Monkeypox (mpox)
This page provides the latest updates on mpox. This page will be updated regularly as the situation and guidance evolves.
Last updated: 13 January 2023
Clinicians who are presented with a suspected case of mpox should contact their local public health unit immediately.
Patients with any concerns should contact Health Direct on 1800 022 222.
Latest Announcements:
NEW Mpox Clinical Decision-Making Tool
View or download the tool here.
NEW Mpox guideline added to the Australian STI Management Guidelines
View the guideline here.
See the our mpox Toolkit for more useful resources.
Monkeypox (mpox) is a rare viral zoonotic disease. The mpox virus is part of the same family of viruses as the variola virus that causes smallpox. Since May 2022 there has been increased case numbers mainly overseas (including Europe and the USA) and in Australia. As of August 2022 there have been over 80 cases of mpox in Australia, most acquired overseas and community transmission increasing.
MPX was declared a Communicable Disease Incident of National Significance by the Australian Government Chief Medical Officer on 28 July 2022, following the WHO declaring the global situation regarding mpox to be a public health emergency of international concern.
Symptoms
Most people's symptoms will clear up on their own after 2 to 4 weeks. Symptoms include distinctive sores (rash/lesions/ulcers), swollen lymph nodes, fever, headache, back pain, muscle aches, exhaustion.
Transmission
Transmission can occur through close contact with sores (rash/lesions/ulcers), through bodily fluids and contaminated objects. It is not considered to be a sexually transmitted infection (STI), although it can be transmitted through physical contact during sexual activities, so differential diagnosis is important. Most of the recent mpox cases in Australia have been diagnosed in gay, bisexual and other men who have sex with men, however transmission can occur in anyone who has close contact with an infectious person, so others might be considered at risk.
Find out more about mpox:
Visit our mpox Resource Toolkit for more useful resources.
Mpox health alerts and factsheets:
- Inform your local Public Health Unit and any on-call infectious disease/microbiology/virology consultants if a diagnosis of mpox is being considered so that appropriate testing and infection control measures can be implemented.
- Providers should use appropriate PPE for the assessment and treatment of patients presenting with possible mpox.
- Services should consider a differential diagnosis of mpox in any patient who meets the possible case definition.
See the mpox Guideline in the Australian STI Management Guidelines for Primary Care.
Please find below the Australian Government guidance for the treatment of mpox:
- Australian Human Monkeypox Treatment Guidelines – published 24 June 2022
Health professionals should also refer to the following:
- Mpox factsheet
- Patient referral and testing guidance
- Laboratory case definition and surveillance case definition
- CDNA National Guidelines for Public Health Units - Mpox SoNG (Series of National Guidelines)
Visit our mpox Resource Toolkit for more useful resources.
These medical images are for clinical and public health usage and are externally sourced – please be aware of copyright and ensure appropriate and respectful usage:
Vaccines for smallpox provide some protection against mpox. There are two vaccines approved for use in Australia:
JYNNEOS® and ACAM2000™.
JYNNEOS is the preferred vaccine for use in Australia based on its safety profile and because it is easier to
administer. The Australian Government secured an initial supply of the JYNNEOS® vaccine in early August. Each
State and Territory will be responsible for administration of the vaccine in their relevant jurisdiction, including
who will be prioritised and where and when the vaccines will be made available.
Please refer to the following:
- ASHM’s Monkeypox (mpox) Intradermal Vaccination Video
- Updated ATAGI Clinical Guidance on Vaccination Against Monkeypox (Version
4.0) 12 December 2022 - Information on vaccines for mpox in Australia
- Consent form for JYNNEOS® vaccination
Click the dropdown boxes below for more information on the vaccine rollouts in the States and
Territories:
NSW Health began vaccinating high-risk groups against mpox in August 2022. In October 2022, up to 25,000 doses will arrive in NSW. Up to 70,000 doses are expected to arrive in 2023. This will allow more people in NSW to be vaccinated against mpox.
Vaccine eligibility in NSW has been expanded to include gay and bisexual men (cis and trans) with multiple or casual sexual partners, anyone who has sex with these men, including women (cis and trans), and non-binary people. NSW Health is working closely with partner agencies such as NSW Sexual Health Infolink (SHIL) and ACON on the vaccine rollout.
Mpox vaccines are free in NSW and you can be vaccinated without a Medicare card.
Referring for access to vaccination
Refer potentially eligible people to to book an appointment through the NSW Health online booking system. The new booking system gives people who need the vaccine more choice over where, and when, they receive the vaccine.
Check the NSW Health mpox vaccine page for the latest information on the vaccine rollout in NSW
ACT Health has secured a small initial supply of the JYNNEOS monkeypox vaccine. These vaccines will be prioritised for individuals who meet the initial priority criteria. As more doses become available over the coming months, the priority groups for the vaccine will be expanded.
The priority criteria for the initial vaccine supply in the ACT are:
-
- People who have close and intimate contact with multiple partners (this can include attendance at sex parties, saunas and sex-on-premises venues)
AND
- Identify as a:
- Sex worker with clients who are gay, bisexual and other men who have sex with men (GBMSM) OR
- GBMSM living with HIV and who have a CD4 count < 500
- GBMSM with barriers to accessing early care and support if they were exposed to monkeypox. This may include individuals who:
- Are homeless or have unstable housing/accommodation arrangements
- Have drug use or mental health concerns that impact on their ability to access care
Vaccination site and availability
Canberra Sexual Health Centre (CSHC) will be the ACT’s initial vaccination site.
Referring for access to vaccination
ACT General Practitioners and community service providers can refer ACT residents (and NSW residents with established links to ACT healthcare providers) who meet vaccination priority criteria to CSHC for vaccine by using the mpox vaccine referral form.
For further details about JYNNEOS® mpox vaccine in the ACT please refer to the Chief Health Officer’s letter to clinicians and community service providers (12 August 2022).
Queensland Health currently has limited supplies of mpox vaccine available and vaccine is being prioritised to support outbreak management. Work is underway to ensure those who are at the highest risk are offered vaccination first.
Eligibility criteria includes:
- Gay, bisexual or a man who has sex with men AND
- Living with HIV or
- Taking HIV pre-exposure prophylaxis (PrEP) or
- Someone who has been diagnosed with a sexually transmitted infection in the last 3 months or
- Someone who has a recent history of multiple sexual partners or attending sex on premises venues or
- Planning travel to a country experiencing a significant outbreak in the next 3 months
- A sex worker whose clients include gay, bisexual or other men who have sex with men
Referring for access to vaccination
Limited supplies of mpox vaccine are available in South Australia for those that meet the current eligibility criteria:
- vaccination for close contacts of mpox cases (i.e. vaccination after exposure to mpox virus to help prevent mpox disease);
- vaccination for prevention of mpox for:
- gay, bisexual or other men who have sex with men (GBMSM) (including cis and trans men) who are:
- staff and clients of sex on premises venues; OR
- currently being prescribed HIV PrEP; OR
- intending to engage in sexual practices with multiple partners during overseas travel to countries with known mpox outbreaks before 31 October 2022;
- gay, bisexual or other men who have sex with men (GBMSM) (including cis and trans men) who are:
-
- sex workers whose clients include gay, bisexual and other men who have sex with men (GBMSM) clients;
- people on assessment and recommendation from accredited HIV S100 Prescribers or publicly funded sexual health clinics.
Referring for access to vaccination
Those that meet the current criteria can express their interest for the vaccine on the SHINE SA and Adelaide Sexual Health Centre websites.
The Tasmanian Department of Health will have access to the JYNNEOS® vaccination in limited supply in late 2022. It is expected that greater supply will be available from 2023. The initial roll-out with this limited supply is being coordinated through the Tasmanian Health Service and will focus on any high-risk close contacts of cases and those most-at risk. The vaccine will available be free of charge.
Eligibility for vaccine includes:
- Post-exposure vaccination for high-risk close contacts of mpox cases.
- Those at greatest risk of exposure and severe outcome, as outlined in the ATAGI guidance
Access to vaccination
Any questions about availability of vaccine should be discussed with the immunisation team in the Communicable Diseases Prevention Unit (CDPU) by contacting the Public Health Hotline on 1800 671 738 (option 3).
More information can be found on the Tasmanian Department of Health website.
In Victoria, MPX vaccine (JYNNEOS® vaccine) is available free-of-charge for specific priority groups but supply is currently limited. Victoria is expected to receive more doses in October and additional doses at the beginning of 2023. A limited supply has been allocated to select public hospitals and sexual health clinics to vaccinate high risk individuals. More clinics and access points will be able to provide the vaccine as additional stock becomes available.
Eligibility criteria will be expanded when additional supply of vaccines become available.
Current eligibility criteria:
- Post exposure prophylaxis for high-risk close contacts of monkeypox cases (within 4 days)
- Laboratory workers who analyse specimens from monkeypox cases
- Sexually active HIV positive gay, bisexual, and other men, non-binary people assigned male at birth, or trans people who have sex with men (including cis and trans men)
- With an STI in the last 12 months OR
- Will be travelling to North America or Europe before 31 October* OR
- Who attend sex on premises venues including saunas, adult cinemas/lounges, beats and sex parties.
- Sexually active HIV negative gay, bisexual, and other men, non-binary people assigned male at birth, or trans people who have sex with men (including cis and trans men)
- With an STI in the last 12 months OR
- Will be travelling to North America or Europe before 31 October* OR
- Who attend sex on premises venues including saunas, adult cinemas/lounges, beats and sex parties.
- Sexually active gay, bisexual, and other men, non-binary people assigned male at birth, or trans people who have sex with men (including cis and trans men) who are homeless, or have significant drug use or psychiatric illness.
- Sex workers who engage in sex with the sexually active groups listed above.
The vaccine will largely be rolled out through sexual health clinics and will be available for pre
and post exposure protection. Vaccination will be largely available in the following locations:
- Melbourne Sexual Health Centre
- Thorne Harbour Health
- Northside Clinic
- Collins Street Medical Centre
- Prahran Market Clinic
Referring for access to vaccination
Refer potentially eligible people to to book an appointment through the Victorian Department of Health or Thorne Harbour Health.
For more information, visit the Victoria Department of Health mpox alert page.
Notify any suspected or confirmed case to the Department of Health by calling 1300 651 160 (24/7).
WA Health has begun vaccinating people at highest risk of monkeypox.
Due to limited vaccine supply, those who are at highest risk of getting the disease and/or severe disease can access the vaccine first, free-of-charge.
Eligibility criteria:
Post exposure vaccination
- Contacts of a case as determined by the Public Health Unit.
Pre-exposure vaccination
- Healthcare workers who are highest risk for monkeypox for example, working at sexual health clinics and administering vaccinations to individuals requiring post exposure vaccination
- Laboratory workers handling live virus
- Gay, bisexual or men who have sex with other men (GBMSM):
- with HIV
- are on HIV PrEP
- with immunocompromised conditions
- who are experiencing homelessness, transgender, Aboriginal, or have significant drug use
- who have had a sexually transmitted infection (STI) in the past 12 months
- with multiple sexual partners
- participating in group sex or attending sex on premises venues
- planning travel to a country experiencing a significant outbreak, with vaccination recommended 4-6 weeks prior to departure.
- Sex workers who have sex with GBMSM.
Referring for access to vaccination
Vaccines are available now and people can register their interest in receiving the monkeypox vaccine.
Medicare cards are not needed to receive the monkeypox vaccine and confidentiality is of priority at all services.
Patients should be encouraged to visit HealthyWA for information regarding vaccination, including registration.
Perth metropolitan area
People in the metropolitan area can register their interest for getting vaccinated at a state-run clinic via VaccinateWA.
People can alternatively contact a clinic to make an appointment for vaccination.
- Royal Perth Hospital Sexual Health Clinic phone: 9224 2178
- GP on Beaufort phone: 9262 8600
- M Clinic phone: 9227 0734
- Sexual Health Quarters phone: 9227 6177
- South Terrace Sexual Health Clinic phone: 9431 2149
- Central City Medical Centre phone: 9225 1188
- View St Medical phone: 9227 0170
Regional Western Australia
People in regional Western Australia can register their interest via the EOI form.
They can also contact their local regional Public Health Unit (external link).
NT Health are accepting referrals for vaccination against mpox from Monday 15th August 2022.
An initial 160 doses of the JYNNEOS® vaccine have been secured for the first phase of
vaccination. These doses will be prioritised to support outbreak management and reach those at
highest risk. More vaccines are expected to arrive in late September/October 2022 and will be
used for people considered to be at the next highest risk.
Initial eligibility criteria: Individuals 18 years and over who meet the eligibility
criteria will be offered the vaccine.
-
- 1. Post exposure prophylaxis for high‐risk close contacts of mpox cases.
- 2. Gay, bisexual men or men who have sex with men (GBM MSM) (including cis and trans men) who
fulfil additional criteria.* - 3. Sex workers whose clients belong to high‐risk categories.
- 4. Sistergirls.
*Additional criteria:
-
-
- GBM MSM intending to engage in sexual practices that put them at higher risk of STIs during
overseas travel to Europe or North America before 31st October 2022. - Aboriginal GBM MSM living in or visiting remote communities.
- Aboriginal GBM MSM on PrEP.
- GBM MSM who are homeless, have significant drug use or psychiatric illness.
- GBM MSM intending to engage in sexual practices that put them at higher risk of STIs during
-
Initially the vaccine will only be administered at Clinic 34 in Darwin and Clinic 34 in Alice
Springs. Clients or their clinicians can call Clinic 34 for final eligibility assessment and if
deemed eligible will be able to book an appointment.
Clinic 34 Darwin: 08 8999 2678
Clinic 34 Alice Springs: 08 8951 7549
- AFAO's Mpox Information Hub provides information on the impact of mpox on AFAO’s members and communities.
- Please refer to the AFAO website for national and state and territory-based members providing further information on mpox to their communities.
- Safer Sex and social gatherings – Advice from the US CDC
Below are recounts of recent lived experience with mpox:
Mpox Webinars
- ASHM mpox Webinar – Clinical Update 27 October
- ASHM mpox Webinar – Responding in Australia, Asia and the Pacific recorded on 18 July 2022. View the key points summary here.
- ASHM mpox Webinar – Mpox Update 25 May
Vaccination Training
- ASHM mpox Vaccination Training course
As a core partner in the National mpox Taskforce, ASHM has created a comprehensive training package to support the national vaccine rollout and protect communities at risk of mpox. The fully self-paced, interactive Monkeypox (mpox) Vaccination Training course is available on the ASHM On Demand platform, and free for all health workers in Australia. - ASHM mpox Vaccination Training Video
The Vaccination Training course also includes a key video resource for vaccine providers, which outlines critical information on the correct storage, dosing and intradermal vaccination technique for administering the JYNNEOS® vaccine. Feel free to share the video within your networks.
Jurisdictional Variance for Vaccination
Some recommendations outlined in the Video and eLearning above, such as preferred needle size/type or storage and transport conditions, may vary based on your jurisdiction's preference or availability. Please follow the below links for further guidance and contact information from your relevant State Health department.
Briefing Paper: Considerations for Monkeypox Isolation
This paper outlines considerations that health authorities can use to determine the appropriate level of isolation required to reduce transmission of monkeypox (mpox). The paper illustrates how jurisdictions can work with AIDS Councils in each state and territory to communicate with people who have mpox about how to prevent sexual and other skin to skin contact with others during isolation.
Published: 6 December 2022 | Click here to open
Briefing Paper: Monkeypox and sex on premises venues
This paper outlines how sex-on-premises venues (SOPVs) may be the site of transmission for the mpox virus between gay, bisexual and other men who have sex with men (GBMSM). The paper describes strategies to mitigate the risk of transmission including cleaning the facility and supporting contact tracing. The paper also notes other ways SOPVs can engage more broadly with the public health response to mpox.
Published: 21 October 2022 | Click here to open
Briefing Paper: Collection and dissemination of monkeypox surveillance data
This paper outlines AFAO and ASHM’s policy position on the collection and dissemination of mpox surveillance data. This paper notes that states and territories should issue mpox surveillance data relating to locally acquired cases as soon as possible as well as data relating to cases among returned travellers.
Published: 10 October 2022 | Click here to open
Briefing Paper: Monkeypox vaccination information
This paper outlines relevant information about the mpox vaccine. It shows how there is a limited supply of these vaccinations available to the community, which has led to logistical and social challenges. This paper describes several strategies to address these challenges such as tailoring outreach to communities, delaying access to second doses and delivering the vaccination intradermally.
Published: 5 October 2022 | Click here to open
Briefing Paper: State and territory servicing of monkeypox
This paper outlines the minimum services that governments should fund to enable AIDS Councils in each state and territory to be effective in the response to mpox. The paper describes the core services that AIDS Councils in each state and territory should be able to provide, which include running independent digital campaigns, community forums, sector forums, peer support and monitoring the media.
Published: 28 September 2022 | Click here to open
Briefing Paper: Terminology when referring to monkeypox
This paper outlines the appropriate language to refer to mpox in external and internal documentation and engagements.
Published: 12 September 2022 | Click here to open
Briefing Paper: Communication regarding sexual contact for the prevention of Monkeypox
This paper outlines AFAO and ASHM’s position that messages to gay, bisexual and other men who have sex with men (GBMSM) about mpox should be provided by GBMSM and other members of the LGBTQI+ community. The paper suggests that government and healthcare stakeholders partner with LGBTIA+ health and HIV organisations to provide messages on risk reduction and to avoid stigmatising sexual behaviour.
Published: 8 September 2022 | Click here to open