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Sadly, we are all too familiar with isolating and quarantining in this COVID-19 era. Monkeypox, the newest public health concern and another disease wreaking havoc on society, requires isolation too. Those infected with monkeypox can protect others from infection with proper isolation, disinfection, and cleaning measures. But be warned, isolation for two to four weeks can be a long-time, but remember it helps keep others healthy.

Because the monkeypox virus (MPX) spreads easily from person to person, you can help protect yourself and others by understanding how the disease spreads and knowing the symptoms that accompany the disease. It seems reasonable to suggest staying home and avoiding social situations if clinical signs appear.

Most people recognize that a rash forms a distinguishing feature of MPX. Remember that this rash goes through 4 different stages before scabbing and healing. However, often before the rash develops or along with it, patients with MPX may also experience body aches, weakness, fever, swollen lymph nodes, or even have signs of a cold (e.g., coughing, sneezing, sore throat). Awareness of these symptoms can help you better understand the steps suggested to stop disease transmission to friends, family, and others.

Generally, MPX causes mild illness for most, but remember, it easily transmits from one to another.

MPX spreads all too easily by respiratory droplets (saliva, coughing, sneezing); contact with contaminated objects; sexual activity, and other related close contacts like hugging and kissing; via contact with various contaminated items; and by coming in direct contact with open sores (rash).

Again, this disease is contagious, easily going from one person to another. As with many viral infections, no treatment exists. Therefore, the goal continues to be identifying symptoms and halting spread.

When to quarantine and when to isolate is the question. A person quarantines when exposed to an infectious disease, like MPX. Isolation actions are undertaken when a person knowingly displays signs of infection, confirmed by laboratory tests or exposure to those positive. At the beginning of the COVID-19 pandemic, if exposed, quarantine requirements were clear: stay home and away from others. However, for MPX, the recommendations are less absolute. However, it is sensible to safeguard others by acting wisely, avoiding close contact with others, and limiting social activities when sick.

What constitutes MPX isolation? The Centers for Disease Control and Prevention, among many other health authorities, recommend complete isolation when symptomatic with MPX. What does isolation mean? Ideally, when one isolates, one should:

Additionally, isolation includes separation from family members within your home. When feasible

If isolation isn’t an option or you cannot isolate yourself for the duration of the illness (up to 4 weeks in some cases), ensure you do not socialize, especially at large gatherings. At a minimum, remain separated from others if you have a sore throat, cough, or fever. If you must interact with others once these symptoms have ended, while the rash continues to heal, wear a properly and tightly fitting facemask and cover all exposed sores/rash (gloves, clothes, bandaids, or bandages). Finally, until the rash is gone and new healthy skin has formed, avoid sharing things that could come in contact with other people or animals.

Finally, launder all worn items promptly and disinfect commonly used surfaces that could have been touched by any of your sores or you may have sneezed or coughed on. Continue to avoid close contact, both physical and sexual, with others. Do not share plates, utensils, or cups. Continue to avoid crowds and social gatherings until you have fully recovered. Finally, always practice proper hygiene - ensure you wash your hands under normal circumstances, especially after directly touching any area affected by the rash.

Studies to date show that under some conditions, monkeypox virus particles can remain infectious to others on inanimate objects (e.g., doorknobs, countertops, tables) from as little as 3 days up to 42 days. The duration MPX remains infectious varies on the environmental humidity levels and temperature.

The ability of MPX to survive on surfaces demonstrates that cleaning and disinfecting commonly used items and frequently washing clothes and bedding is warranted. Virus particles have been shown to occur when shed from the respiratory tract (snot, mucus), blood, urine, and open sores or scabs. So the potential to leave virus particles on any surface can easily be understood.

The combination of cleaning and disinfecting can help limit the spread of MPX. Cleaning alone, however, likely isn’t sufficient. Cleaning refers to using water, soap, and mechanical rubbing to remove the majority of grime and dirt from common areas. Compare this to disinfecting, which kills most germs (e.g., viruses) on surfaces and objects. This is done after cleaning and uses bleach or other chemicals. You must first remove any dirt and grime and then disinfect surfaces according to the manufacturer’s label recommendations.

Clean frequently touched areas like handles, doors, cabinets, and light switches after each use, and prevent dust accumulation on common surfaces. When cleaning, prevent dust and other particles from getting into the air using damp, wet cleaning methods rather than dusters and avoid sweeping. Clean any shared bathrooms or other spaces after use. Use common household cleaners such as many detergents or related products to disinfectant cleaned areas. But remember, if using wipes or sprays, read the label carefully to see how long the surface must remain wet to properly kill any viruses or bacteria of concern.

Anyone sick with MPX must frequently launder any worn or contaminated clothing and used bedding. Normal detergents should be sufficient, though ideally, on the hottest setting garments can tolerate. Use full cycles, avoid the energy and water saver shorter cycles as they may prohibit complete cleaning.

When bringing clothes to the machines, do not shake them as that could place virus particles onto surfaces or in the air. Rather than using a hamper that may not be fully washable, place the soiled laundry of infected people into plastic garbage bags to minimize spread.

If you lack washing machines, hand washing still works. Consider using a bathtub or scrub sink and ensure warm enough water and appropriate detergents are used.

Isolating yourself from any loved one helps protect them, but how isolated you need to be and the importance of isolation measures in your home increase when you have:

While birds, reptiles, and fish have not been shown to get MPX, any mammal can, theoretically, contract it. Such pets, like dogs, cats, rabbits, or ferrets, may be at risk. Though the risk remains extremely low, you still want to minimize your pet’s exposure. Pets with underlying conditions, especially immunosuppression, may be more susceptible to the disease.

If you or a family member has been sick with MPX and a pet in your home develops any abnormalities such as a rash, sneezing, coughing, or changes in appetite, contact your local veterinarian or a public health or state veterinarian for further recommendations.

Isolation includes separating yourself physically from others. It means not sharing communal spaces and cleaning used items and clothing yourself to help minimize environmental contamination and decrease the exposure risks to others. Isolation can be lonely, but its benefits far outweigh the risks and frustrations it can cause. However, while taking care to prevent those around you from getting sick, you still need to take care of yourself.

Self-care during isolation includes not just treating flu-like symptoms and keeping your sores clean and dry. It also involves ensuring your mental well-being doesn’t suffer. Zoom with friends and family, read a book, watch movies, and get some fresh air. Isolation doesn’t mean you cannot partake in everyday activities or enjoy nature. You just need to be aware of those around you and take measures to protect them.

Keeping in mind that MPX has no cure, it is nevertheless essential to recognize the symptoms and stop the spread. Treat symptoms similar to the flu the same way you would any viral illness. If you develop symptoms of MPX, contact your individual public health departments, physicians, or related personnel to determine isolation requirements and recommendations in your area. Each local jurisdiction, school district, and state likely has different requirements, so check what is both required and right for you. Isolation may be necessary, but for most, MPX resolves over time; you just need to have patience.

Those with monkeypox should self-isolate, protecting others.

Frequent laundering of clothes, disinfecting, and cleaning common surfaces minimizes household monkeypox contamination.

Monkeypox isolation requirements vary depending on your location. Keep others safe by isolating.

Though rare, pets are susceptible to monkeypox.

“Since we’re going to die, we should be preparing for it.” - a death doula Alua Arthur.

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