There is no cure for mpox (formerly monkeypox), but most people recover fully without any specific treatment. The infection runs its course over two to four weeks, and the body’s immune system clears the virus on its own in the vast majority of cases. The mortality rate for the strain circulating in most of the world (Clade II) is less than 0.1%, and even the more severe Clade I strain has a mortality rate under 2.5% with proper supportive care.
Why No Cure Exists Yet
Mpox is caused by a virus, and like most viral infections, there’s no drug that kills it outright. The primary antiviral that’s been studied, tecovirimat, was originally developed for smallpox and has never been fully approved for mpox. It remains investigational, meaning it’s only available through special access protocols rather than as a standard prescription.
A major clinical trial called STOMP, run by the National Institutes of Health, tested whether tecovirimat could speed up healing or reduce pain in adults with mild to moderate mpox. The results were disappointing: there was no difference in the time it took lesions to heal between people who took the drug and those who received a placebo. Pain levels were also the same in both groups. An interim analysis found less than a 1% chance the drug would show any benefit even if the trial continued to completion. The drug was safe, but it simply didn’t work for typical cases.
Treatments Available for Severe Cases
Although tecovirimat didn’t help mild cases, it and other therapies are still reserved for people at high risk of dangerous complications. The CDC makes tecovirimat available under a compassionate use protocol for specific groups: people with severely weakened immune systems (such as those with advanced HIV, organ transplants, or active cancer treatment), pregnant or breastfeeding individuals, children under 18, and anyone with skin conditions like eczema or psoriasis that raise the risk of widespread infection. It’s also offered to patients whose disease is already life-threatening, including those with lesions covering 25% or more of the body, airway involvement, or inflammation of the heart or brain.
Two additional antiviral drugs can serve as backup options when tecovirimat isn’t working or isn’t an option. Neither has been tested in human clinical trials for mpox specifically, though both show activity against related viruses in lab and animal studies. A concentrated antibody product derived from vaccinated donors is another tool reserved for severe or high-risk cases. All of these remain investigational, not standard treatments.
What Recovery Actually Looks Like
For the vast majority of people, mpox is managed at home with supportive care, meaning treatment focuses on comfort rather than attacking the virus. The illness typically starts with fever, body aches, and swollen lymph nodes, followed by a rash that progresses through several stages before scabbing over and falling off. You’re considered no longer infectious once all scabs have fallen off and a fresh layer of intact skin has formed, which generally takes two to four weeks.
Pain management is the biggest practical challenge during that window. Over-the-counter pain relievers like acetaminophen and ibuprofen handle general discomfort. For lesions in sensitive areas, topical numbing agents can provide local relief, though they should be used carefully on broken skin. Lesions in the mouth respond well to saltwater rinses four times a day or medicated mouthwashes. Rectal lesions, which can make bowel movements extremely painful, are managed with stool softeners, warm sitz baths with baking soda or Epsom salt, and topical numbing agents. For severe pain that doesn’t respond to these measures, short courses of prescription pain medications are sometimes necessary.
One important risk during recovery is secondary bacterial infection of the skin lesions. Watch for increasing redness, warmth, swelling, or pus around any lesion, which could signal that bacteria have moved into the broken skin. To prevent spreading the virus to other parts of your own body, wear disposable gloves when applying any topical treatment to lesions, then throw the gloves away and wash your hands.
Vaccination as Prevention
While there’s no cure, there is a vaccine. The JYNNEOS vaccine, given as a two-dose series, has proven effective at preventing infection. Among nearly 189,000 fully vaccinated people tracked across 31 U.S. jurisdictions through May 2024, the infection rate was just 0.1%. When breakthrough infections did occur in vaccinated individuals, they tended to be less severe than infections in unvaccinated people. A single dose provides some protection, but two doses are needed for the full benefit.
The vaccine is recommended as pre-exposure prevention for people at higher risk of encountering the virus, including men who have sex with men and have multiple partners, people with recent sexually transmitted infections, and healthcare workers who may be exposed. It can also be given after a known exposure, ideally within four days, to prevent or reduce the severity of illness.
Clade I vs. Clade II: Does Severity Differ?
Two main strains of the virus circulate globally. Clade II, which drove the international outbreak that began in 2022, causes milder illness with a mortality rate under 0.1%. Clade I, found primarily in Central and Eastern Africa, was historically considered far more dangerous, but recent data with better access to supportive care show mortality rates below 2.5% and in some settings below 0.5%. The difference between the two strains matters most in regions with limited healthcare access, where supportive care may not be readily available.
Regardless of strain, the same principle holds: the body clears the infection on its own in nearly all cases. The gap between “no cure” and “good outcomes” is filled by a functioning immune system and basic symptom management. For the small number of patients who face serious complications, investigational antivirals and immune therapies exist as a safety net, even if none has yet earned full approval for this specific virus.