagious.12 Historically, smallpox had an incubation period between 1 week and 17 days, with an average fatality rate of approximately 30%.13 In contrast, monkeypox symptoms typically appear between 6 and 13 days after infection, with skin eruptions beginning within five days of fever onset, and the disease is rarely fatal.12

13 Monkeypox transmission occurs through close contact with infected skin, nasal secretions, and contaminated surfaces, while12 smallpox was primarily transmitted through direct face-to-face contact, with cases peaking in winter and early spring due to aerosolized viruses surviving longer in cooler temperatures and lower humidity levels.

Conclusion

In conclusion, monkeypox is a viral illness that can cause a range of symptoms, including a distinctive rash, fever, swollen lymph nodes, fatigue, and muscle aches.14 The illness typically lasts 2-4 weeks, but can be longer in those with weakened immune systems.14 Monkeypox is transmitted through close contact with infectious individuals or contaminated materials, and certain groups, such as children, pregnant people, and the immunocompromised, are at higher risk for complications.14 While monkeypox is related to smallpox, it is a distinct virus with generally milder symptoms.15 Understanding the symptoms and transmission of monkeypox is crucial for preventing the spread of this emerging public health concern.1416

FAQ

What are the symptoms of monkeypox?

Common symptoms of monkeypox include a rash or mucosal lesions, fever, headache, muscle aches, back pain, low energy, and swollen lymph nodes.

What is monkeypox?

Monkeypox (mpox) is a viral illness caused by the monkeypox virus, which is a species of the genus Orthopoxvirus. There are two main genetic clades of the virus – clade I and clade II.

What is the history of monkeypox?

The monkeypox virus was first discovered in 1958 in Denmark in monkeys kept for research, and the first reported human case was in a nine-month-old boy in the Democratic Republic of the Congo in 1970. After the eradication of smallpox in 1980 and the end of smallpox vaccination worldwide, monkeypox steadily emerged in central, east, and west Africa.

How does the monkeypox rash develop?

The monkeypox rash goes through several stages of development. It begins as a flat sore that then develops into a blister filled with liquid. As the rash heals, the lesions dry up, crust over, and eventually fall off, revealing a new layer of skin underneath.

When do the first symptoms of monkeypox appear?

The first symptoms of monkeypox typically appear within 1-21 days after exposure to the virus. For some people, the first symptom is the rash, while others may experience different symptoms first, such as fever, headache, muscle aches, back pain, low energy, and swollen lymph nodes.

Where can monkeypox lesions appear on the body?

Monkeypox lesions can appear on various parts of the body, including the face, mouth, hands, feet, genital, and anal areas. The rash can start on the face and spread to other areas.

What are some additional symptoms of monkeypox?

Some people with monkeypox may experience rectal pain and swelling, as well as difficulties urinating, due to the location of lesions in the anal and genital areas.

How long do monkeypox symptoms last?

The illness usually lasts 2-4 weeks, but it can last longer in individuals with weakened immune systems.

How is the monkeypox virus transmitted?

The monkeypox virus can be transmitted through direct contact with infectious skin or other lesions, as well as through respiratory droplets or short-range aerosols from prolonged close contact. The virus can also be contracted from infected animals or contaminated objects.

Which groups are at higher risk for monkeypox complications?

Children, pregnant people, and individuals with weakened immune systems are at higher risk for developing complications from monkeypox.

What are the potential complications of monkeypox?

Potential complications of monkeypox include bacterial skin infections, pneumonia, vision problems, dehydration and malnutrition, sepsis, and inflammation of organs.

How does monkeypox differ from chickenpox?

While both monkeypox and chickenpox cause skin rashes, they are caused by different viruses and have some key differences in the appearance of the rash and the symptoms.

How does monkeypox differ from smallpox?

Monkeypox and smallpox are both part of the Orthopoxvirus genus, but they are distinct viruses. Smallpox was more contagious and had a higher fatality rate than monkeypox, which generally has milder symptoms.

Source Links

  1. https://www.who.int/news-room/fact-sheets/detail/monkeypox
  2. https://www.cdc.gov/poxvirus/mpox/about/index.html
  3. https://www.nebraskamed.com/infectious-diseases/monkeypox/how-does-monkeypox-start-plus-5-pictures-to-show-how-the-bumps-progress
  4. https://www.canada.ca/en/public-health/services/diseases/mpox/symptoms-management.html
  5. https://www.mayoclinic.org/diseases-conditions/infectious-diseases/expert-answers/monkeypox-faq/faq-20533608
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10397518/
  7. https://www.who.int/news-room/questions-and-answers/item/monkeypox
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9628741/
  9. https://www.ndtv.com/health/what-is-the-difference-between-monkeypox-chickenpox-3276197
  10. https://health.osu.edu/health/virus-and-infection/think-your-rash-might-be-monkeypox-or-chickenpox
  11. https://www.nicd.ac.za/wp-content/uploads/2017/11/Monkeypox-Diseases-A-Z-FAQ_2017_NOVEMBER_16.pdf
  12. https://lifesciencesintelligence.com/features/smallpox-chickenpox-monkeypox-understanding-the-differences
  13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9746567/
  14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9552975/
  15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9791242/
  16. https://www.cnn.com/2022/05/19/health/what-is-monkeypox-virus-explainer-wellness/index.html