Updated October 4, 2022

hMPXV (Monkeypox) is spreading in Multnomah County. In the current global outbreak, most, but not all, cases are among men who have sex with men. 

If someone in your social group has hmpxv, you are at higher risk. Public health recommends you 

  • Get vaccinated to prevent infection
  • Avoid prolonged skin-to-skin contact with others if you or your sexual partner(s) have a rash
  • Watch for symptoms
  • Get tested if you have symptoms.
  • Get vaccinated within 14 days if you have been exposed

Public Health is focused on reaching the communities most impacted by the current outbreak to help stop the spread of the disease. Our strategy includes outreach, communication, intervention, and vaccination of affected communities and networks through public health and community clinics. 

Avoid prolonged skin-to-skin contact 

Monkeypox usually spreads by having close, direct contact with skin that has rashes or sores. In the current outbreak most (but not all) spread has occurred during sex or other intimate contact. Sores can be anywhere on the body, including hands, face, genital area, around the anus or butt, and in the mouth. 

If you have sex with a new partner or partners: 

  • Have sex in a well-lit place where you can see if someone has a rash on the part of their body that will be in contact with yours. 
  • Talk openly about whether they have felt sick or noticed new bumps or a rash recently. This is not a “sexy” conversation, for sure, but this is a way to stop transmission.
  • Keep up-to-date contact information for partners so you can reach them if you test positive for hMPXV. They may be able to get a preventive vaccine. 

If the suggestions above won’t work, consider decreasing or taking a break from back room sex and sex club sex until the virus is no longer spreading locally. 

  • Consider “keeping your shirt on” at clubs. So far, most of the cases seem to be from direct sexual contact, but we are still learning, and we know that direct skin-to-skin contact with the rash or bumps can spread disease.
  • Don’t share towels or clothes at the gym, beach, etc.
  • Sometimes an individual with infection only has sores on their penis or in their rectum/vagina. In those cases, using condoms may reduce risk of transmission. The best prevention is to avoid intimate/sexual contact until the sores are completely gone, but some people who have sores only in their rectum or mouth may not know they are there.

Watch carefully for rash or sores

  • If you start to feel sick with a fever, headache, chills, weakness, fatigue, or swollen lymph nodes. 
    • This can be the start of many viral infections, including COVID or hMPXV. Not everyone with hMPXV will start with these symptoms. Some people only have a rash which can be quite painful.
  • If you have been in close contact with someone:
    • Diagnosed with hMPXV
    • Waiting on test results for hMPXV
    • With symptoms of hMPXV
  • If you have been at an event or venue as an employee or guest, and had:
    • Skin-to-skin contact with others. Remember: skin to skin is NOT only genital area contact–the rash can be on hands and other parts of the body, so things like holding hands with someone who has the rash on their hands, dancing with skin touching, cuddling, massage transmit it. 
    • Contact with used towels, sheets, clothing or surfaces that others may have used or touched. 

We also recommend individuals watch for signs of infection if, in the last 14 days, they have had multiple or anonymous sex partners.

If you might have been exposed to hMPXV (Monkeypox) (OHA)

How to identify the rash, bumps or sores

If you believe you are at-risk for hMPXV infection, check your body regularly, such as before or after bathing. Look at your whole body in good lighting. Use a mirror to look at your back. Pay attention to anything that looks like a new bug bite, pimple, ingrown hair, or rash. Here are pictures of typical rash/sores. Check 

  • Chest
  • Belly
  • Armpits
  • Back
  • Feet
  • Hands
  • Face
  • Neck.

Use a hand mirror and flashlight or desk lamp, or have a partner, friend or housemate help look around the anus and genital area. Shine the light into the mirror instead of directly on the skin. It’s easier to aim, less glare.

Sores can be itchy or very painful, and can be flat or raised, fluid-filled (like little blisters or large pimples) or not. Classic sores have an indent in the middle, but not everyone will develop a classic rash.

If the sores you have are in your throat or rectum, they may cause significant pain but not be visible. 

If you see a rash or have other symptoms

  • Isolate from others and get tested. Stay isolated until your results are back and are negative. 
  • Stay at home except to seek medical care. 
  • If you live with others, wear a mask in common spaces.
  • Use a separate bathroom if possible and if not, clean it frequently with a germicidal wipe, and prevent others from touching your bedding, towels, clothes, etc. 
  • Going outside for recreation is safe and encouraged, but avoid contact with others, especially in indoor spaces, public transportation, or anywhere else your skin may come in contact with surfaces others may touch.


Request testing from your healthcare provider. If you can’t find testing or don’t have a provider, call the Multnomah County STD Clinic at 503-988-3700. 

More support

We recognize that learning of a new disease spreading in a specific community - especially one that has experienced and continues to experience stigma - can be upsetting and traumatizing.

Anyone who needs support can call the Multnomah County Behavioral Health Crisis line any time of day or night. Services are free and interpretation services are available for non-English speakers. Call 503-988-4888 or 800-716-9769.

Learn more

What we Know, Gay Men’s Sexual Health Alliance

Guidance, Cascade AIDS Project

Social Gathering, Safer Sex and Monkeypox, CDC

Guidance for Home Isolation (OHA) (more languages)