Mpox (Monkeypox): Early Symptoms, How It Spreads, and How It Differs from Herpes and Syphilis
Updated: 4 days ago
Written by นพ. ภัทร วรวุทธินนท์, dermatologist
Mpox (monkeypox), known in Thai as ฝีดาษวานร and widely searched as ฝีดาษลิง, is a viral infection spread through close contact. In its latest update, Thailand's Department of Disease Control on 9 November 2026 said that clade Ib is now the main strain in Thailand and that symptoms may not look the way people expect: some patients have a boil-like bump on the buttock, or a sore throat like tonsillitis without a clear rash. There are no signs of wide spread in the population. Most people recover on their own. If you notice an unusual rash, bump or sore after a possible exposure, see a doctor to get checked.
What is the latest mpox news from Thailand?
Thailand's Department of Disease Control (DDC) gave an update on 9 November 2026 after posts by health workers on social media described patients with changing symptoms. In summary:
Strain: clade IIb used to be the main strain in Thailand. Since mid-2026, clade Ib has been found more often and is now the main strain.
Severity: the case fatality rate of this strain is below 0.5%, but symptoms can be more marked or severe in people with weakened immunity, or with other illnesses that are not being treated consistently.
Distribution: cases are scattered across large cities, tourist provinces and densely populated areas, with occasional cases elsewhere. There are no signs of wide spread.
Who has been affected: mostly men aged 18–49. Reported risk factors are sex-related contact, parties with someone who has mpox, and living in the same household.
Case numbers: DDC data up to 31 October 2026 show 470 cases in Thailand this year and 3 deaths.
The DDC stresses that anyone with an exposure can get mpox, that being ill is nothing to be ashamed of, and asks everyone not to stigmatize or discriminate against patients, so people with symptoms feel able to come forward for testing.
What causes mpox?
Mpox is caused by the monkeypox virus, an orthopoxvirus. There are two main clades: clade I (subclades Ia and Ib) and clade II (subclades IIa and IIb). The global outbreak that began in 2022 was caused by clade IIb; clade Ib has been found more often recently.
The old name "monkeypox" comes from the virus first being found in monkeys kept for research, but today it mainly spreads from person to person.
What are the early symptoms of mpox?
Symptoms usually start about 3–17 days after exposure, and up to 21 days. Early symptoms can include:
fever, headache, back pain, muscle aches, tiredness
swollen lymph nodes
sore throat
then a rash or bumps; the NHS says this usually appears 1–5 days after the first symptoms
Symptoms and their order vary from person to person. For some people the rash comes first, and not everyone has every symptom. The Institute of Dermatology notes that some people do not have swollen lymph nodes, so their absence does not rule mpox out.
Newer presentations to know about
In the current outbreak doctors are seeing many patients without the classic picture, for example:
a boil-like bump on the buttock or around the anus, which can look like an ordinary boil or inflamed spot
a sore throat like tonsillitis or a respiratory infection, with no clear rash or only a little
anal pain or pain when passing stool, or sores on mucous membranes, without a rash spreading over the body
only a few bumps, limited to the genitals, anus or inside the mouth
If you have these symptoms after a possible exposure, tell your doctor honestly, because they can look a lot like other conditions.
What do mpox bumps look like?
Mpox bumps usually go through stages: a red spot or raised bump, then a clear blister, then a pus-filled bump, which then crusts over and falls off. The bumps are usually separate from each other and are often painful; some people find them itchy. The number varies widely, from one or two to hundreds.
They can appear almost anywhere, including the genitals, anus, mouth, face, arms, legs, palms and soles. Some people also have pain or swelling in the rectum, or pain when urinating or swallowing.
Looking at a rash or a photo alone cannot confirm mpox, because it can look like herpes, chickenpox or other skin infections. Laboratory testing is needed.
How does mpox spread?
Mpox mainly spreads through close contact with an infected person:
direct contact with the rash, blisters, pus-filled bumps, sores or scabs, including during sex, kissing and skin-to-skin contact
shared items such as clothing, towels and bedding contaminated with the virus
respiratory particles during prolonged face-to-face contact
from parent to baby during pregnancy or birth
What is not a main route of spread?
The DDC says mpox does not spread easily through ordinary daily life, and the Institute of Dermatology says simply being in the same place or casual contact without touching a rash or sore is not a high-risk route. Infection is not only through sex; other close contact, such as living with and caring for someone with mpox, can also spread it.
A person can pass mpox on until all the bumps have healed and new skin has formed.
How is mpox different from herpes, syphilis, chickenpox, boils and hand, foot and mouth disease?
All of these can cause bumps or sores. This table gives a rough picture, but telling them apart needs a doctor's examination, and some people can have mpox together with another infection such as syphilis or herpes.
Condition | Bumps or sores | Common sites | Notes |
Mpox | Raised bumps that become blisters, then pus-filled bumps, then crusts; often painful; may be only a few | Genitals, anus, mouth, face, arms, legs, palms, soles | May come with fever, swollen lymph nodes, sore throat or anal pain; confirmed by PCR |
Herpes | Small blisters that burst to leave red sores; often tingling, burning or itching first | Mouth, genitals, anus, thighs, buttocks | Can come back |
Syphilis | Early: a small sore, usually painless, often only one. Later: a rash that is usually not itchy | Sores on genitals, anus or mouth; rash on palms and soles that may spread | Symptoms may go away while the infection remains; testing is needed |
Chickenpox | Itchy spots; new spots appear while others are blistering or crusting, so several stages are seen at once | Anywhere, including inside the mouth and around the genitals | Common in children; spreads easily |
Boil | A hard, painful lump filled with pus; may start as an itchy or tender spot | Anywhere on the body | Do not squeeze or pierce it yourself |
Hand, foot and mouth disease | Raised spots that can turn into blisters; can be painful | Hands, feet, mouth ulcers; sometimes groin and buttocks | Common in children, adults can get it; usually better in 7–10 days |
Further reading on similar conditions (articles in Thai):
How is mpox tested, and when should you get tested?
See a doctor if you have an unusual rash, bump or sore, especially after a possible exposure. Don't wait for it to spread over your body. This also applies to a sore throat or anal pain without a clear rash if you have been in contact with someone with mpox.
Testing usually involves:
History and examination: the doctor will ask about symptoms and possible exposures and look at the lesions. Please be honest; health workers must keep your information confidential.
PCR confirmation: a test for the virus's genetic material, using a swab from a skin or mucosal lesion. If there are no skin lesions, a throat or anal swab may be used.
Routine blood tests do not confirm mpox.
Testing for other sexually transmitted infections where appropriate, such as syphilis, herpes and HIV, because they can occur at the same time.
If the test is negative but symptoms continue, new bumps appear or symptoms change, go back to the doctor with your earlier results. The doctor may assess you again or repeat the swab.
How should you look after yourself while waiting for results?
The DDC advises people with suspected mpox who are waiting for a test or results to:
stay apart from others and avoid close contact and sex
keep lesions covered
wash hands often with soap or 70% alcohol, especially before and after touching the bumps
wear a well-fitting mask around other people
use your own plates, cups, towels and bedding, and wash clothes and clean shared items
The WHO adds:
do not pop, pick or scratch the bumps, as this slows healing, spreads the rash and can lead to bacterial infection
do not shave areas with bumps until the scabs have fallen off and new skin has formed
rinse with salt water if you have mouth sores
when alone in your room, keep the skin dry and uncovered; cover lesions when others are present
Can mpox be cured?
Most people with mpox recover on their own in about 2–4 weeks. Care focuses on symptoms: relieving pain, looking after the skin to prevent infection, and preventing complications. Not everyone needs hospital care; the doctor decides based on symptoms, risk and whether you can isolate at home.
The WHO says there is no proven effective antiviral treatment for mpox yet, so do not buy medicines to take or apply yourself. Any additional treatment is the doctor's decision for each person. People living with HIV who take antiretroviral therapy should keep taking it.
People who need closer assessment and care include those with weakened immunity, including people living with HIV that is not well controlled, pregnant women and young children.
How can mpox be prevented?
Avoid skin contact with the rash or sores of anyone who has an unusual rash, bumps or sores
Avoid close contact and sex with people who have suspected symptoms
Do not share clothes, towels or bedding
Wash your hands often
Condoms reduce the risk but do not fully prevent mpox, because skin not covered by a condom can still pass the virus. The WHO advises using condoms for 12 weeks after recovering
People who have been in contact with someone with mpox should watch for symptoms for 21 days and avoid sex during that time
In Thailand the mpox vaccine is used for at-risk groups according to DDC guidance; see the FAQ below
When should you see a doctor urgently?
An unusual rash, bump or sore, especially after a possible exposure
A boil-like bump on the buttock, anal pain or a sore throat after contact with someone with mpox
Seek care immediately if you have severe pain, cannot drink or eat, have lesions in or near the eye, or are getting worse
You are pregnant, have weakened immunity, or are a young child with suspected symptoms
For more information, contact your nearest health facility or the DDC hotline 1422.
Frequently asked questions about mpox
Are "monkeypox" and "mpox" the same disease?
Yes. Mpox is the current international name for the disease previously called monkeypox. In Thailand its official name is "โรคฝีดาษวานร", and many people search for it as "ฝีดาษลิง".
How long is the mpox incubation period?
According to the Institute of Dermatology, Thai Department of Medical Services, it is usually about 3–17 days and can be up to 21 days after exposure. People who have been in contact with someone with mpox should watch for symptoms for about 21 days.
Can you have mpox without a clear rash?
Yes. Thailand's Department of Disease Control says some people have fever, a sore throat like tonsillitis, or anal pain with no clear rash, or only a few spots. If this happens after a possible exposure, see a doctor and share your history honestly.
Is there an mpox vaccine in Thailand, and who should get it?
According to the 2026 guidance of Thailand's Department of Disease Control, the mpox vaccine available in Thailand is JYNNEOS, used for at-risk people aged 18 and over: before exposure for health workers and high-risk groups, and after exposure for people who had contact or sex with someone with mpox. It is given as 2 doses at least 4 weeks apart. It is not recommended for pregnant women, people under 18 or people with severely weakened immunity, and people who have already had mpox do not need it. Ask a doctor or health facility whether you are in a group that should be vaccinated.
Do condoms prevent mpox?
They reduce the risk but do not fully prevent it, because the virus can spread through skin not covered by a condom, as well as through kissing and other close contact.
How long should someone with mpox isolate?
Thailand's Department of Disease Control advises isolating and following the doctor's advice until all lesions have healed, scabs have fallen off, new skin has formed, and any lesions on mucous membranes have healed. This usually takes about 2–4 weeks. Not everyone needs to stay in hospital; the doctor decides case by case.
See a dermatologist at คลินิกเฉพาะทางผิวหนัง Siam Dermatology
If you have an unusual rash, bump or sore and are not sure what it is, you can see a dermatologist at คลินิกเฉพาะทางผิวหนัง Siam Dermatology. The doctor will take your history, examine the lesions, help tell it apart from similar conditions, and advise or refer you for confirmatory testing as appropriate. If you think it might be mpox, please contact us on LINE @siamderm or call +66 61 448 7000 before coming to the clinic so we can arrange your visit appropriately.
References
Cover image: Image: NIAID / CC BY 2.0 · resized · Wikimedia Commons
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