The monkeypox virus can spread from person to person through close physical contact with infectious lesions or pustules, by touching items — like clothing or bedding — that previously touched the rash, or via the respiratory droplets produced by coughing or sneezing.
Monkeypox can also be transmitted from mother to fetus via the placenta or through close contact during and after birth.
It is unclear whether monkeypox is also transmitted sexually, though in a study of more than 500 cases that were reported in 16 countries between April and June, researchers found that 98 percent of monkeypox cases were among men who have sex with men. Researchers in another study found evidence of monkeypox virus D.N.A. in saliva, urine, feces and semen, but they do not yet know if the virus found there is able to replicate and infect another individual.
Some experts and academics are concerned about the stigma that comes with labeling monkeypox a sexually transmitted infection. Others argue that it is important to acknowledge sex as a possible risk factor in order to help those who are most vulnerable right now — men who have sex with men.
Anyone can potentially catch and transmit monkeypox, but the number of cases in women and children has remained relatively small, even as testing has expanded around the globe.
Currently, the risk to the general population is pretty low. People are unlikely to get monkeypox in shared spaces like schools and offices, or by trying on clothes in stores, as some social media posts have suggested, said Dr. Seth Blumberg, an expert in infectious diseases at the University of California, San Francisco.
Other evidence also points to sex as a likely route of transmission. Many cases in the recent outbreak have involved presentation of lesions or pustules on genital regions, rather than the classic flu-like symptoms of monkeypox followed by a body-wide rash. Several small studies have also found monkeypox virus DNA in semen and other bodily fluids collected from patients, although it is not clear yet whether the virus found there is able to replicate and infect another individual.
As a precaution, some public health experts have suggested that those at risk of monkeypox temporarily reduce their number of partners to reduce their risk and avoid sex if they do get sick. The W.H.O. has also updated its guidance to recommend that those who have a confirmed or suspected monkeypox infection use condoms during sex for 12 weeks after they have completely recovered to reduce the risk of spreading monkeypox to partners.
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