MPOX can vary greatly in appearance. Some lesions are small, while others may develop larger lesions. MPOX lesions are often filled with pus and scab over as they start to heal. Oftentimes, these lesions are painful.

The key symptom of MPOX are rashes, bumps or blisters. These may appear anywhere on the body, including the genitals. It may present similar to syphilis, herpes, etc. 

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Early on in a MPOX infection an individual may also feel:

• Fever and headache

• Muscle aches

• Cough or sore throat

• Malaise or exhaustion

• Chills

• Swollen lymph nodes

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Symptom onset ranges from 5-21 days after exposure. MPOX rarely results in death, although severely immunocompromised people may suffer worse outcomes. Hospitalizations also remain rare. In most instances, individuals hospitalized for MPOX have been hospitalized for pain management.

The most common way MPOX is spread is through direct contact with the rash.

MPOX can spread when a person has close contact with an infected person; by touching MPOX lesions on a person’s skin; by encountering respiratory droplets or secretions from the eyes, nose and mouth from a person with MPOX; or when a person encounters materials (bedding, towels, etc.) that are contaminated with the virus.

MPOX can also spread from animals to people, although this form of MPOX spread has not been reported in the U.S. this year.

To prevent the spread of MPOX, infected or exposed individuals should avoid skin-to-skin contact including hugging, kissing, talking closely and sex. Touching shared fabrics, shared surfaces and objects should also be avoided.​

Limiting your number of sexual partners and avoiding anonymous sex can lower your risk.

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Screen potential partners for symptoms. Under good lighting, look at exposed skin before touching. If your partner's skin is not warm, dry, and intact, do not touch it and encourage your partner to get assessed by a healthcare provider.

Also avoid hooking up with people who have recently had a fever or unexplained rashes.

Contact your primary care provider right away to get tested. If you don't have a primary care provider or are having trouble getting testing call 406-258-3896 to be connected to services.

If you test positive for MPOX, Missoula Public Health (MPH) will reach out to you with specific isolation guidance. Isolate from your ENTIRE household until MPH reaches out to you. This INCLUDES PETS. Human-to-animal transmission of the virus is possible. While the comfort of a cat or dog during this uncomfortable time sounds appealing, please stay away from your pet/s.

CDC data suggest people can spread MPOX from the time symptoms start until all symptoms have resolved, including full healing of the rash with formation of a fresh layer of skin. The CDC says, ideally, people with MPOX would remain in isolation for the duration of illness, which typically lasts two to four weeks. 

Missoula Public Health will reach out to you with specific guidance. In the meantime, close contacts of MPOX cases should monitor their health for 21 days after their last exposure. This includes taking their temperature at morning and night and checking for other symptoms of MPOX. If symptoms develop, individuals will need to isolate themselves from others.

If you fit into one of the following eligibility categories, call Missoula Public Health at 406-258-3896 to be added to the vaccine appointment wait list.

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Post-exposure prophylaxis (PEP): 

• Adults 18 years* and older who have had exposure to individuals with confirmed orthopoxvirus/MPOX virus infection.  

Post-exposure prophylaxis ++ (PEP++):

• Adults 18 years* and older who have had multiple sexual partners in the past 14 days in a jurisdiction with known MPOX. 

• This may include:  

  • Known contacts who are identified by public health via case investigation, contact tracing, and risk exposure assessments   

  • People who are aware that one of their sexual partners from the past 2 weeks has received a MPOX diagnosis.

  • Gay, bisexual, other men who have sex with men, and transgender people who report any of the following in the past 2 weeks:  

    • Group sex or sex with multiple partners. 

    • Sex at a commercial sex venue or in association with an event, venue, or defined geographic area where MPOX transmission has been reported.   

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Pre-exposure prophylaxis (PREP):  

• Adults 18* and older who meet one of the following criteria: 

  • Individuals who have recently had multiple or anonymous sexual partners; OR

  • Partners of individuals who have had multiple or anonymous sexual partners; OR

  • Sex workers; OR

  • Staff at establishments where sexual activity occurs (e.g., bathhouses, saunas, sex clubs); OR

  • Were diagnosed with gonorrhea or early syphilis within the past 12 months; OR

  • Persons experiencing homelessness with high-risk behaviors; OR

  • Are on HIV pre-exposure prophylaxis; OR

  • Are part of high risk cohorts identified by clinical staff in the correctional system; OR

  • Individuals deemed to have high-risk based on individual risk assessments.

Note: eligible persons, per the criteria above, who are immunocompromised (e.g., those with advanced or uncontrolled HIV) or those who have underlying medical conditions that confer increased risk for severe disease (e.g., atopic dermatitis, eczema) could be prioritized for vaccination.

• Certain healthcare and public health response team members designated by public health authorities to be vaccinated for preparedness purposes according to ACIP guidance.  

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At this time, most clinicians in the U.S. and laboratorians not performing the orthopox generic test to diagnose orthopoxviruses, including MPOX virus, are not advised to receive MPOX vaccine PrEP 

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*For individuals under the age of 18 years, Jynneos may be administered under the current EUA as a 2-dose 0.5 mL subcutaneous injection given 28 days apart. 

Currently, there are no specific approved treatments for MPX  infections, but CDC says antivirals such as tecovirimat (TPOXX) may be recommended for people who are more likely to get severely ill. Although TPOXX is only FDA-approved to treat smallpox, it has been used in a small number of MPX patients nationwide. Many of these patients have reported that the TPOXX lessened the pain associated with MPX. Montana DPHHS has a small stockpile of TPOXX. If you have MPX and are in severe pain, reach out to your primary care physician and let them know if you are interested in trying TPOXX.

The CDC's website has robust information on MPX. Please visit the CDC MPX page here.