After a diagnosis, monkeypox treatment mainly involves managing symptoms, said Dr. Bernard Camins, the medical director for infection prevention at the Mount Sinai Health System. Patients with anal or rectal lesions may experience a lot of pain, especially while defecating, and in those cases, a doctor may prescribe pain killers or recommend stool softeners and shallow sitz baths, used to relieve pain or itchiness in the genital area, he said. Patients with sores in their mouth may have difficulty swallowing and can use medication to help. Some may develop secondary bacterial infections and require antibiotic treatment, especially if they have large, open lesions.
Antivirals such as tecovirimat, or TPOXX, are typically recommended only for people who have more systemic symptoms, like a fever, headache, swollen lymph nodes or a bodywide rash and are at high risk for complications from monkeypox. Doctors must request the drug from the government’s stockpile, fill out extensive paperwork and get patients’ informed consent in order to obtain the treatment.
“It’s not a medication that is sitting on the shelf in the pharmacy or in the clinic,” said Dr. Sandro Cinti, an infectious disease physician at the University of Michigan in Ann Arbor.
Regardless of whether they are able to receive antiviral treatment, patients should isolate at home as soon as they develop monkeypox symptoms. They should cover all skin rashes as much as possible, and, like those with Covid-19, avoid close contact with friends, family members and pets, and wear high-quality masks if they must come in contact with others for medical care. The C.D.C. recommends limiting exposure to others and staying in isolation until any lesions are completely healed. You’re out of the woods only after lesions crust over, scabs fall off and a fresh layer of intact skin has formed. And that can take a long time — anywhere from two to four weeks.
