Can Masks Help Prevent Monkeypox? What We Know So Far
The disease is mainly transmitted through close contact—but masking may still offer protection in some situations.
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The Centers for Disease Control and Prevention sparked confusion earlier in June when the agency recommended travelers wear masks to protect against the spread of monkeypox—and then promptly deleted it.
"Wear a mask," the CDC said in a June 6 update to its Travelers' Health website. "Wearing a mask can help protect you from many diseases, including monkeypox." But within hours, that guidance was taken down. "Late yesterday, CDC removed the mask recommendation from the monkeypox Travel Health Notice because it caused confusion," a CDC spokesperson told Reuters the next day.
But in trying to prevent confusion, the agency may have inadvertently caused more regarding how the disease is transmitted, and what protective measures people should take. Here, infectious disease experts weigh in on how much protection—if any—face masks can provide against monkeypox, and which modes of transmission are most common.
How Does Monkeypox Spread?
Monkeypox spreads a few different ways, but it's transmitted most easily through skin-to-skin contact, Andrew Noymer, PhD, associate professor of population health and disease provention at the University of California, Irvine, told Health.
The majority of the current outbreak is linked to men who have sex with men—but monkeypox is not a sexually transmitted disease. "Many of these cases were spread through intimate encounters, but that's only because intimate encounters involve skin-to-skin contact, not because of anything exclusively sexual," said Noymer.
While direct contact is the most common way for monkeypox to spread,, it's not the only way. Noymer says that monkeypox lesions can form in the respiratory tract before appearing on other body parts. When those lesions seep, there is the potential for transmission via droplets, especially in very close contact.
Although those droplets can spread monkeypox, their infection vector is limited by their size and weight. The droplets are much larger than the aerosol particles we associate with COVID-19, so they are limited in how far they can travel, due to gravity, Luis Ostrovsky, MD, an infectious disease specialist at Memorial Hermann Hospital in Houston, Texas, tells Health.
"Droplets by their size tend to travel no more than six feet because of gravity," said Dr. Ostrovsky. In order for infection to take hold, people would have to be within six feet for a prolonged period of time in most cases.
According to the CDC, monkeypox can also spread through touching items, like clothing and sheets, that have also come into contact with monkeypox lesions or bodily fluids. Pregnant people are also able to pass the virus to their fetus through the placenta.
Are Masks Effective Against Monkeypox?
According to Dr. Ostrovsky, masking is standard operating procedure for medical professionals, but it may not be necessary in a community setting.
"If you're taking care of a patient that had monkeypox we would require masking with N95s and gowns, gloves, eye protection, etc. Because again, we're dealing with body fluids, and we may be exposed to aerosols in close proximity," he said. "But at this point, I don't think there's enough evidence for requiring masking in the community for it."
For those that live with someone infected with monkeypox, that advice changes. Since prolonged, close-contact exposure heightens the likelihood of respiratory transmission, caregivers should consider masking—still with an N95, but surgical masks may work too—as well as limiting skin-to-skin contact with an infected person.
"I would mask, just as I would in a COVID case," said Noymer, who added that more effective preventative measures include frequently laundering bedding and clothing worn by infected people, disinfecting countertops, and cleaning toilets. The most recent cases have shown more concentrated lesions around rectal and genital areas, so anything in a restroom may need extra sanitation.
How to Protect Against Monkeypox
As monkeypox case counts continue to rise in the U.S., health officials are urging a state of awareness—but not panic—regarding the disease.
According to the CDC, anyone who has a rash that looks like it could be monkeypox—i.e., small pimples or blisters—should contact their health care provider, even if they aren't aware of any close contact with another infected person.
To further avoid monkeypox infection, people should avoid contact with anyone who may have the virus, as well as any materials or surfaces they may have touched. It's also important to practice good hygiene—handwashing, cleaning surfaces—and isolate from or wear personal protective equipment around infected people.
Because the highest concentration of monkeypox cases right now are among men who have sex with men—though monkeypox is not a sexually-transmitted illness—the CDC has also issued guidance for safer sex pratices during the monkeypox situation, including having virutal sex and limiting the number of partners to help reduce the spread.
Though monkeypox is typically self-limiting—meaning it can clear up on its own—the disease is still considered contagious until monkeypox lesions and scabs have completely healed, and a new layer of skin has formed over the affected areas. This can take about two to four weeks, the CDC said—during which time contact and sharing items should be avoided.
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