A recent outbreak of monkeypox has researchers questioning how the virus spreads. Once rarely seen outside of Africa, this disease is similar to smallpox. As of June 17, 2022, there have been more than 2,520 cases across 37 countries where the virus isn’t normally seen, according to the Centers for Disease Control and Protection (CDC). Because it’s traveled far beyond its presumed initial origins, and in an effort to destigmatize the virus’s connection to Africa, the World Health Organization (WHO) is in the process of determining a name change.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Researchers are discovering that a majority of the cases this year have occurred in the United Kingdom, predominantly among men who have sex with men (MSM). Given the risk of stigma and worsening discrimination, it’s important to recognize that this is the first widespread outbreak of monkeypox mainly among this demographic and that anyone can get monkeypox, not just MSM.
Given the numbers, researchers believe the virus may be spreading through social gatherings, sexual activity and intimate skin-to-skin contact. Infectious disease expert Steven Gordon, MD, explains how monkeypox may be spreading in this way and shares advice on why it’s increasingly important to have safe sex during an outbreak.
How monkeypox spreads
Monkeypox can be spread in two ways: from either an infected animal or a human carrier of the virus. Monkeys, apes, rabbits and a variety of rodents like rats, mice and squirrels can carry the infection. Animal-to-human transmission can occur through broken skin caused by bites or scratches or through direct contact with an infected animal’s blood, bodily fluids or open sores.
Similarly (but less commonly), monkeypox is spread from person to person when you have skin-to-skin contact with an infected individual who has open sores or scabs. You can also transmit the virus through respiratory droplets and oral fluids. Additionally, you can become infected if you come in contact with contaminated materials used by an infected person or animal, like clothing, bedding, shared sex accessories and other linens or fabrics.
Researchers are currently investigating if the virus can be transmitted through semen or vaginal fluids, but it’s possible that skin-to-skin contact may be enough to cause infection.
Since sex requires close, intimate, person-to-person contact, it’s possible to get monkeypox while participating in sex. This includes kissing and oral sex.
How to protect your sexual health
Monkeypox can spread from the time symptoms start until all of your sores (including scabs) are fully healed. This can take several weeks, so it’s important to reduce any skin-to-skin contact as much as possible during this time.
If you feel sick or have any rashes or open sores, you should refrain from attending any large social gatherings. This includes areas where infections can be spread across small, enclosed spaces like locker rooms and saunas.
If you or your partner have monkeypox (or if you feel sick, have a rash or open wounds of any kind), you can protect yourself and each other by not having sex and sleeping in separate beds until the infection has fully healed. Of course, abstinence isn’t always possible (or probable). If you choose to engage in sexual activity, the CDC recommends the following:
- Have virtual sex with no in-person contact.
- Mutual masturbation at least 6 feet apart, without touching each other and without touching any rash or sores.
- Wear condoms or dental dams when engaging in sexual activity.
- Have sex with your clothes on or cover areas where a rash or sores are present.
- Avoid kissing.
- Wash your hands, sex accessories and any fabrics (bedding, towels, clothing) after having sex.
- Limit your number of sexual partners to avoid opportunities for further infection.
What to do if you’ve been in contact with someone who has monkeypox
If you or someone you know shows any symptoms or you notice an unexplained rash or sores developing, you should see your healthcare provider immediately to be diagnosed. Until you’re able to see your healthcare provider, you should try to stay at least 6 feet apart from people at all times and wear protective clothing that covers your rash and open sores. This will reduce the possibility of transmitting any infection. If you had close, intimate contact with someone within a week of noticing these symptoms, you may want to consider notifying them of your condition so they can see their healthcare provider, too.