Can people be infected with monkeypox through airborne transmission? Q&A with an immunologist.

Mark Cameron, PhD is an associate professor at the Case Western Reserve University School of Medicine and member of the American Association of Immunologists and American Society for Virology. Dr. Cameron’s research experience focuses on population health, virus outbreaks and vaccine development. He was recruited to be part of the rapid research team when SARS hit Toronto in 2003 and is a nationally recognized expert on COVID-19.

Monkeypox Q&A

How worried should the general public be about monkeypox at this point? 

Many of us are closely following the CDC’s ‘Monkeypox in the U.S.’ webpage because the spread of monkeypox is a story still being written.  The CDC is currently tracking monkeypox in the U.S. as an outbreak, which, while causing great concern in its own right, already sets it apart from a pandemic where infections are much more widespread globally and with deadly consequences.  

That said, monkeypox is spreading in countries where it’s not normally reported, including here in the U.S.  The case trends are worrisome with confirmed cases numbering over 7,500 in the U.S. Currently, greatly overshadowing previous encounters with monkeypox including travel cases and a 2003 outbreak in the U.S. involving contact with infected animals.  

At this time, however, the CDC is tracking monkeypox infections as occurring primarily amongst close contacts.  This is all quite different than the status of the COVID-19 pandemic, where high levels of community spread are still occurring amongst people who are not in close, personal contact.             

Is monkeypox airborne? The CDC lists “contact with respiratory secretions” as a way it spreads—what does this mean? 

We don’t actually know how often monkeypox can spread through respiratory means, but most researchers agree that transmission takes much closer contact with respiratory secretions than what would normally describe an airborne virus.  That said, the CDC's advice to reduce the risk of being infected with monkeypox where it might be, or is known to be, present includes avoiding contact with respiratory secretions, as well as skin to skin contact and  other measures.    

If monkeypox spreads through sexual contact, is it an STD?

Monkeypox is not an STD in the traditional sense, where an infection is passed from one person to another via sexual activity.  Close contact with someone who has monkeypox need not include sexual activity to risk infection, including indirectly handling fabric or objects of theirs that haven’t been disinfected.   

The CDC has very frank guidance for reducing your chances of being infected with monkeypox on its ‘Learn More’ webpage.  Their guidance includes information on where or when spread of monkeypox is at risk, safer sex advice to reduce the chances of being infected with monkeypox during sexual activity, and what to do in more public or caregiving settings where monkeypox is, or may be, present and skin to skin contact is possible or probable.