• Mpox infections are caused by a virus
• Early signs of Mpox include
  • Fever, chills, headache, muscle aches, fatigue, and swollen lymph nodes (glands)
• After a few days, a rash usually develops
  • The rash starts as red, slightly raised bumps
  • The bumps can often be painful
  • The bumps turn into blisters that fill with pus
  • These blisters will eventually crust over, and the scabs will fall off
• Symptoms usually last for about 2–4 wks if you/your child is diagnosed with Mpox
• A person is contagious until all the scabs have fallen off and new skin has formed
• You or your child must stay isolated at home until the scabs have fallen off and new skin has formed

Follow these instructions until the test results are available.

• Negative test: Stop home isolation.
• Positive test: Stay home and follow instructions until all scabs have fallen off and new skin forms. This may take 2-4 wks.
  • Do not attend school or daycare
  • Friends, family, or others should not visit unless they need to be in the home
  • Avoid close contact with others
  • Avoid close contact with pets and other animals in the home
  • Do not engage in sexual activity that involves direct physical contact
  • Do not share potentially contaminated items
    • e.g., bed linens, clothing, towels, washcloths, drinking glasses, eating utensils
  • Routinely clean and disinfect commonly touched surfaces and items
    • e.g. counters or light switches
  • Wear well-fitting masks when in close contact with others at home
  • Avoid the use of contact lenses to prevent accidental infection of the eye
  • Avoid shaving rash-covered areas of the body, as this can spread the virus

Follow the prevention steps below until a healthcare provider or local or state health department says you can return to your normal activities.

• General Hygiene Tips
  • Frequent hand washing
  • Use an alcohol-based hand rub or soap and water after touching anything that may have had contact with the rash
    • e.g., clothing, linens, or environmental surfaces
  • Cover all skin rashes as much as possible by wearing long sleeves or long pants
  • When not in isolation, consider wearing gloves to cover the rash on the hands
  • Wear gloves when receiving medical care
  • People with Mpox who are over 2 yrs old should use a well-fitting mask
    • e.g., a medical mask
  • Masks should be worn if you cannot avoid closer contact with others
    • e.g., when receiving medical care
  • Anyone in your home over 2 yrs old should wear a well-fitting mask if they are in close contact with an infected person for more than a few minutes
  • When possible, the person with Mpox should change their own bandages
  • When possible, the person with Mpox should handle their own dirty linens
    • Wear disposable gloves when handling dirty linens
    • Immediately wash hands with soap and water or use an alcohol-based hand rub after removing gloves
  • Caregivers should avoid extensive contact with the infected person
  • At a minimum, caregivers should wear disposable medical gloves and a well-fitting mask or respirator when caring for an infected person
  • Any clothing that contacts the rash during dressing changes should be laundered immediately
    • Gloves should be disposed of after use
    • Immediately wash hands with soap and water or use an alcohol-based hand rub after removing gloves
  • Contain and dispose of contaminated waste, such as dressings, bandages, or disposable gloves

• If possible, use a separate bathroom if others live in the same household
• If there is no separate bathroom in the home
  • Clean and disinfect surfaces such as:
    • Counters, toilet seats, and faucets after using a shared space
  • Surfaces should be cleaned and disinfected, especially after showering, using the toilet, or changing bandages that cover the rash
  • Consider using disposable gloves while cleaning if the rash is on the hands

• Cover areas of broken skin with bandages as best as you can
• Avoid direct skin-to-skin contact with the rash
• Avoid contact with unaffected individuals while you have the rash
• Only resume contact with unaffected individuals after:
  • The rash has resolved
  • The scabs have fallen off
  • A fresh layer of intact skin has formed
• When possible, limit the number of caregivers to one person
• Isolate in a room or area separate from other household members and pets when possible
• Limit the use of spaces, items, and food shared with other household members
  • Do not share dishes and other eating utensils
• The infected person doesn't need to use separate utensils if correctly washed
• Wash soiled dishes and eating utensils in a dishwasher or by hand with warm water and soap

• People with Mpox should avoid contact with animals, including pets
• If possible, friends or family members should care for healthy animals until the owner has fully recovered
• Keep any potentially infectious bandages, textiles, such as clothes, bedding, and other items away from pets, domestic animals, and wildlife
• In general, any mammal may become infected with Mpox
• Other animals, such as reptiles, fish, or birds, cannot be infected

• Caretakers and household contacts of children diagnosed with Mpox should self-monitor for symptoms
• Isolate yourself from others and contact your primary care provider if you believe you have been exposed to Mpox and start to develop symptoms
• Your primary care provider, in partnership with your local public health department, will be able to discuss options and next steps with you
  • These steps may include testing, vaccination, or the need for any antiviral treatment
• Seek medical attention if you are feeling sick
• Contact your provider or workplace for additional guidance

• Mpox is spread mainly by individuals who have had close, intimate contact with others when they are contagious
• More specifically, it is spread through
  • Direct contact with the infectious rash, scabs, or body fluids
  • Prolonged intimate or face-to-face contact
  • Touching objects which have been touched by others who are contagious
• Touching contaminated objects is a less common form of transmission but is possible
• These types of interactions have not been reported as the cause of any current Mpox cases
  • Short interactions with someone positive, like a brief conversation
  • Being physically close to someone positive for a long time
    • e.g., sitting next to someone positive on an airplane

• If you have a MyCHOP account, Mpox test results will be available on the website in about 3–5 days
• If the test is negative, you may not receive a follow-up at all
• If you do not see test results in your patient portal within 5–7 days, please call your Primary Care Provider
• You must follow the suspected Mpox isolation instructions to prevent further spread
• If you/your child have a positive Mpox test, a clinician will contact you about the results
• The public health department will also contact you and let you know if you have close contacts who may be eligible for vaccination
• You may not be contacted if your child's test result is negative, the virus which causes Mpox was not found

• If you/your child has Mpox, antibiotic treatment will not help because this is a viral infection
• However, like other viral infections, care is supportive, see next section

• Use Ibuprofen or acetaminophen for fever or aches and pains
• Continue normal bathing/showering to keep the rash clean to help prevent a bacterial infection
• Keep the rash dry and covered to avoid spreading the infection to others
• Do not pick at scabs
  • Picking at scabs can cause spreading, infection, or worsen scarring
• Always wash your hands with soap and water after touching the rash
• You can apply calamine lotion or Vaseline
• After the scab falls off, you can apply Aquaphor ointment for comfort
• Your doctor may give you an antibiotic if there is a concern about bacterial infection; follow the instructions provided
• People with weakened immune systems who test positive for Mpox may be prescribed a course of an antiviral called Tecovirimat (TPOXX)

• Is less than 2 mos old, and the temperature is greater than 100.4°F (38.0°C) rectally
• Is constantly crying, irritable, and you cannot console them
• Does not urinate for more than 8 hrs

• There are new symptoms of pain
  • e.g., earache or burning with urination
• There has been a fever for more than 3 days
• The rash has spreading redness, increased pain, yellow crusting, or pus drainage
• You have any other concerns

• Call your local Department of Public Health
  • The Philadelphia Department of Public Health: (215) 685-5488
  • The Montgomery County Department of Public Health: (610) 278-5117
  • The Camden County Department of Health and Human Services: (856) 374-6370
• Visit the CDC website: Clinical Signs and Symptoms of Monkeypox