Monkeypox

Monkeypox is a rare disease caused by infection with the monkeypox virus. Monkeypox virus is part of the same family of viruses as variola virus, the virus that causes smallpox. Monkeypox symptoms are similar to smallpox symptoms, but milder, and monkeypox is rarely fatal. Monkeypox is not related to chickenpox.

Monkeypox was discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research. Despite being named “monkeypox,” the source of the disease remains unknown. However, African rodents and non-human primates (like monkeys) might harbor the virus and infect people.

The first human case of monkeypox was recorded in 1970. Prior to the 2022 outbreak, monkeypox had been reported in people in several central and western African countries. Previously, almost all monkeypox cases in people outside of Africa were linked to international travel to countries where the disease commonly occurs or through imported animals. These cases occurred on multiple continents.

Signs and Symptoms

Symptoms of monkeypox can include:

• Fever
• Headache
• Muscle aches and backache
• Swollen lymph nodes
• Chills
• Exhaustion
• Respiratory symptoms (e.g. sore throat, nasal congestion, or cough)
• A rash that may be located on or near the genitals (penis, testicles, labia, and vagina) or anus (butthole) but could also be on other areas like the hands, feet, chest, face, or mouth.
  • The rash will go through several stages, including scabs, before healing.
  • The rash can look like pimples or blisters and may be painful or itchy.

You may experience all or only a few symptoms

• Sometimes, people get a rash first, followed by other symptoms. Others only experience a rash.
• Most people with monkeypox will get a rash.
• Some people have developed a rash before (or without) other symptoms.

Monkeypox symptoms usually start within 3 weeks of exposure to the virus. If someone has flu-like symptoms, they will usually develop a rash 1-4 days later.

Monkeypox can be spread from the time symptoms start until the rash has healed, all scabs have fallen off, and a fresh layer of skin has formed. The illness typically lasts 2-4 weeks.

If You Have a New or Unexplained Rash or Other Symptoms...

• Avoid close contact, including sex or being intimate with anyone, until you have been checked out by a healthcare provider.
• If you don’t have a provider or health insurance, visit a public health clinic near you.
• When you see a healthcare provider, wear a mask, and remind them that this virus is circulating in the area.

How it Spreads

Monkeypox spreads in a few ways.

• Monkeypox can spread to anyone through close, personal, often skin-to-skin contact, including:
  • Direct contact with monkeypox rash, scabs, or body fluids from a person with monkeypox.
  • Touching objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with monkeypox.
  • Contact with respiratory secretions.

• This direct contact can happen during intimate contact, including:
  • Oral, anal, and vaginal sex or touching the genitals (penis, testicles, labia, and vagina) or anus (butthole) of a person with monkeypox.
  • Hugging, massage, and kissing.
  • Prolonged face-to-face contact.
  • Touching fabrics and objects during sex that were used by a person with monkeypox and that have not been disinfected, such as bedding, towels, fetish gear, and sex toys.

• A pregnant person can spread the virus to their fetus through the placenta.

It’s also possible for people to get monkeypox from infected animals, either by being scratched or bitten by the animal or by preparing or eating meat or using products from an infected animal.

A person with monkeypox can spread it to others from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. The illness typically lasts 2-4 weeks.

Scientists are still researching:

• If the virus can be spread when someone has no symptoms
• How often monkeypox is spread through respiratory secretions, or when a person with monkeypox symptoms might be more likely to spread the virus through respiratory secretions.
• Whether monkeypox can be spread through semen, vaginal fluids, urine, or feces.

Prevention

Take the following steps to prevent getting monkeypox:

• Avoid close, skin-to-skin contact with people who have a rash that looks like monkeypox.
  • Do not touch the rash or scabs of a person with monkeypox.
  • Do not kiss, hug, cuddle or have sex with someone with monkeypox.
• Avoid contact with objects and materials that a person with monkeypox has used.
  • Do not share eating utensils or cups with a person with monkeypox.
  • Do not handle or touch the bedding, towels, or clothing of a person with monkeypox.
• Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially before eating or touching your face and after you use the bathroom.

In Central and West Africa, avoid contact with animals that can spread monkeypox virus, usually rodents and primates. Also, avoid sick or dead animals, as well as bedding or other materials they have touched.

CDC recommends vaccination for people who have been exposed to monkeypox and people who may be more likely to get monkeypox.

People more likely to get monkeypox include:

• People who have been identified by public health officials as a contact of someone with monkeypox
• People who are aware that one of their sexual partners in the past 2 weeks has been diagnosed with monkeypox
• People who had multiple sexual partners in the past 2 weeks in an area with known monkeypox

• People whose jobs may expose them to orthopoxviruses, such as:
  • Laboratory workers who perform testing for orthopoxviruses
  • Laboratory workers who handle cultures or animals with orthopoxviruses
  • Some designated healthcare or public health workers

Treatment 

There are no treatments specifically for monkeypox virus infections. However, monkeypox and smallpox viruses are genetically similar, which means that antiviral drugs and vaccines developed to protect against smallpox may be used to prevent and treat monkeypox virus infections.

Antivirals, such as tecovirimat (TPOXX), may be recommended for people who are more likely to get severely ill, like patients with weakened immune systems.

If you have symptoms of monkeypox, you should talk to your healthcare provider, even if you don’t think you had contact with someone who has monkeypox.

Safer Sex, Social Gatherings, and Monkeypox

While CDC works to contain the current monkeypox outbreak and learn more about the virus, this information can help you make informed choices when you are in situations or places where monkeypox could be spread.

How can a person lower their risk during sex?

Talk to your partner about any recent illness and be aware of new or unexplained rashes on your body or your partner’s body, including the genitals and anus. If you or your partner have recently been sick, currently feel sick, or have a new or an unexplained rash, do not have sex and see a healthcare provider.

If you or a partner has monkeypox, the best way to protect yourself and others is to avoid sex of any kind (oral, anal, vaginal) and do not kiss or touch each other’s bodies while you are sick, especially any rash. Do not share things like towels, fetish gear, sex toys, and toothbrushes.

If you or your partner have (or think you might have) monkeypox and you decide to have sex, consider the following to reduce the chance of spreading the virus:

• Have virtual sex with no in-person contact.
• Masturbate together at a distance of at least 6 feet, without touching each other and without touching any rash.
• Consider having sex with your clothes on or covering areas where rash is present, reducing as much skin-to-skin contact as possible. If the rash is confined to the genitals or anus, condoms may help; however, condoms alone are likely not enough to prevent monkeypox.
• Avoid kissing.
• Remember to wash your hands, fetish gear, sex toys and any fabrics (bedding, towels, clothing) after having sex. Learn more about infection control.
• Having multiple or anonymous sex partners may increase your chances of exposure to monkeypox. Limiting your number of sex partners may reduce the possibility of exposure.
• Avoid touching the rash. Touching the rash can spread it to other parts of the body and may delay healing.

What should a person do if they have a new or unexplained rash or other symptoms?

• Avoid sex or being intimate with anyone until you have been checked out by a healthcare provider.
• If you don’t have a provider or health insurance, visit a public health clinic near you.
• When you see a healthcare provider, wear a mask, and remind them that this virus is circulating in the area.
• Avoid gatherings, especially if they involve close, personal, skin-to-skin contact.

Think about the people you have had close, personal, or sexual contact during the last 21 days, including people you met through dating apps. To help stop the spread, you might be asked to share this information if you have received a monkeypox diagnosis.

How can a person lower the chance of getting monkeypox at places like raves, parties, clubs, and festivals?

When thinking about what to do, seek out information from trusted sources like the local health department. Second, consider how much close, personal, skin-to-skin contact is likely to occur at the event you plan to attend. If you feel sick or have a rash, do not attend any gathering, and see a healthcare provider.

• Festivals, events, and concerts where attendees are fully clothed and unlikely to share skin-to-skin contact are safer. However, attendees should be mindful of activities (like kissing) that might spread monkeypox.
• A rave, party, or club where there is minimal clothing and where there is direct, personal, often skin-to-skin contact has some risk. Avoid any rash you see on others and consider minimizing skin-to-skin contact.
• Enclosed spaces, such as back rooms, saunas, sex clubs, or private and public sex parties where intimate, often anonymous sexual contact with multiple partners occurs, may have a higher likelihood of spreading monkeypox.

 

Monkeypox is a disease that can cause flu-like symptoms and a rash. Human-to-human transmission of monkeypox virus occurs by direct contact with lesions, infected body fluids, or from exposure to respiratory secretions during prolonged face-to-face contact. Reports of human-to-human transmission include close contact with a person with monkeypox symptoms. A person is considered to be infectious until all scabs separate and a fresh layer of skin is formed.

If a staff member, volunteer, or resident of a congregate living setting has a monkeypox infection, transmission could occur within the setting. For the purposes of this document, congregate living settings are facilities or other housing where people who are not related reside in close proximity and share at least one common room (e.g., sleeping room, kitchen, bathroom, living room). Congregate living settings can include correctional and detention facilities, homeless shelters, group homes, dormitories at institutes of higher education, seasonal worker housing, residential substance use treatment facilities, and other similar settings. These settings may provide personal care services but are not traditional healthcare settings (e.g. hospitals).  If healthcare services are provided on site, they are usually provided in specific healthcare areas or by outside healthcare personnel (e.g., home health care workers). 

If a monkeypox case has been identified in a congregate living facility, consider the following actions:

• Communicate with staff, volunteers, and residents — Provide clear information to staff, volunteers and residents about monkeypox prevention, including the potential for transmission through close physical contact such as sexual activity. Provide prevention guidance including considerations for safer sex. Keep messages fact-based to avoid introducing stigma when communicating about monkeypox.
• Respond to cases — Consider the following actions to respond to cases in the facility:
  • Staff, volunteers, or residents who are suspected to have monkeypox should be medically evaluated and tested for monkeypox. Anyone who is identified to have monkeypox should isolate away from others until all scabs separate and a fresh layer of healthy skin has formed underneath. Decisions about discontinuation of isolation should be made in consultation with the local or state health department.
  • Staff or volunteers who have monkeypox should isolate at home until they are fully recovered. Flexible, non-punitive sick leave policies for staff members are critical to prevent spread of monkeypox.
  • Some congregate living facilities may be able to provide isolation on-site while others may need move residents off site to isolate. Resident isolation spaces should have a door that can be closed and a dedicated bathroom that other residents do not use. Multiple residents who test positive for monkeypox can stay in the same room.
  • Staff should only enter isolation areas if they are essential to isolation area operations.
  • If residents with monkeypox need to leave the isolation area, they should wear a well-fitting disposable mask over their nose and mouth and cover any skin lesions with long pants and long sleeves, or a sheet or gown.
  • Waste from isolation areas (i.e., handling, storage, treatment, and disposal of soiled PPE, patient dressings, etc.) should be managed in accordance with U.S. Department of Transportation (DOT) Hazardous Materials Regulations (HMR; 49 CFR, Parts 171-180.) Required waste management practices and category designation can differ depending on the Monkeypox virus clade (strain) the patient has. Cases in the current outbreak have been identified to be West African clade and waste from these patients is classified as regulated medical waste (Category B). Facilities should also comply with state and local regulations for handling, storage, treatment, and disposal of waste.
• Identify people who might have been exposed to monkeypox — Facilities should work with their state or local health department to identify and monitor the health of any staff, volunteers, or residents who might have had close contact with someone who has monkeypox. Contact tracing can help identify people with exposure and help prevent additional cases. However, this might not be feasible in all settings.
  • Where contact tracing is feasible, use exposure risk assessment recommendations to identify people who had high degree of exposure to someone with monkeypox. The state or local health department can provide post-exposure vaccination for people with high degree exposures.
  • In facilities where contact tracing is not feasible, staff, volunteers, and residents who spent time in the same area as someone with monkeypox should be considered to have intermediate or low degree of exposure, depending on the characteristics of the setting (e.g. level of crowding). Post-exposure vaccination is not necessary for low or intermediate degree exposures unless deemed appropriate by the state or local health department.
• Ensure access to handwashing — Soap and water or hand sanitizer with at least 60% alcohol should be available at all times and at no cost to all staff, volunteers, and residents. Anyone who touches lesions or clothing, linens, or surfaces that may have had contact with lesions should wash their hands immediately.
• Clean and disinfect the areas where people with monkeypox spent time — Avoid activities that could spread dried material from lesions (e.g., use of fans, dry dusting, sweeping, or vacuuming) in these areas. Perform disinfection using an EPA-registered disinfectant with an Emerging Viral Pathogens claim, which may be found on EPA’s List Q. Follow the manufacturer’s directions for concentration, contact time, and care and handling. Linens can be laundered using regular detergent and warm water. Soiled laundry should be gently and promptly contained in a laundry bag and never be shaken or handled in a manner that may disperse infectious material. Covering mattresses in isolation areas (e.g. with sheets, blankets, or a plastic cover) can facilitate easier laundering.
• Provide appropriate personal protective equipment (PPE) for staff, volunteers, and residents — Employers are responsible for ensuring that workers are protected from exposure to Monkeypox virus and that workers are not exposed to harmful levels of chemicals used for cleaning and disinfection. PPE should be worn by staff, volunteers, or residents in these circumstances:
  • Entering isolation areas — Staff who enter isolation areas should wear a gown, gloves, eye protection, and a NIOSH-approved particulate respirator equipped with N95 filters or higher.
  • Laundry — When handling dirty laundry from people with known or suspected monkeypox infection, staff, volunteers, or residents should wear a gown, gloves, eye protection, and a well-fitting mask or respirator. PPE is not necessary after the wash cycle is completed.
  • Cleaning and disinfection — Staff, volunteers, or residents should wear a gown, gloves, eye protection, and a well-fitting mask or respirator when cleaning areas where people with monkeypox spent time.

Purpose of Home Disinfection

People with monkeypox who do not require hospitalization may be isolated at home. Monkeypox spreads between people through direct contact with an infectious rash, body fluids, or by respiratory secretions during prolonged, face-to-face contact. Transmission of Monkeypox virus is possible from the onset of the first symptoms until the scabs have separated and the skin has fully healed.

During the infectious period of time, body fluids, respiratory secretions, and lesion material from people with monkeypox can contaminate the environment. Poxviruses can survive in linens, clothing and on environmental surfaces, particularly when in dark, cool, and low humidity environments. In one study, investigators found live virus 15 days after a patient’s home was left unoccupied. Studies show that other closely related Orthopoxviruses can survive in an environment, similar to a household, for weeks or months. Porous materials (bedding, clothing, etc.) may harbor live virus for longer periods of time than non-porous (plastic, glass, metal) surfaces.

Orthopoxviruses are very sensitive to UV light. Despite the ability of Orthopoxviruses to persist in the environment, they are also sensitive to many disinfectants, and disinfection is recommended for all areas (such as home and vehicle) where a person with monkeypox has spent time, as well as, for items considered to be potentially contaminated.

Disinfectant

Use an EPA-registered disinfectant, in accordance with the manufacturer’s instructions. Follow all manufacturer directions for use, including concentration, contact time, and care and handling. When choosing a disinfectant, it is important to consider any potential health hazards, and do not mix disinfectants or add other chemicals. Follow these steps for safe and effective disinfectant use:

• Check that your product is EPA-registered: Find the EPA registration number on the product.
• Read the directions: Follow the product’s directions. Check “use sites” and “surface types” to make sure this is the right product for your surface. Next, read the “precautionary statements.”
• Pre-clean the surface: Make sure to wash the surface with soap and water if the directions mention pre-cleaning or if the surface is visibly dirty. Dirt can keep the disinfectant from working.
• Follow the contact time: Follow the instructions: The surface should remain wet for the amount of time indicated to ensure the product is effective. Reapply if necessary.

Cleaning and Disinfection

During isolation at home, people with monkeypox should clean and disinfect the spaces they occupy regularly to limit household contamination.

• ISOLATING ALONE IN HOME: People with monkeypox who are isolating alone at home should regularly clean and disinfect the spaces they occupy, including commonly touched surfaces and items, to limit household contamination. Perform hand hygiene afterwards using an alcohol-based hand rub (ABHR) that contains at least 60% alcohol, or soap and water if ABHR is unavailable.
• ISOLATING WITH OTHERS IN HOME: People with monkeypox who are isolating in a home with others who don’t have monkeypox should follow the isolation and infection control guidance, and any shared spaces, appliances, or items should be disinfected immediately following use.

People who have recovered from monkeypox and whose isolation period has ended should conduct a thorough disinfection of all the spaces within the home that they had been in contact with. Follow the steps below to minimize risk of infection to others in your home after recovery.

• If cleaning and disinfection is done by someone other than the person with monkeypox, that person should wear, at a minimum, disposable medical gloves and a respirator or well-fitting mask.
• Standard clothing that fully covers the skin should be worn, and then immediately laundered according to recommendations below.
• Hand hygiene should be performed using an ABHR, or soap and water if ABHR is unavailable.
• Focus on disinfecting items and surfaces that were in direct contact with the skin of the person with monkeypox, or often in the presence of the person with monkeypox, during isolation. If unsure, disinfect.
• Do not dry dust or sweep as this may spread infectious particles.
  • Wet cleaning methods are preferred such as disinfectant wipes, sprays, and mopping.
  • Vacuuming is acceptable using a vacuum with a high-efficiency air filter. If not available, ensure the person vacuuming wears a well-fitting mask or respirator.

• Clean and disinfect household in the following order:
  1. General waste containment
     1. Collect and contain in a sealed bag any soiled waste such as bandages, paper towels, food packaging, and other general trash items.
  2. Laundry
     1. Gather contaminated clothing and linens before anything else in the room is cleaned. Do not shake the linens as this could spread infectious particles.
  3. Hard surfaces and household items
  4. Upholstered furniture and other soft furnishing
  5. Carpet and flooring
  6. Waste disposal

Laundry

Used or contaminated clothing, linens and bedding materials, towels, and other fabric items should be contained until laundering. When at all possible, people with monkeypox should handle and launder their own soiled laundry. Laundry should not be mixed with that of other members of the household.

Follow these laundering procedures:

• Handle soiled laundry according to standard practices, avoiding contact with contaminates from the rash that may be present on the laundry.
• Soiled laundry should never be shaken or handled in a manner that may spread infectious particles.
• In-home laundry facilities:
  • Transfer soiled laundry items to be laundered in an impermeable container or bag that can be disinfected afterwards. Alternatively, a fabric bag may be used that can also be laundered along with the soiled items.
  • Wash laundry in a standard washing machine with detergent, following label instructions. Laundry sanitizers may be used but are not necessary.
• In-home laundry facilities not available:
  • When in-home laundry facilities (facilities not shared with other households) are not available, individuals should coordinate with their local public health department to determine appropriate laundering options.

Hard Surfaces (and non-porous car interiors)

Routinely clean and disinfect commonly touched surfaces and items (such as counters or light switches) using an EPA-registered disinfectant in accordance with the manufacturer’s instructions.

• This includes surfaces like tables, countertops, door handles, toilet flush handles, faucets, light switches, and floors.
• Include interior surfaces of refrigerator, freezer, other appliances, interior cabinet spaces, or drawers if they have been accessed by the person with monkeypox.
• Items and surfaces within the home that have likely not been in contact with the person while sick with monkeypox do not need to be disinfected.
  • This includes clothing and items in drawers or boxes that have not been in contact with, or in the direct presence of the person with monkeypox.
• Wash soiled dishes and eating utensils in a dishwasher with detergent and hot water or by hand with hot water and dish soap.

Upholstered Furniture, Carpet and Soft Furnishing (and porous car interiors)

• If the person with monkeypox had direct skin contact and/or excessive drainage of fluids from rashes onto soft furnishings, such as upholstered furniture, carpets, rugs, and mattresses, steam cleaning can be considered. Discuss with state or local health authorities for further guidance.
• If the person with monkeypox had minimal contact with soft furnishings, disinfect the surface with a surface-appropriate disinfectant.

Waste Disposal

Generally, management of waste from homes, including those of people with monkeypox isolating at home, should continue as normal. Municipal waste management systems routinely collect and dispose of waste materials from individuals with infectious diseases and can do so safely using existing procedures.

• The person with monkeypox should use a dedicated, lined trash can in the room where they are isolating.
  • Any gloves, bandages, or other waste and disposable items that have been in direct contact with skin should be placed in a sealed plastic bag, then thrown away in the dedicated trash can.
  • The person with monkeypox or other household members should use gloves when removing garbage bags and handling and disposing of trash.

Pets in the Home

Infected animals can spread Monkeypox virus to people, and it is possible that people who are infected can spread Monkeypox virus to animals through close contact, including petting, cuddling, hugging, kissing, licking, sharing sleeping areas, and sharing food.

People with monkeypox should avoid contact with animals, including pets, domestic animals, and wildlife to prevent spreading the virus. If your pet is exposed to monkey pox:

• Do not surrender, euthanize, or abandon pets just because of a potential exposure or Monkeypox virus
• Do not wipe or bathe your pet with chemical disinfectants, alcohol, hydrogen peroxide, or other products, such as hand sanitizer, counter-cleaning wipes, or other industrial or surface cleaners.

If the person with monkeypox did NOT have close contact with pets after symptom onset, ask friends or family members who live in a separate home to be the animal’s caretaker until the person with monkeypox fully recovers. Close contact includes petting, cuddling, hugging, kissing, licking, sharing sleeping areas, and sharing food.

After the person with monkeypox is recovered, disinfect your home before bringing healthy animals back; follow Disinfecting Home and Other Non-Healthcare Settings.

Pets that had close contact with a symptomatic person with monkeypox should be kept at home and away from other animals and people for 21 days after the most recent contact. Infected people should not take care of exposed pets. The person with monkeypox should avoid close contact with the exposed animal, and when possible, ask another household member to care for the animal until the person with monkeypox is fully recovered.

In some cases, it may be necessary to isolate and care for animals that have been exposed to monkeypox in a location other than the home. For example, people who are immunocompromised, pregnant, have young children present (<8 years of age), or with a history of atopic dermatitis or eczema, should not provide care for animals that had close contact to a person with monkeypox as they may be at increased risk for severe outcomes from monkeypox disease.

If you have monkeypox and must care for your healthy pets during home isolation, wash your hands, or use an alcohol-based hand rub, before and after caring for them. It is also important to cover any skin rash to the best extent possible (i.e. long sleeves, long pants), and wear gloves and a well-fitting mask or respirator while providing care for your animals.

• Do not put a mask on your pet.
• Avoid close contact with your pet.
• Ensure your pet cannot inadvertently come into contact with contaminated articles in the home such as clothing, sheets, and towels used by the person with monkeypox.
• Do not let animals come into contact with rashes, bandages, and body fluids.
• Ensure food, toys, bedding, or other items that you provide for your animal during its isolation do not come in direct contact with skin or uncovered rash.

What to do if a pet show signs of monkeypox

While we do not know all the symptoms infected animals may have, watch the animal for potential signs of illness including lethargy, lack of appetite, coughing, nasal secretions or crust, bloating, fever, and/or pimple- or blister-like skin rash. Call you veterinarian if you notice an animal appears sick within 21 days of having contact with a person who has probable or confirmed monkeypox. A veterinarian can help notify your state public health veterinarian [PDF – 7 pages] or state animal health official.

• Do not euthanize pets with suspected monkeypox unless directed by a veterinarian.
• Do not wipe or bathe your pet with chemical disinfectants, alcohol, hydrogen peroxide, or other products, such as hand sanitizer, counter-cleaning wipes, or other industrial or surface cleaners.

Steps to take if you think your pet has monkeypox

• Get your pet tested if they have had close contact with a person with probable or confirmed monkeypox and they have a new rash or two other clinical signs. Call you veterinarian if you notice an animal appears sick within 21 days of having contact with a person who has probable or confirmed monkeypox. A veterinarian can help notify your state public health veterinarian or state animal health official.
  • Possible clinical signs of monkeypox in animals include lethargy, lack of appetite, coughing, bloating, nasal and/or eye secretions or crust, fever, and/or pox-like skin lesions (may initially resemble a pimple or blister before progression to a characteristic monkeypox lesion) or rash.
• Separate the sick pet or animal from other animals and minimize direct contact with people for at least 21 days after becoming ill or until fully recovered.
  • It is preferable to keep animals with signs of illness isolated in their home and away from anyone who has not had monkeypox.
  • People who are immunocompromised, pregnant, have young children present (<8 years of age), or with a history of atopic dermatitis or eczema, should not provide care for ill animals that had close contact with a person with monkeypox.
• Wash your hands often and use personal protective equipment (PPE) when caring for and cleaning up after sick animals. PPE includes wearing gloves, using eye protection (safety glasses, goggles, or face shield), wearing a well-fitting mask or respirator (ideally a disposable NIOSH-approved N95 filtering facepiece respirator), and wearing a disposable gown.
  • If a disposable gown is not available, wear clothing that fully covers the skin (i.e. long sleeves, long pants), and immediately remove and launder clothing after contact with the animal, animal enclosures, or animal bedding.
  • Carefully remove PPE to avoid self-contamination.
  • Use an alcohol-based hand rub or wash hands with soap and water after PPE has been removed.
• Consult your local public health department for guidelines for waste disposal, but general precautions include:
  • Use a dedicated, lined trash can for all potentially contaminated waste.
  • Do not leave or dispose of waste outdoors as Monkeypox virus infections in wildlife may occur.
  • If appropriate for the species and your plumbing system, flush animal waste down the toilet.
  • Disposable animal housing, disposable rodent bedding, and animal waste that cannot be flushed down the toilet should be sealed in a bag and disposed of properly to prevent these materials from infecting people or other animals, including wild animals and household pests like mice and rats. Follow guidelines for Disinfecting Home and Other Non-Healthcare Settings.
• Bedding, enclosures, food dishes, and any other items in direct contact with infected animals must be properly disinfected following the Disinfecting Home and Other Non-Healthcare Settings.
• Soiled laundry and bedding (including disposable rodent bedding) should not be shaken or otherwise handled in a manner that may disperse infectious particles.
• For household disinfection, follow Disinfecting Home and Other Non-Healthcare Settings.