Mpox/Monkeypox Virus 

Mpox is a disease caused by the mpox virus that has regularly been reported in 

some parts of the world. In May 2022, an international outbreak of mpox was 

identified in Western Europe, Canada, and the United States, where mpox does 

not typically occur. The mpox virus is closely related to the variola virus (the 

cause of smallpox) but is much less deadly. Initial symptoms of mpox disease 

include fever, headache and body aches, fatigue, and swollen lymph nodes, 

followed by a rash of lesions on the skin. Like smallpox and other pox viruses, 

mpox is classified as a high-risk pathogen because it can easily be transmitted 

from person-to-person, posing a danger to public health. Cases may be severe, 

especially in children, pregnant women, or people with suppressed immune 

systems. As a result, on August 4, 2022, the U.S. Department of Health and 

Human Services (HHS) declared a public health emergency (PHE) in response to 

the current outbreak. 

Mpox virus can infect both animals and people. 

Employers and workers whose job duties might 

put them in close, personal, often skin-to-skin 

contact with people that have a mpox infection 

or in contact with contaminated materials should 

take precautions to prevent work-related mpox 

transmission. According to the Centers for 

Disease Control and Prevention (CDC), mpox can 

spread through direct contact with an infected 

person or animal including close contact with 

a mpox rash, scabs, or body fluids including 

respiratory droplets, and contaminated materials 

such as clothing, bedding, and towels. However, 

during the current 2022 outbreak, mpox virus 

has been primarily transmitted through close 

personal or intimate/sexual contact with a 

person with mpox infection.

Signs and Symptoms

Early symptoms of mpox that can occur before 

the characteristic rash may include headache, 

fatigue, back and body aches, fever, chills, 

swollen lymph nodes, and rarely respiratory 

symptoms (nasal congestion, cough, sore 

throat). Nearly all people with mpox develop a 

rash, which may be painful or itchy. The rash 

may develop before or without other symptoms 

and can appear on the face, extremities, palms 

of hands, soles of feet, conjunctiva (eye), anus, 

genitalia, and inside of the mouth. It may first 

appear as flat discolored spots or raised firm 

pimples, which turn into blister-like lesions 

filled with clear or yellow fluid. The blisters 

form scabs that later fall off. Symptoms usually 

develop within 3 weeks (21 days) of becoming 

infected with mpox. An individual with a mpox 

infection is contagious from the time when 

symptoms begin until all scabs have fallen off 

and new skin has formed. Symptoms usually last 

between 2–4 weeks and go away on their own 

without treatment. Some people may develop 

complications (e.g., pneumonia, skin infections, 

eye infections). 

Mpox skin rash images

(Source: UK Health Security Agency) 

FactSheet
The severity of mpox illness may depend on 

many factors including:

• The amount of virus present during 

transmission.

• The health and age of the individual. People 

with weakened immune systems (due to 

advanced HIV disease, steroids, immune 

therapy) and those who are pregnant are at 

increased risk. 

• Vaccination status. People born before 1972 

and others who received a vaccine against 

smallpox may have some immunity against 

mpox virus. Some people may have also been 

vaccinated during this outbreak. 

Worker Exposure

Risk for mpox in most work settings is extremely 

low. During the current outbreak, mpox virus 

has been transmitted primarily through close 

personal or intimate/sexual contact with a 

person with mpox infection.

Risks in the workplace can be mitigated by 

taking specific precautions. Workers whose 

duties may involve the types of contacts that 

could spread mpox may include (but are not 

limited to):

• Healthcare workers and first responders 

may encounter mpox through contact with a 

patient with mpox, contaminated materials, or 

biological samples. This includes those working 

at outpatient clinics (e.g., clinics specializing in 

care for sexually transmitted infections):

− Clinical staff such as doctors, nurses, and 

nursing assistants.

− Laboratory staff including clinical and 

research scientists and technicians who 

work with biological samples with the 

potential to contain mpox virus. 

− Housekeeping staff who may have contact 

with contaminated material in patient rooms 

when dusting, sweeping, or handling used 

clothing, bedding, and towels. 

− Administrative staff who may be exposed 

to body fluids during patient intake and 

other direct contact with a patient with a 

mpox infection. 

* According to the CDC, research is still being conducted to determine if mpox can be spread by semen and vaginal fluids. If those modes 

of transmission are confirmed, then the OSHA Bloodborne Pathogens standard will apply.

• Workers in congregate settings such as 

recreational facilities or social venues, homeless 

shelters, group homes, hotels, dormitories, and 

correctional and detention facilities.

• Massage, spa, fitness, and salon workers

whose jobs require close physical contact 

with clients.

• Housekeepers, janitors, cleaning service 

workers, dry cleaning, and laundry workers

who may have contact with contaminated 

material when dusting, sweeping, or handling 

clothing, bedding, and towels. 

• Animal care workers such as veterinary staff.

Information for Employers 

Employers must furnish a place of employment 

that is free from recognized hazards that are 

likely to cause death or serious physical harm 

to their employees (General Duty Clause of the 

OSH Act).

Employers should assess the workplace for 

mpox hazards according to OSHA Guidance 

for Hazard Prevention and Control. In addition, 

employers must follow applicable OSHA 

standards for providing appropriate Personal 

Protective Equipment (PPE) (29 CFR 1910, 

Subpart I), including Respiratory Protection (29 

CFR 1910.134) to workers with increased risk 

of exposure to the virus. OSHA’s Bloodborne 

Pathogens standard (29 CFR 1910.1030) applies 

to occupational exposure to human blood 

and other potentially infectious materials that 

typically do not include respiratory secretions, or 

rash lesions fluid or pus, that may contain mpox 

virus (unless visible human blood is present).*

However, the Bloodborne Pathogens Standard 

offers a framework that may help control some 

sources of the virus, including exposures to 

body fluids not covered by the standard. Other 

guidance on PPE, disinfection, and waste 

management can be found on the Centers for 

Disease Control (CDC) infection control website. 

Employers should ensure that workers with 

mpox isolate and are restricted from work from 

the time symptoms start until the rash has fully 

healed and a fresh layer of skin has formed. 

Employers should offer telework and flexible, 

non-punitive sick leave.
DTSEM FS-4191 01/2023

This is one in a series of informational fact sheets highlighting OSHA programs, policies or standards. It 

does not impose any new compliance requirements. For a comprehensive list of compliance requirements 

of OSHA standards or regulations, refer to Title 29 of the Code of Federal Regulations. This information 

will be made available to sensory-impaired individuals upon request. The voice phone is (202) 693-1999; 

teletypewriter (TTY) number: (877) 889-5627.

Precautions for Workers 

Workers should be trained on the following work 

practices (and how to use PPE): 

• Be alert for people who have rashes or 

symptoms consistent with mpox.

• Isolate people with mpox infection from 

others and cover skin lesions.

• Avoid skin-to-skin contact with people who 

are ill or have visible lesions.

• Avoid unprotected contact with any 

potentially contaminated materials, such as 

clothing, bedding, or eating utensils used by 

someone with mpox infection in healthcare

and non-healthcare settings. 

• Practice good hand hygiene. Wash your hands 

with soap and water or use alcohol-based 

hand sanitizer provided by your workplace 

free of charge.

For more information, please see the CDC toolkit 

for Workplaces and Businesses.

Healthcare workers in clinical settings should 

follow CDC guidance on Infection Prevention and 

Control of Mpox in Healthcare Settings and wear 

recommended PPE including protective clothing

and respirators. 

Laboratory workers should follow CDC-specific 

biosafety guidelines for mpox.

Vaccine Information

Current information about vaccine 

recommendations can be found on the 

CDC website.

Workers’ Rights

Workers have the right to:

• Working conditions that do not pose a risk of 

serious harm.

• Receive information and training (in a 

language and vocabulary the worker 

understands) about workplace hazards, 

methods to prevent them, and the OSHA 

standards that apply to their workplace.

• Review records of work-related injuries 

and illnesses.

• File a complaint asking OSHA to inspect their 

workplace if they believe there is a serious hazard 

or that their employer is not following OSHA’s 

rules. OSHA will keep all identities confidential.

• Exercise their rights under the law without 

retaliation, including reporting an injury or 

raising health and safety concerns with their 

employer or OSHA. If a worker has been 

retaliated against for using their rights, they 

must file a complaint with OSHA as soon as 

possible, but no later than 30 days.

For more information, visit the OSHA Worker 

Rights and Protections page.

For questions or to get information or advice, 

to report an emergency, fatality, inpatient 

hospitalization, amputation, or loss of an eye, 

to file a confidential complaint, or to request 

OSHA’s free on-site consultation service, contact 

your nearest OSHA office, visit www.osha.gov, 

or call OSHA at 1-800-321-OSHA (6742), TTY 

1-877-889-5627.