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As monkeypox spreads across the United States, it may be giving people flashbacks to the days of wiping down counters and groceries to get rid of the coronavirus. But for most people, the risk of getting monkeypox remains low. Almost all cases in the current outbreak — 98 percent — have been in adult men who have sex with men.
So how is the virus spreading? Studies of previous outbreaks suggest that the monkeypox virus is transmitted in three main ways: through direct contact with an infected person’s rash, by touching contaminated objects and fabrics or by respiratory droplets produced when an infected person coughs or sneezes. There is also evidence that a pregnant woman can spread the virus to her fetus through the placenta.
Scientists are still trying to understand if the virus can spread through semen, vaginal fluids, urine or feces and if people can be contagious before they develop visible symptoms.
Several factors can determine your risk of getting monkeypox, whether from caring for someone who is ill to attending packed parties or simply having sex. How close you are to someone who is sick, how infectious they are, how much time you spend in their vicinity and your own personal health may affect your susceptibility, said Dr. Jay Varma, a physician and epidemiologist who specializes in infectious diseases at Weill Cornell Medical School in New York City.
Here is how experts are thinking about everyday interactions, how the virus is transmitted during them and which behaviors carry the most risk.
The activities that put a person at highest risk of catching the virus involve close, intimate contact with another infected individual. This includes the kind of skin-to-skin contact that occurs during sex, as well as when cuddling, hugging, massaging or kissing another person. Condoms probably add a layer of protection during sex, but they are unlikely to prevent contact with lesions on an infected person’s groin, thighs, buttocks or on other parts of their body.
Roommates and family members in the same house are also at significantly higher risk of getting monkeypox compared to any other individuals a patient may come into close contact with, said Dr. Bernard Camins, the medical director for infection prevention at the Mount Sinai Health System.
Household contacts can catch monkeypox through contaminated clothes, towels and bedding. Shared utensils that may carry an infected person’s saliva should also be considered high risk, said Saskia Popescu, an infectious disease epidemiologist at George Mason University.
When it comes to respiratory droplet transmission, face-to-face or almost face-to-face contact is riskier than being several feet away. Health officials recommend maintaining at least 6 feet of distance from unmasked patients to avoid getting exposed, although some experts argue that this number is arbitrary. Still, just as with Covid-19, masking up indoors is a good idea if you want to protect yourself from monkeypox. Attending a packed indoor party could put you at risk of getting the virus, particularly in parts of the country where cases are high. Raves where people are having direct, skin-to-skin contact, dancing together for a longer duration of time may be riskier still, Dr. Popescu said.
People are unlikely to get the virus by trying on clothing in a store or touching nonporous items like door handles and counters, Dr. Popescu said. “Personally, I’m less concerned with trying clothing on in the store,” she said. For those who are really nervous, she suggested just putting a new item in the laundry when they get home for some peace of mind.
Additionally, some activities that people learned to limit during Covid-19 surges are probably not as risky for monkeypox transmission. For example, sitting on a subway, bus or other public transportation or going to an office or school are unlikely to put people at risk of a monkeypox exposure. But experts caution that this guidance could change as researchers gather more data on monkeypox. If the virus keeps spreading unchecked, it could eventually spill over to a broader population, increasing everyone’s chances of an infection. But, Dr. Camins said, “We’re not there yet.”
Audio produced by Kate Winslett.