mpox (monkeypox)

Details

First Published:
2022
Last Updated:
10 May 2024
Resource Type:
Educational Resource

Overview

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:

9 May 2024 Update

As small numbers of new, unlinked and locally acquired mpox cases are detected in Australia, the National mpox Taskforce has released new recommendations to manage the outbreaks.

In a statement, the Taskforce calls for ongoing mpox vaccination planning and roll-out across state and territory governments. In particular, planning must consider the heightened risk of transmission amongst newly sexually active people and people that have experienced a shift in their sexual behaviour.

Previous updates

While in May 2023 the World Health Organization declared that the mpox outbreak is no longer a global health emergency, it is noted that sporadic cases are still being detected overseas and in Australia. Clinicians are urged to remain alert for symptoms. Mpox symptoms can include painful ulcers on the genitals and in/around the mouth and/or anus. If a person with epidemiological risk presents with symptoms of mpox, then immediately contact your local public health unit for advice.

Mpox (monkeypox) 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. 

Mpox 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.

  • 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:  

Health professionals should also refer to the following: 

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:

Click the dropdown boxes below for more information on the vaccine rollouts in the States and
Territories:

NSW

NSW Health began vaccinating high-risk groups against mpox in August 2022. The arrival of additional doses have allowed more people in NSW to be vaccinated against mpox.

Vaccine eligibility in NSW has been expanded to include all sexually active gay and bisexual men (cis and trans) , anyone who has sex with the aforementioned men, and sex workers. 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.

Access to vaccination

Information on where to booking vaccines in NSW can be found here. Check the NSW Health mpox vaccine page for the latest information on the vaccine rollout in NSW

ACT

Eligibility criteria to receive the mpox vaccine have been expanded in the ACT.

Eligibility criteria for the vaccine in the ACT are:

    • Sexually active men (cis and trans) who are gay, bisexual or have sex with other men
    • Partners of the people above
    • Sex workers

Vaccination site and availability

Eligible people can book their vaccine at the ACT monkeypox vaccination clinics. GPs and community service providers in the ACT no longer need to refer eligible people for a vaccination.

For more information, refer to the ACT Government mpox webpage for health professionals and community service providers.

QLD

The eligibility criteria to receive the mpox vaccine in Queensland has expanded.

In addition to the key risk groups recommended by ATAGI to receive vaccination, individuals eligible to receive mpox vaccination in QLD include:

  • all sexually active gay, bisexual and other men who have sex with men (cis and trans)  and their sexual partners
  • sex workers

Access to vaccination

Mpox Vaccination Centres can be found here: Mpox Vaccination Centres.

For more information, visit the Queensland Health mpox webpage.

SA

Limited supplies of mpox vaccine are available in South Australia for those that meet the eligibility criteria:

      • Post-exposure preventive vaccination (PEPV) for close contacts of mpox cases;
      • Primary preventive vaccination (PPV) for:
        • all sexually active gay, bisexual or other men who have sex with men (including cis and trans men);
        • sexual partners of the people above; and
        • sex workers.

    Access to vaccination

    Mpox vaccine availability and booking information can be found on the SHINE SA and Adelaide Sexual Health Centre websites.

    TAS

    Limited supplies of mpox vaccine are available in Tasmania for those people  that meet the current eligibility criteria.

    After exposure to mpox:

    It is recommended that people who have already been exposed to mpox get a vaccination within 4 days of their exposure. Though less ideal, vaccination can be given up to 14 days after exposure.

    Before exposure to mpox:

    The vaccine is available free of charge for eligible persons aged 16 years and older, including:

    • all sexually active gay, bisexual, non-binary people assigned male at birth, trans people, and other men who have sex with men (including with cis and trans men)
    • sexual partners of the people above and
    • sex workers

    Access to vaccination

    Appointment can be booked directly with the providers listed on the Tasmanian Department of Health website here.

    Any questions about availability of vaccine can be discussed with the immunisation team in the Communicable Diseases Prevention Unit (CDPU) by contacting the Public Health Hotline on 1800 671 738.

    More information can be found on the Tasmanian Department of Health website.

    VIC

    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 preventive vaccination for high-risk close contacts of mpox cases, preferably within 4 days.

    Primary preventive vaccination has been expanded to include:

      • All sexually active gay and bisexual men (cis and trans).
      • Sexual partners of the above.
      • Sex workers.
      • Immunisation providers who are administering the ACAM2000™ smallpox vaccine.
      • Laboratory workers who analyse specimens from mpox cases.
      • Vaccination may also be considered for healthcare workers at higher risk of exposure to patients with mpox, including primary care, sexual health clinics, hospital staff and others, based on local risk assessments. The risk of transmission should be also minimised by using infection control measures

      Access to vaccination

      In Victoria, mpox vaccines are available at the services listed on the Victoria Department of health mpox webpage.

      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).

      For all other enquires regarding the mpox vaccine in Victoria, email immunisation@health.vic.gov.au.

      WA

      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 at risk for mpox. For example, working at sexual health clinics and administering vaccinations to individuals requiring post exposure vaccination
      • laboratory workers handling live virus
      • all sexually active gay, bisexual or other men who have sex with men (including cis and trans)
      • sexual partners of the people above
      • sex workers.

      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 contact a clinic to make an appointment for vaccination.

      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

      Mpox vaccines are free in the NT for eligible people.

      Updated eligibility criteria: Individuals 16 years and over who meet the eligibility
      criteria will be offered the vaccine.

        • high risk close contact of a confirmed case
        • gay or bisexual man
        • man who has sex with men
        • trans (binary and non-binary people) who have sex with men
        • sex worker
        • sistergirl
        • any person who perceives themselves to be at increased risk of acquisition  (e.g. Because they are attending a high risk event as an advocate/allies)

      For more information or to book contact Clinic 34:

      Clinic 34 Darwin: 08 8999 2678
      Clinic 34 Alice Springs: 08 8951 7549
      Clinic 34 Katherine: 08 8973 9049
      Clinic 34 Nhulunbuy: 08 8987 0357

      For more information visit the NT Government website.

      • 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

      Vaccination Training

      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 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

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