How the Mpox Virus Spreads

Medically Reviewed by Dr. Vijay Kumar Sohanlal, MBBS, MS (Orthopaedics), Orthopaedic & Joint Replacement Surgeon, Founder & Owner of  MAHI Multispeciality Hospitals, Kilpauk, Chennai
Last medically reviewed: September 2026

Mpox spreads mainly through close, physical contact with someone who is infected. This includes touching an active rash or scabs, skin to skin contact during sex, kissing, or extended face to face interaction. The virus can also linger on and spread through contaminated clothing, bedding, towels, and other shared items, and in certain regions, people can catch it from contact with infected animals.

Understanding how the mpox virus spreads matters because the risk of transmission depends heavily on the nature and length of contact, not just being in the same room as an infected person. Brief, casual encounters carry far less risk than sustained physical closeness or direct contact with lesions or contaminated materials.

Close Skin-to-Skin Contact is the Main Route

Mpox can spread when a person comes into direct contact with infectious lesions, scabs or body fluids. The virus can enter through broken skin or through mucous membranes such as the mouth, eyes, nose, genitals or anus.

Close contact can happen in everyday situations as well as during intimate contact.

• Touching a rash or scab: Direct contact with an infectious lesion can transmit the virus.
• Kissing or hugging: Close physical contact can create opportunities for exposure, particularly when lesions or infectious secretions are present.
• Massage or prolonged skin contact: Extended physical contact can increase the opportunity for the virus to pass from one person to another.
• Contact with affected areas that are not immediately visible: Mpox lesions can occur in the mouth, throat, genital area, vagina or anus, making the infection less obvious in some people.

Clinical Pearl: The presence of a rash is important, but mpox transmission is not limited to lesions that are easy to see. Close contact with affected mucosal areas can also result in exposure.

Sexual Contact Can Spread Mpox

During the global outbreak that began in 2022, much of the documented person-to-person transmission occurred through sexual or intimate contact. However, mpox is not exclusively a sexually transmitted infection. Anyone who has close contact with an infectious person can potentially become infected.

Transmission can occur during:

Condoms alone may not fully prevent mpox because infectious lesions can occur on parts of the body that are not covered.

Can Mpox Spread Through Clothes, Bedding or Towels?

Yes. Mpox can spread through contaminated materials that have been in contact with an infectious person, although direct close contact remains the main route of transmission.

Items that may require particular care include:

• Clothing and bedding that have touched infectious lesions or body fluids.
• Towels and other fabrics shared with someone who has mpox.
• Personal or intimate items that come into direct contact with affected skin.
• Objects and surfaces that have been contaminated and have not been appropriately cleaned.

The practical concern is not simply touching an ordinary household object. The risk comes from contact with material contaminated by an infectious person, particularly when the virus can subsequently reach broken skin or mucous membranes.

For this reason, sharing personal items with someone who has mpox should be avoided until appropriate cleaning and infection-control measures have been followed.

Is Mpox an Airborne Infection?

This is one of the most common concerns, and the distinction matters.

Mpox is not known to spread easily through the air across a room in the way highly transmissible airborne infections can. CDC notes that it is not known to spread through ordinary situations such as being in the same classroom, office or travelling near an infected person.

However, WHO recognises that infectious respiratory particles can contribute to transmission during close, prolonged face-to-face contact, particularly when an infected person has respiratory symptoms.

So, being briefly in the same room as someone with mpox does not automatically mean you have been exposed. The level and duration of close contact matter.

Mpox Can Also Spread From Animals to People

Mpox is a zoonotic infection, meaning the virus can pass between animals and humans. In areas where the virus circulates naturally among animals, people may become infected through direct contact with an infected animal or its tissues and body fluids.

Possible exposures include:

• Bites or scratches from infected animals.
• Handling sick or dead wild animals.
• Hunting, trapping, skinning or preparing infected animals.
• Contact with contaminated animal tissues or body fluids.
• Eating contaminated meat that has not been thoroughly cooked, in settings where animal-to-human transmission occurs.

Animal-to-human transmission is particularly relevant in regions where mpox is regularly maintained in animal populations.

Can Mpox Spread Before Symptoms Appear?

This area requires some caution because the evidence is still developing.

People are generally considered infectious from the time symptoms begin until all lesions have healed, scabs have fallen away and fresh skin has formed. Some data have suggested that transmission may occasionally occur shortly before symptoms become apparent. However, WHO notes that evidence regarding transmission before symptoms remains limited. There is also no established evidence that people who never develop symptoms routinely transmit the virus.

This is why new or unexplained mpox-like lesions should be taken seriously, particularly after a known exposure.

How Long Can Someone With Mpox Spread the Virus?

A person can remain infectious while active lesions are present.

Transmission can continue until:

1. All lesions have crusted over.
2. The scabs have fallen off.
3. Fresh skin has formed underneath.
4. Lesions affecting areas such as the mouth, throat, eyes, genitals or anus have also healed.

This healing stage is important because someone may feel better before every infectious lesion has completely resolved.

Expert Insight: Recovery should not be judged only by whether fever or other early symptoms have disappeared. Complete healing of the lesions is an important part of determining when the infectious period has ended.

What Does Not Usually Spread Mpox?

Understanding what does not commonly transmit mpox can prevent unnecessary fear.

The key distinction is between casual proximity and close exposure. Mpox transmission is primarily associated with direct close contact, contaminated materials or specific animal exposures.

Reducing the Risk of Mpox Transmission

Preventing transmission does not require avoiding everyday life. It mainly involves recognising situations where close exposure is possible and taking sensible precautions.

• Avoid direct contact with a person who has an unexplained mpox-like rash until they have been medically assessed.
• Do not touch lesions, scabs or affected skin of someone known to have mpox.
• Avoid sharing clothing, towels, bedding or personal items used by an infected person.
• Wash your hands regularly, particularly after potential contact with contaminated materials.
• Clean and disinfect commonly touched surfaces and materials appropriately when caring for someone with mpox.
• Follow medical advice about isolation and vaccination if you have been exposed or are at increased risk of infection.

For people caring for someone with mpox at home, additional precautions may be necessary, including appropriate handling of laundry and personal protective measures.

The Takeaway

Mpox spreads mainly through close physical contact, especially contact with infectious skin lesions, scabs, body fluids or affected mucosal areas. Sexual and other intimate contact can create opportunities for transmission, but mpox is not limited to sexual transmission. The virus can also spread through contaminated materials and, in certain settings, from infected animals to people. At the same time, mpox is not known to spread easily through casual everyday proximity or across a room through the air.

Knowing how transmission actually occurs helps you focus on the exposures that matter while avoiding unnecessary fear of ordinary social contact.