Monkeypox (mpox) spreads primarily through close, direct contact with an infected person or animal. This includes:

• Direct contact with the lesions, scabs, or body fluids of someone with monkeypox.
• Close, intimate, or sexual contact, including touching the genitals, anus, mouth, or throat areas where lesions are present.
• Contact with contaminated materials such as clothing, bedding, towels, or objects that have been used by someone infected.
• Respiratory particles from coughing, sneezing, talking, or breathing close to an infected person, although airborne spread plays a smaller role.
• Animal to human transmission occurs through bites, scratches, or handling infected animals or their meat in endemic areas.

Notably, monkeypox can also spread from a pregnant person to the fetus through the placenta, and possibly to newborns during or after birth. The infectious period lasts from the onset of symptoms until all the lesions have healed completely, which can take 2 to 4 weeks. Some transmission may occur before symptoms start, but this is less common or less understood. Avoiding close contact, practicing good hand hygiene, and disinfecting contaminated items can reduce the risk of spread.