Mpox (previously known as monkeypox)

Mpox (previously called monkeypox) is an infection caused by a virus belonging to the same family as smallpox viruses.

Mpox has historically occurred mainly in Central and West Africa, but since May 2022, there has been an increase in mpox infections in many parts of the world where the illness has not previously been seen. Local transmission of mpox has occurred in Queensland and Interstate.

Mpox does not spread easily between people and is mainly spread through very close or intimate contact with someone infected with mpox. People most at risk in Australia are gay, bisexual or other men who have sex with men, especially anyone having sex overseas or with overseas travellers.

Signs and Symptoms

Mpox is usually a mild illness, and symptoms can start between 5 to 21 days after contact with the virus. Most people recover within a few weeks.  Some people develop a more severe illness or complications, particularly those who have a weakened immune system.

Symptoms of mpox may include:

• rash or skin lesions
• fever
• headache
• back pain and muscle aches
• fatigue
• swelling of the lymph nodes (lymphadenopathy)
• pain on urination or rectal pain, discharge or bleeding.

The rash can be the first symptom that is noticed or may appear 1 to 5 days after a fever. It can be anywhere on the body, including the face, mouth, genitals or buttocks.

The rash goes through different stages. Usually starting as a flat red rash, fluid-filled or blister-like lesions (vesicles) often develop and may fill with pus (pustules). After 2–3 weeks the lesions dry and become crusted scabs. The scabs will fall off and leave new but often discoloured skin underneath.

Some people only notice a single or small number of pimple-like lesions or sores in the genital area or buttocks.

Some people who have been vaccinated for mpox may still get infected, but the illness and rash are usually mild.

Treatment

Most people can be managed at home with rest and oral fluids. Paracetamol and ibuprofen can lower a fever and reduce pain or discomfort.

Some therapies are available for people at high-risk of severe disease, such as people with weakened immune systems. People with severe disease or complications may need to stay in hospital.

Transmission

Mpox is spread person-to-person through:

• close physical contact with skin lesions/rash
• infectious body fluids, including semen
• contaminated materials or items such as clothing, bedding or towels.

Transmission through tiny droplets created by coughing and sneezing is much less common and usually requires prolonged face-to-face contact.

Mpox is commonly spread between sexual partners during kissing, sex, or skin-to-skin contact with the infectious skin rash.

Someone who has mpox is infectious as soon as the first symptoms start. They should isolate from others until the rash and lesions have crusted, scabs have fallen off and a new layer of skin has formed underneath.

For 12 weeks after infection, condoms should be used for any sexual activity and blood, semen and organ donation should be avoided.

Prevention

There is a safe and effective vaccine for mpox called Jynneos.

Mpox vaccination is free* ( a medicare card is not required) and recommended for the following groups:

• all sexually active gay, bisexual and other men who have sex with men (cis and trans) and their sexual partners (including anonymous or intimate contacts)
• sex workers
• people living with HIV who are at risk of exposure to mpox
• people whose occupations might put them at increased risk, including, but not limited to:
  • sex-on-premises venue staff
  • laboratory staff who analyse mpox specimens, based on a local risk assessment
  • healthcare workers at higher risk of exposure to individuals with mpox, including workers in primary care, sexual health clinics, hospital staff and others, based on a local risk assessment. The risk of transmission should also be minimised by using appropriate infection control measures.

* If you are accessing a GP clinic for vaccination, ask your vaccination provider if a consultation fee applies.

Two doses of the vaccine, given at least 28 days apart are required for best protection against mpox. The vaccine is most effective 2 weeks after the second dose. If you have not had your second dose, find your nearest mpox vaccination centre by using the mpox clinic finder.

While smallpox vaccines are effective against mpox since the two viruses are closely related, protection decreases over time and people who received smallpox vaccines in childhood may still catch mpox.

Vaccination may be offered to people who have had close contact with someone with mpox to help prevent disease. Vaccination given within 4 days after exposure provides the highest level of protection, however, vaccination may be considered at any time following exposure.

Vaccination is only one way to prevent mpox infection. Other ways to protect yourself from mpox include:

• Avoid close contact with people who have mpox or mpox symptoms.
• Avoid contact with any materials such as clothing, bedding or towels that have been in contact with an infected person.
• Practise good hand hygiene.
• Be aware of the risk of mpox if travelling overseas or in other states/territories where cases have been reported, especially if planning to have sex or attend large or intimate social gatherings such as raves, parties, clubs or festivals.
• Practice safe sex, but be aware that condoms may not completely protect someone from the virus as transmission can occur during any skin-to-skin contact.

If you have had contact with someone with mpox, contact your GP, sexual health clinic or public health unit.

If you have symptoms of mpox, avoid contact with others and seek medical attention from a GP or local sexual health clinic wearing a mask and covering any exposed skin lesions.

Other resources

Mpox (monkeypox) | Australian Government Department of Health and Aged Care

Queensland Positive People - About mpox

Queensland Council for LGBTI Health – MPXV (Monkeypox)

Help and assistance

Get qualified health advice 24/7 for the cost of a local call on 13 HEALTH (13 43 25 84).

If you are in an emergency situation, call 000 immediately.

For further assistance, please contact your local doctor, community health centre or nearest public health unit