Monkeypox (also MPXV or MPX)

german version / auf deutsch

On this page, we summarize the most important info on the cases of monkeypox (also known as MPXV or MPX) that have occurred and provide information on symptoms, transmission, treatment and course of infection. We will update the information continuously, as new developments occur.

last update: 25.05.2022

What you need to know about monkeypox

  • There is no reason to panic about monkeypox: The virus infection is very rare and usually heals on its own.
  • Infections are in most cases milder than smallpox.
  • The virus is difficult to transmit from person to person: Possible ways of transmission are through direct skin contact with the rash or scabs, inhalation of droplets when a person with rash coughs or sneezes, or contact with used clothing or linens, or towels.
  • As of January 2022, treatment with Tecovirimat is approved for severe cases. 
  • So far, severe courses of the disease have mostly only occurred in regions without comparable healthcare as in Germany.
  • If you experience symptoms, contact your doctor. Symptoms may appear within 7 to 21 days. These include mainly: fever, headache, muscle aches, joint pain, swollen lymph nodes, rash after about 5 days, which often begins in the genital area or face, and then spreads to other parts of the body.

Sources: RKI / UKHSA

Monkeypox as negative contrast

Monkeypox as negative contrast; electron microscopy. Source: Andrea Männel / RKI

Below we have compiled the most important questions about monkeypox.

What do monkeypox (MPX-virus) and HIV have in common?

Monkeypox and HIV have nothing in common. They are completely different, virologically as well as symptomatically. Monkeypox is not nearly as infectious as smallpox (variola) and the infection is usually mild. In most cases, the disease does not require further medical treatment.

What is monkeypox?

Monkeypox virus ( or MPXV) was first found in monkeys, giving it its name. However, it is thought that the virus is actually found primarily in rodents (e.g. squirrels and rats). Transmission to humans is possible, for example, through bites, body fluids (droplet infection), and consumption. It belongs to the smallpox family, but causes much milder disease than smallpox (variola) and is also not as infectious. 

How dangerous is monkeypox?

Most people with a healthy immune system experience a milder disease compared to smallpox. The RKI currently estimates the public health risk for the general population to be low.  Severe cases are, overall, very rare.

How dangerous is monkeypox for people living with HIV?

So far, there is limited evidence as to how monkeypox may affect people living with HIV. However, it seems plausible that people living with HIV who are undergoing HIV treatment and show a good immune status are no more at risk than others. People with a severely weakened immune system could be at greater risk of monkeypox and of a more severe course. However, reliable data on this is limited.  

What are the symptoms of monkeypox?

After infection with monkeypox, symptoms may appear within 7 to 21 days. These may include:

  • Fever,
  • headache, muscle aches, joint pain,
  • swollen lymph nodes,
  • Rash developing after about 5 days, often beginning on the face or in the genital area before spreading to other parts of the body.

What is the course of monkeypox infection?

A rash develops within 1 to 3 days after the onset of the first symptoms (fever, headache, joint pain, muscle pain). The rash usually heals after about 21 days after infection and progressesseveral stages:

  1. Spots without elevation: The rash usually starts on the face or genital area and within 24 hours spreads to other parts of the body such as arms and legs, hands and feet, including palms and soles.
  2. Papules: The spots begin to progress from flat to raised.
  3. Vesicles: After about four to five days, the affected vesicles fill with clear fluid.
  4. Pustules: After about six days, the vesicles are notably raised and filled with an opaque, yellowish fluid.
  5. Scabs: The pustules crust and form scabs, which fall off after about a week.

After the scabs fall off, a transmission of monkeypox is no longer possible. 


How is monkeypox transmitted?

Monkeypox is relatively difficult to transmit. It usually takes close physical contact and direct contact with the pathogen for the virus to enter the body. We have compiled all important information on the transmission of monkeypox here.

How can you protect yourself from monkeypox?

small pox scar

Typical smallpox vaccination scar on the upper arm. (Image: Cristian Storto Fotografia | iStockphoto)

There is no specific vaccination for monkeypox. However, the RKI points out that vaccination against smallpox (variola) is also effective against the less fatal monkeypox. However, contact with infectious body parts should be avoided. These are usually the pox-like skin lesions. A face mask can prevent inhalation of droplets when sneezing or coughing. 

What should I do if I think I have monkeypox?

different Monkeypox

Illustration of different monkeypox pustules (Photo: UKHSA).

If unusual skin changes occur, these should be clarified by a doctor. Avoid close physical contact with others and follow hygiene rules (e.g. avoid contact with clothing, towels, bedding of infected persons).  

How can monkeypox be treated?

Most of the time there is no need  for further medical treatment for monkeypox. Usually, the disease heals by itself. If necessary, symptoms (e.g. fever and pain) can be treated or relieved. For severe cases, the drug Tecovirimat is approved.

How long are monkeypox transmittable?

The monkeypox virus can persist for long periods (from days to months) on surfaces (e.g. glasses, cutlery, sex toys, bedside table) or on fabrics (e.g. linens or towels) and be infectious. Therefore, proper sanitation is necessary.

Does monkeypox only affect gay men or men who have sex with men?

No. Monkeypox can affect anyone. It is also not a sexually transmitted infection in the stricter sense. Close physical contact, not only during sex, can lead to transmission. 

Further information is available at the Robert Koch Institute (RKI) in German.

Important info about the CSD and Pride Season

We have compiled the most important questions and answers on the subject of "CSD and monkeypox" here