Mpox, formerly known as monkeypox, is a viral disease that has garnered significant public health attention. The name change was implemented to align with current public health messaging and avoid stigmatization. It is accurate to state that mpox can be transmitted through sexual contact, particularly during intimate activities. However, it is important to understand that mpox is not exclusively a sexually transmitted infection (STI), as there are other ways the virus can spread.
Primary Transmission Routes During Sexual Contact
During sexual activity, the primary way mpox spreads is through direct, skin-to-skin contact with mpox rashes, sores, or scabs. These lesions can appear on any part of the body, including the genitals, anus, and mouth, making intimate physical contact a highly efficient route for transmission. Activities such as oral, anal, or vaginal sex, as well as touching the genitals or anus, can facilitate this direct contact.
Close, face-to-face interactions during sex, like kissing, can also transmit the virus through respiratory secretions. Mpox viral DNA has been found in various bodily fluids, including seminal fluid, rectal swab specimens, and respiratory secretions. Direct contact with infectious sores or rashes remains the most common and significant driver of mpox spread during sexual contact.
Transmission Outside of Sexual Contact
Mpox can also spread through close personal contact that does not involve sexual activity. This includes direct contact with an infected person’s rash, scabs, or bodily fluids, such as through hugging, cuddling, or prolonged face-to-face interaction. The virus can also be transmitted through respiratory droplets during extended close conversations or breathing near an infected individual. While possible, the likelihood of human-to-human respiratory transmission appears to be low compared to direct contact.
Another recognized transmission route involves contact with contaminated materials, known as fomites. This occurs when someone touches items like clothing, bedding, towels, or sex toys that have been used by a person with mpox. The virus can persist on these surfaces, and subsequent contact can lead to infection. Additionally, mpox can spread from animals to humans through bites, scratches, or direct contact with infected animal fluids.
Risk Reduction and Prevention
To reduce the risk of mpox infection, it is advisable to avoid close, skin-to-skin contact with anyone who has a rash that resembles mpox, including what might appear as pimples, blisters, or scabs. Open communication with sexual partners about any new or unexplained rashes or symptoms is also an important step in prevention.
Vaccination is a significant prevention method, with the JYNNEOS vaccine being recommended for individuals at higher risk of exposure. This vaccine typically involves two doses administered four weeks apart, providing the best protection. While condoms can offer some protection by covering certain areas, they may not prevent all exposures since mpox sores can appear on any part of the body not covered by the condom. Infected individuals should isolate themselves until all sores have healed and a new layer of skin has formed, which can take several weeks.