Do I Have the Monkeypox Virus?
This assessment is taken anonymously and your answers / results will remain 100% confidential.
The following test is a qualitative assessment for monkeypox:
Based on your input, you will receive the resulting likelihood of an infection based on the latest information provided by the Centers for Disease Control and Prevention and World Health Organization. This assessment is NOT definitive and must not be substituted for your healthcare professional.
This assessment is taken anonymously and your answers / results will remain 100% confidential.
The following test is a qualitative assessment for monkeypox:
Based on your input, you will receive the resulting likelihood of an infection based on the latest information provided by the Centers for Disease Control and Prevention and World Health Organization. This assessment is NOT definitive and must not be substituted for your healthcare professional.
Have you been in contact with somebody infected with monkeypox?
Yes
No
Not sure
What kind of possible contact?
Skin-to-skin (sex, sports, cuddling)
Sharing clothes, towels, linens, etc.
Possibly exposed to respiratory droplets (friends sneezing, etc.)
None of the above
If possible skin-to-skin contact, what type of contact?
Sexual/Intimate contact (vaginal, oral, anal sex or touching genitals)
Kissing, sustained face-to-face contact
Hugging, cuddling, massages
Contact sports (tackling, grappling)
Hand-to-hand (handshakes, arm wrestling, holding hands)
No skin-to-skin contact
Have you received the smallpox vaccine within the last 3 years?
Yes
No
Not sure
When did you receive the smallpox vaccine?
This year
Last Year
2 Years Ago
3 Years Ago
Have you received a monkeypox vaccine?
Yes
No
Which vaccine did you receive?
ACAM2000
Imvamune/Imvanex (JYNNEOS)
Other
Not sure
Do you currently have a fever (or had a fever in the past week)?
Yes
No
Not sure
How long did the fever last?
Less than a day
1 day
2 days
3 days
4 days
5 days
More than 5 days
Are you experiencing swelling of the lymph nodes?
Yes
No
Are you experiencing nausea (or felt nauseated in the past week)?
Yes
No
Have you noticed any significant swelling of your tonsils?
Yes
No
Have you experienced chills or night sweats?
Yes
No
Are you experiencing body aches (or experienced body aches in the past week)?
Yes
No
Are you experiencing abnormal issues with your eyes?
Yes
No
Are you experiencing vomiting or diarrhea?
Yes
No
Please list any other symptoms you may be experiencing
(Optional. May be used anonymously for research to help efforts against the outbreak)
Do you have a rash, lesions, blisters, or bumps?
Yes
No
Not sure
How many bumps do you count on your body?
1-5
6-10
11-30
31-50
51-100
100+
Which parts of your body are affected?
Face
Neck
Hands and Feet
Arms and Legs
Mouth
Penis / Vagina
Eyes
Chest / Abdomen
Back
Rectum / Anus
What do your rash lesions look like? You may select multiple
0%
0
0%
0
0%
0
0%
0
0%
0
Do you or does anybody in your family have a history of eczema?
Yes
No
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