Monkeypox usually begins with symptoms similar to the flu including fever, headache, muscle aches, chills, exhaustion and swollen lymph nodes. 'Anyone with a rash or lesion around or involving their genitals, their anus or any other place that they have not seen it before, should be fully evaluated, both for that rash but particularly for sexually transmitted infection and other illnesses that can cause rash,' Brooks said. He added that it's important for physicians and individuals to be aware of the symptoms associated with monkeypox, particularly anal or genital lesions that can be confused with herpes, syphilis or chickenpox. The virus spreads through contact with body fluids and sores, Brooks said. Monkeypox is not a sexually transmitted disease, which is generally passed through semen or vaginal fluid, but it can be transmitted through sexual and intimate contact as well as through shared bedding.