From person to person:
Mpox spreads from person to person mainly through close contact with someone who has mpox. Close contact includes skin-to-skin (such as touching or sex) and mouth-to-mouth, or mouth-to-skin contact (such as kissing), and can also include being face-to-face with someone who has mpox (such as talking or breathing close to one another, which can generate infectious respiratory particles). During the global outbreak that began in 2022, the virus mostly spread through sexual contact. More research is needed on how mpox spreads during outbreaks in different settings and under different conditions.
People with mpox are considered infectious until all their lesions have crusted over, the scabs have fallen off and a new layer of skin has formed underneath, and all the lesions on the eyes and in the body (in the mouth, throat, eyes, vagina and anus) have healed too, which usually takes from 2 to 4 weeks.
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It is also possible for the virus to persist for some time on clothing, bedding, towels, objects, electronics and surfaces that have been touched by a person with mpox. Someone else who touches these items may become infected, particularly if they have any cuts or abrasions or touch their eyes, nose, mouth or other mucous membranes without first washing their hands. Cleaning and disinfecting surfaces/objects and cleaning your hands after touching surfaces/objects that may be contaminated can help prevent this type of transmission.
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The virus can also spread during pregnancy to the fetus, during or after birth through skin-to-skin contact, or from a parent with mpox to an infant or child during close contact.
Although getting mpox from someone who is asymptomatic (not showing symptoms) has been reported, there is still limited information on whether the virus can be transmitted from someone with the virus before they get symptoms or after their lesions have healed. Although live virus has been isolated from semen, we do not yet know the extent to which infection can spread through semen, vaginal fluids, amniotic fluids, breastmilk or blood.
From animals to humans:
Someone who comes into physical contact with an animal which carries the virus, such as some species of monkeys or a terrestrial rodent (such as the tree squirrel) may also develop mpox. Exposure by such physical contact with an animal or meat can occur through bites or scratches, or during activities such as hunting, skinning, trapping or preparing a meal. The virus can also be caught through eating contaminated meat which is not cooked thoroughly.
The risk of getting mpox from animals can be reduced by avoiding unprotected contact with wild animals, especially those that are sick or dead (including their meat and blood). In countries where animals carry the virus, any food containing animal parts or meat should be cooked thoroughly before eating.
From humans to animals:
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There have been a few reports of the virus being identified in pet dogs. However, it has not been confirmed whether these were true infections or whether the detection of virus was related to surface contamination.
Since many species of animals are known to be susceptible to the virus, there is the potential for spillback of the virus from humans to animals in different settings. People who have confirmed or suspected mpox should avoid close physical contact with animals, including pets (such as cats, dogs, hamsters, gerbils), livestock and wildlife.
More detailed advice for pet owners and persons working with animals can be found in the WOAH risk guidance on reducing spillback of monkeypox virus.
WHO continues to work with its One Health partners, the Food and Agriculture Organization (FAO) and the World Organisation for Animal Health (WOAH), to learn more about the natural reservoir of the virus and help countries to reduce the risk of mpox transmission from or to animals.
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