Monkeypox: Symptoms, getting tested, what to do if you’re infected or were exposed

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Symptoms

Monkeypox is usually a self-limited viral infection with a rash that may be painful. Most people recover on their own after a few weeks.

In some circumstances, people can become very sick and could die.

People usually develop symptoms 5 to 21 days after being exposed to the monkeypox virus.

Symptoms typically last from 2 to 4 weeks and may pass through several stages.

Photos of monkeypox rash

The rash can be painful and could affect any part of the body, such as the:

The rash usually lasts between 14 and 28 days and changes through different stages. It finally forms scabs that later fall off. The rash can be accompanied by general symptoms such as:

You are contagious from the onset of first symptoms until the scabs have fallen off on their own and the skin is healed.

If you have symptoms:

What to do if you have monkeypox infection

Getting tested

Contact your health care provider to get assessed and tested for monkeypox virus infection.

You can get tested for monkeypox infection based on a combination of factors, such as:

Monkeypox infection can appear similar to other infectious diseases, such as chickenpox, or several sexually transmitted infections (such as herpes or gonorrhea). This is why it's important to consult a health care provider and be tested.

Vaccines and treatment

Treatment for symptomatic monkeypox infection is mainly supportive, and includes:

Limited data are available on the clinical effectiveness of specific antiviral treatments for monkeypox infection in people. These antivirals were first developed to treat smallpox. In some cases, they may also help treat monkeypox.

The Imvamune vaccine is authorized by Health Canada for immunization against monkeypox and orthopoxvirus infections in adults 18 years of age and older who are at high risk of exposure.

The National Advisory Committee on Immunization (NACI) recommends the Imvamune vaccine may be offered to people with high-risk exposures to a probable or confirmed case of monkeypox, or within a setting where transmission is happening.

Provinces and territories determine their immunization programs based on their unique circumstances. Contact your local public health authority to learn more.

If you have monkeypox infection

If you've been infected with the monkeypox virus, your local public health authority may require that you isolate to prevent further spread. They may recommend that you isolate at home or at a different location, depending on your living situation. "Home" will be the term used to refer to your isolation location.

It's important that you continue to follow your local public health authority's advice on isolation, including the length of time they recommend. While isolating, follow measures to reduce the risk of spreading the virus to others in your household.

Isolation requirements and recommendations may vary across federal, provincial, territorial and local public health authorities as the situation in Canada evolves.

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When isolating in your home

Follow instructions on isolation

Follow the advice of your local public health authority.

Stay in isolation until they tell you that you no longer have to isolate.

This usually occurs once:

  • your scabs have fallen off on their own and
  • your skin is healing and has a light pink or shiny pearl appearance
Avoid contact with people

Where possible, avoid contact with people who are vulnerable, such as:

  • children under 12 years of age
  • immunocompromised individuals
  • pregnant people

Avoid directly touching other people, including through sexual contact. When your isolation period is over, wear a condom for 12 weeks during any sexual contact, including oral and non-penetrative contact.

Limit contact with others from outside the home. This includes not having visitors inside the home, except your health care provider (if needed).

Avoid contact with animals

Avoid contact with pets and livestock, when possible. Have someone in your household care for these animals. If this isn't possible, you should:

  • cover all your lesions with clothes or bandages
  • wear a well-fitting medical mask and gloves when near the animal
  • clean and disinfect high-touch surfaces and objects frequently

Avoid all contact with wildlife around your home.

This will help limit the potential risk of introducing the monkeypox virus into animal populations in Canada.

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Stay at home and isolate in a separate space

Avoid leaving your home unless you need urgent medical care. Tell your health care provider about your infection before an in-person appointment, when possible.

Have necessities, such as medication or groceries, delivered to your home as much as possible.

Isolate in a separate space. For example, use a private room for sleeping and use a separate washroom whenever possible, especially if you have:

  • respiratory symptoms, particularly if you have lesions inside your mouth or throat
  • lesions that are hard to cover such as on the face
  • weeping lesions

If a private room for sleeping isn't available, separate your bed as far away as possible from others.

If a separate washroom isn't available, you should:

  • clean and disinfect all surfaces and objects that you touched
  • do not share used towels with other people
  • immediately remove and wash used towels

Avoid areas that are shared with others in the household. If you must use shared areas, wear a well-fitting medical mask, ensure your lesions are well covered, and clean and disinfect surfaces and objects after use.

Learn more about recommendations on:

Avoid sharing items that may be contaminated

Do not share items that may be contaminated with the virus, including:

  • linens
  • razors
  • towels
  • clothes
  • utensils
  • needles
  • sex toys
  • bedding
  • toothbrushes
  • any other items
Cover your lesions and wear a mask

Cover all your lesions with clothing or bandages as much as possible.

Wear a well-fitting medical mask when around others. For example, in a shared space or when receiving care. When this isn't possible, other household members should wear a well-fitting medical mask when in a shared space with you.

Clean your hands and cover coughs and sneezes

Clean your hands properly and frequently.

You should also:

  1. cough or sneeze into a tissue or the bend of your arm, not your hand, if you're not wearing a mask
  2. throw any tissues you've used into a plastic-lined waste container as soon as possible
  3. clean your hands immediately afterwards

Learn more about recommendations on:

Keep your environment clean

Clean and disinfect all surfaces and objects that you've had contact with.

Handle and wash your own clothes, bedding, towels and other laundry, unless you're unable to do so.

Handle your own used utensils and dishes, unless you're unable to do so.

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Postpone non-urgent appointments

Do not donate blood or any other body fluid (including sperm) or tissue.

Postpone all non-urgent medical visits and procedures.

Seek advice if you're breastfeeding

Consult your health care provider for advice if you're breastfeeding.

Providing care at home to someone with monkeypox infection

Ideally, only one person in the home should provide care to someone who is in isolation. This will help reduce the risk of spreading the monkeypox virus to others.

The caregiver should not be someone who is considered vulnerable, including people who are:

Watch for signs or symptoms of monkeypox infection for 21 days since your last exposure to the person you're caring for. If signs or symptoms develop, immediately isolate, contact your local public health authority and follow their instructions.

Reduce your risk of becoming infected by avoiding:

You should also:

If you can't avoid close contact with someone you're caring for

  • wear a well-fitting medical mask
  • wear disposable gloves and cover exposed skin with long clothing when in direct contact with lesions
    • long clothing may include:
      • an apron
      • full length pants
      • shirts with long sleeves
  • immediately remove and wash your clothes after providing care to prevent infecting yourself or others, or contaminating surfaces and objects
  • follow recommendations on hand and environmental hygiene

Learn more about recommendations on:

If you've been exposed

If you know you've been exposed to someone with monkeypox infection, contact your local public health authority immediately. Your local public health authority may also tell you that you've been exposed to someone infected with the monkeypox virus. They will provide you with instructions on what to do and how to reduce the risk of further spread.

Instructions could vary depending on your exposure risk level, which may range from lower to higher risk.

In some instances, you may be instructed to:

Watch for symptoms for 21 days after you've been exposed. Avoid taking medications that that are known to lower fever, such as acetaminophen, ibuprofen and acetylsalicylic acid. They may mask an early symptom of monkeypox infection.

If you develop symptoms of monkeypox infection, isolate immediately and contact your local public health authority or health care provider. Tell your health care provider that you've been exposed before an in-person appointment, when possible.

Continue to practise hand hygiene, respiratory etiquette and safe sex behaviours during your self-monitoring period.

Help reduce your overall risk of exposure to the monkeypox virus and common sexually transmitted infections by:

Seeking medical care

If you're feeling unwell, contact your health care provider immediately.

If you call an ambulance, tell the dispatcher that you have or may have monkeypox infection. Follow any directions provided.

If using a private vehicle to get to the hospital, call ahead to let them know that that you have or may have monkeypox infection.

While travelling in a private vehicle, follow strict individual public health measures to reduce the risk of transmission and:

Do not use public transportation to seek medical care unless you have no other choice.

Recommendations on hand and environmental hygiene

Proper hand and environmental hygiene can reduce the risk of getting or spreading the monkeypox virus. Do your laundry before you clean and disinfect surfaces and objects to reduce the risk of contaminating yourself, others or surfaces and objects.

Hand hygiene

Wash hands regularly with soap and water for at least 20 seconds. If soap and water aren't available, use hand sanitizer containing at least 60% alcohol. When hands are visibly soiled, soap and water is the preferred method.

If you have monkeypox infection, clean your hands before touching common surfaces and objects.

If you're a caregiver or household member of someone infected with the monkeypox virus, clean your hands:

  • before and after any contact with the person in isolation
  • before and after removing gloves
  • after touching surfaces and objects that the person in isolation has:
    • touched with their hands, skin or mouth
    • sat on
    • laid on

Avoid touching your eyes, nose or mouth with unwashed hands if you're a caregiver or household member.

Disposable gloves

Always clean your hands before and after putting on and taking off gloves.

When wearing gloves, if they become soiled or torn:

  1. remove them
  2. clean your hands
  3. put on a new pair

To remove gloves safely:

  1. pull off the first glove from the fingertips using your opposite gloved hand
  2. as you're pulling, form the glove into a ball within the palm of your gloved hand
  3. slide your ungloved hand in under the wrist of your second glove and
    1. gently roll it inside out and away from your body
  4. avoid touching the outside of the gloves with your bare hands
  5. discard the gloves in a plastic-lined waste container then dispose of the bag
  6. clean your hands immediately after removal and disposal of gloves

Watch this video to learn how to properly remove disposable gloves.

Handling laundry

If you have monkeypox infection, you should handle your own laundry, such as clothes, towels and bed linens.

Wash your contaminated laundry in a washing machine using hot water (70 °C) with detergent. Your laundry must be dried in a dryer and be completely dry before taking it out.

If you don't have access to a washing machine and dryer, contact your local public health authority. They may help you in getting support to help wash your contaminated items appropriately.

If you're a caregiver who has to wash the laundry of the person who has monkeypox infection:

  • wear a well-fitting medical mask and disposable gloves
    • properly dispose these items after use
  • keep contaminated laundry away from your skin or clothing
    • cover any of your skin that could come in contact with the contaminated laundry
    • if the clothes you're wearing come in contact with the contaminated laundry:
      • remove them and
      • clean in the same way as other contaminated laundry
  • put the contaminated laundry in a leak-proof bag or garbage bag when transporting it
    • before you dispose the bag, put it inside in another garbage bag then close and dispose immediately
  • do not shake the contaminated laundry to avoid spreading infectious particles
  • clean and disinfect surfaces after use

Removing contaminated clothing

Bring an extra change of clean clothes in case your clothes get contaminated.

To remove contaminated clothing:

  1. Keep mask and gloves on while removing clothing
  2. Remove the contaminated clothing
    • minimize contact with the outer surface and avoid agitating clothing while doing so
  3. Wash your contaminated laundry in a washing machine using hot water (70 C) with detergent
    • clean and disinfect contaminated footwear, if worn
  4. If you need to transport your contaminated clothing to another location, place it in a disposable leak-proof bag.
    • After putting the clothing in the laundry, place the bag used to transport it in another disposable garbage bag, close it, and dispose of it.
  5. Remove and dispose of gloves and clean your hands
  6. Remove and dispose of mask and clean your hands
  7. Put on clean clothes

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Cleaning and disinfecting surfaces and objects

Frequently clean and disinfect surfaces and objects that the person infected with the monkeypox virus may have come into contact with. This is especially important for high-touch surfaces, which may include:

  • toilets
  • tabletops
  • countertops
  • door handles
  • light switches
  • computer keyboards

If a surface or object is visibly dirty, clean it with regular cleaning products first then use a disinfectant. Always follow product label directions. If you're using household bleach, follow instructions on proper dilution.

We recommend using single-use disposable cleaning products, such as disposable towels. If they aren't available, you can either:

  • wash your cleaning products, such as cloths or sponges or
  • place your cleaning products in a disinfectant solution that is effective against viruses, such as a bleach solution

Discard the cleaning products after use if you're unable to wash or disinfect them.

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Cleaning furniture and carpets

Vacuum your upholstered furniture and carpet floors using a vacuum with a high-efficiency particulate air (HEPA) filter. Do not vacuum furniture or carpet with a vacuum cleaner without a HEPA filter as this may spread infectious particles.

If your upholstered furniture and carpets are visibly dirty, use commercial cleaning products or hire a professional steam cleaning service. Consult your local public health authority for advice if furniture is very dirty.

Cleaning dishes and utensils

If you have monkeypox infection, do not share your dishes and other eating utensils.

You should also handle and wash your used dishes and utensils.

You don't need to use separate utensils if properly washed, which you can do by:

  • putting them dishwasher
  • washing by hand with warm water and soap

If you can't clean your own dishes and utensils, your caregiver should make sure they are properly washed.

Supplies

Supplies you'll need when someone is isolating at home include:

Recommended hygiene products include:

Read and follow manufacturer's instructions for safe use of cleaning and disinfection products.

Reach out to family, friends or neighbours if you can't get these supplies. You can also contact your local public health authority or a community organization for advice, support and resources.

If you're isolating or providing care, do so at a place that has access to running water whenever possible. This will make it easier to practise hand washing, cleaning and disinfecting, and laundering.

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