Monkeypox Spreads on Surfaces Only in Certain Cases — Here's What to Know

We’ve been asking KQED readers and listeners “what do you need to know about monkeypox?”

Although monkeypox has existed among humans for over 50 years, this most recent outbreak in the United States has seen a significant amount of misinformation online about the disease and how it spreads. And one of the biggest questions we’ve gotten from our audience: Do I need to worry about the risks of monkeypox and surfaces?

Anyone, regardless of sexual orientation or preference, can get monkeypox. Right now, the monkeypox outbreak in the United States is particularly affecting communities of gay and bisexual men, and men who have sex with men, and the World Health Organization notes that trans people and gender-diverse people “may also be more vulnerable in the context of the current outbreak.”

The main way that the virus spreads is via close, skin-to-skin contact with a person who’s infected with monkeypox — which includes sexual contact but is not limited to it. Monkeypox can also spread via respiratory droplets through very close, sustained face-to-face contact. Another way monkeypox can be transmitted that’s far less common than skin-to-skin contact is on shared surfaces and items.

So how worried should you be about the risk of monkeypox spreading through surfaces or through the air?

The short answer: your risk of catching monkeypox from surfaces is highest if you’re sharing a home with a person who has monkeypox. Keep reading for what you need to know about the risks of monkeypox and surfaces.

Also, please remember that the advice that follows is based on what information we currently know and the data experts have right now about monkeypox. As with COVID, you may find that advice and best practices around monkeypox evolve and shift as more scientific information becomes available.

Don’t see your question answered below, or in our other guides covering monkeypox? Send us your question and tell us what to cover.

Monkeypox can live on surfaces — but your risk of being infected this way is low

According to the Centers for Disease Control and Prevention, one scientific study found that the monkeypox virus can live on surfaces for up to 15 days. Yes, that may sound pretty alarming, but the most recent data actually shows that monkeypox doesn’t do so well spreading through routes that don’t involve close physical or intimate contact.

Last week, the World Health Organization reported only around 0.2% of people infected are thought to have caught the virus from a contaminated surface in this current outbreak. 

Syra Madad, an infectious disease epidemiologist at Harvard’s Belfer Center, recently told Slate that “just because you have viral particles on a surface doesn’t mean (they’re) going to cause infection in another person.” That is, it’s not enough for that virus to be present — there also needs to be enough of that virus getting transferred first onto the surface by an infected person, and then onto the skin of someone who isn’t infected. “It’s not as easy as ‘I’m going to touch this doorknob and somebody with monkeypox just touched it so I’m going to get infected,’ ” she says.

Dr. Peter Chin-Hong, an infectious disease specialist at UCSF, says that clothing, materials and surfaces are most likely to be a method of virus transmission within the home of someone with monkeypox, specifically when someone else is having sustained contact with those items, rather than brief contact.

But going to the thrift store or purchasing bedding at Bed Bath & Beyond? “That’s very, very low risk,” he said.

What about being in shared, high-touch public spaces like a gym or a pool? “It’s very, very low risk to get monkeypox in a swimming pool,” says Dr. Chin-Hong. “The risk of just touching objects in the gym or in the yoga studio is very, very small. It’s really in the context of a household where you’re touching the same things multiple times over and over again for multiple hours.”

Even when you’re armed with the facts, the thought of monkeypox virus being on shared spaces in the outside world — on door handles, public transit or clothing in a store — still feels unsettling, especially if you’re being bombarded with headlines and TikToks on the subject. But remember: what gains traction online isn’t always reliable or fact-checked — and rare instances don’t equal a widespread risk.

Infectious disease doctor Susan McLellan at the University of Texas Medical Branch in Galveston, Texas, offered this perspective to NPR: “During this outbreak, there will probably be at least one random case where somebody gets it on a bus,” she said. “But, you know, that’s going to be profoundly rare, probably less likely than being hit by that bus.”

“If monkeypox were easily transmitted on the subway, on buses, we would be seeing it among a very different population than almost purely among the population where transmission is occurring mostly during close, intimate contact,” she noted.

Monkeypox can live in the air — but only briefly

The monkeypox virus can also spread through respiratory droplets that a person infected with monkeypox breathes out onto another person. This contact would have to be very close and sustained — a lengthy face-to-face conversation or kissing are some examples — for the virus to spread this way.

This means yes, monkeypox can live in the air — but not in the way you might be imagining. The idea of whether you can catch monkeypox from the air is “probably one of the most controversial areas right now,” says Dr. Chin-Hong — and he stresses that it’s important to understand what we mean by “airborne.”

Unlike COVID, monkeypox virus is not thought to linger in the air for a sustained period of time. That is, if someone with COVID breathes out respiratory droplets, those droplets can hang in the air for some time, and could expose the next person who steps into that space to the coronavirus. The monkeypox virus doesn’t operate the same way, says Dr. Chin-Hong. “COVID is a respiratory virus by its definition,” he notes. “Monkeypox is not.”

“In general, it’s not going to be the same way we think about ‘droplets’ or ‘airborne’ and COVID,” he says. You can’t get monkeypox from casual conversations, or by passing someone with monkeypox — say, in a store.

So how else could you theoretically catch monkeypox “in the air,” if not through very close conversations or kissing? This is where sharing a home with someone who has monkeypox definitely presents the virus with more opportunities for transmission.

Dr. Chin-Hong points to the example of a person with monkeypox sleeping in a bed, and their monkeypox rash shedding scabs onto the bedsheets. If another person comes in the next morning and changes those sheets, waving them around into the air, “these little scabs are filled with a virus which can survive for some time, but then go in the air, and if you inhale it, you can be afflicted with monkeypox.”

Some individuals have absolutely gotten monkeypox that way within households, says Dr. Chin-Hong — but “only because these small scabs are floating in the air temporarily.” For this reason, the San Francisco Department of Public Health explicitly warns against shaking out bedding and towels that have been used by someone with monkeypox.

If you’re sharing a home with someone who has monkeypox, worrying about virus on shared surfaces is justified — but there are steps you can take.

If you’re sharing a home with someone with an active monkeypox infection — or if you yourself have monkeypox and want to keep those you live with safe — being aware of how monkeypox can spread within a home and taking the appropriate measures is the best way to stop the virus spreading.

If someone in your home has monkeypox …

You should not be sharing materials like bedding, clothing and towels. You should also not be sharing cooking or eating utensils.

As with COVID, it’s ideal that someone isolating with monkeypox uses their own bathroom exclusively, away from the rest of the household. But depending on your home setup, this may not be possible.

Be particularly careful around laundry, especially bedding

As Dr. Chin-Hong says above, bedding and laundry can pose a particular risk because of how a person’s lesions with active monkeypox virus can rub onto those materials. Ideally, a person with monkeypox should do their own laundry and change their own bedding. Sheets and laundry should not be shaken out, in case scabs are thrown into the air and inhaled.

If you have to do laundry or change the bedding of someone with monkeypox, consider wearing a mask and eye protection to avoid this kind of contamination, and wash your hands very thoroughly after.

If you have monkeypox and can’t avoid being in the same room as other people, the WHO advises you to keep any rashes or lesions covered with clothing or a bandage. This way, there’s far less chance of the virus shedding onto shared materials or surfaces within a home.

Anyone who thinks they’ve been exposed to monkeypox in the home, or through their networks, should seek a vaccine.

The CDC recommends that the monkeypox vaccine be given to a person within four days of the date they were exposed to monkeypox, for the best chance of preventing onset of the disease.

If a person gets the vaccine between 4 and 14 days of being exposed, the vaccine may reduce the symptoms of monkeypox, but may not prevent the disease altogether. Read more on how to find a monkeypox vaccine near you.

Follow cleaning protocols to reduce the risk of spread

Yes, monkeypox can live on shared surfaces, and potentially spread through them as a result of repeated contact. But as Harvard’s Syra Madad told Slate, “the monkeypox virus is a DNA-based virus and is a bit of a wimpy virus in that you can actually kill it with household disinfectants and UV light and the like.”

The CDC recommends regularly cleaning and disinfecting your household spaces to prevent the spread of monkeypox. The Environmental Protection Agency has a list of approved cleaning products and disinfectants for monkeypox, which includes common items you might already own like Lysol and Clorox. If you don’t have those products already in your home and you’re isolating with monkeypox, consider exploring home delivery options or asking friends or family to deliver cleaning products to your home.

Even if you’re isolating with monkeypox alone in your home, the CDC still recommends regularly cleaning and disinfecting your spaces if you’re able to, to limit household contamination for anyone that does enter your home later.

Read the CDC’s full guide to cleaning and disinfecting your home during a monkeypox infection.

Monkeypox sounds scary — but don’t let fear of transmission distract you from COVID

Monkeypox can seem frightening. Especially if you’re part of a community that’s been particularly impacted by the spread of the virus.

But despite these natural fears, Dr. Chin-Hong wants to remind you that “at this point, you’re much more likely to get something like COVID than monkeypox. Although I know it’s really scary to people.” Monkeypox is not nearly as contagious as COVID-19.

You shouldn’t feel ashamed for worrying about how the monkeypox virus spreads. It’s an understandable fear — not least because we’ve been here before, with COVID.

Two years ago, the idea of surface transmission for the coronavirus was very much in the popular consciousness, as early public health messaging around COVID-19 laid heavy emphasis on strong hand-washing and sanitation practices, and videos like “How to Safely Grocery Shop During Coronavirus” racked up huge views. And while good hygiene practices remain important around the coronavirus, more recent and complete data has taught us that respiratory transmission between people poses a far greater risk.

Nonetheless, it’s hard not to hear fears about monkeypox and fomites without being transported back to those first unsettling months of the COVID pandemic — a pandemic we’re still very much in, even as we work to keep our communities safe from the new public health threat in monkeypox.

What other questions do you have about monkeypox?

If you have more questions about monkeypox, we want to hear them. If you can’t find an answer in this post, or in our guide on what monkeypox symptoms are or in our guide on how to find a monkeypox vaccine near you, you can use the box below to submit your question. What you send us will make our reporting on monkeypox stronger, and help us decide what to cover here on our site and on KQED Public Radio.

Please know that we can’t reach back out directly to everyone who asks a question, and we can’t give out individual medical advice. If you’re concerned about monkeypox or another health matter, we urge you to reach out to your health care provider, or a local community clinic if you don’t have insurance. (See our list of community clinics in your county.)