UPDATE: 15 August 2022
There have been 34 cases of monkeypox identified in NSW since 20 May 2022.
If you believe you may be at risk of transmission, you can now register your interest to receive a monkeypox vaccine. Find out more information here.
You may have heard of monkeypox (MPXV) recently. MPXV is a viral illness that is traditionally found in Central and West Africa. However, since May 2022 there have been people presenting with MPXV in other countries in Europe, Asia and North America.
In Australia, there are now confirmed locally-acquired cases of MPXV – that is, the person/s who acquired it have no history of overseas travel. Contact tracing is underway to determine the source of MPXV within Australia, which includes, very likely in NSW.
As the situation develops, health authorities are encouraging communities to remain informed, aware, and monitor for symptoms especially if you have had close physical contact with others including sexual encounters, or if you have recently returned from or are travelling to an international location with known cases of MPXV.
You can read more and keep up to date with the latest on MPXV from ACON here.
What is monkeypox (MPXV)?
MPXV is a zoonotic disease (meaning it can spread between animals and people) that is caused by viral infection. MPXV belongs to the same family of viruses as smallpox, although is less severe.
MPXV is commonly found in tropical rainforest areas of remote parts of West and Central Africa. It was first identified as an illness of non-human primates, which is where its name came from, although the source of the disease remains unknown.
What are the symptoms of MPXV?
Symptoms of MPXV may vary from person to person, but typically begins with flu-like symptoms followed by a rash, lesions or sores.
- Skin rash, lesions or sores
- Swollen lymph nodes
- Fever and chills
- Muscle aches, back pain and joint pain
- Low energy and exhaustion
The rash, lesions or sores may be in areas that are hard to see such as the genitals and anus, anal area or in the mouth. They may also be on the face, arm, chest, back and legs.
The rash, lesions or sores may vary from person to person – for some it can look like pimples, for others they may resemble blisters. Rashes may also look like herpes or syphilis.
Most people develop symptoms in 1-2 weeks but the incubation period (the time from infection to the onset of symptoms) can be up to 21 days.
People may experience all or only a few of these symptoms. Most people with MPXV will get a rash, while others may develop sores before developing flu-like symptoms. Some may not develop any flu-like symptoms at all.
How is MPXV transmitted?
Unlike other viruses such as COVID-19, MPXV does not spread easily from person to person, so the risk to the population remains low.
MPXV is transmitted through close physical contact with someone who has symptoms. This includes through:
- Skin rashes, lesions or sores
- Bodily fluids (such as fluid, pus or blood from skin lesions)
- Ulcers, lesions or sores in the mouth (meaning the virus can spread through kissing)
- Ulcers, lesions or sores in and around the anal area and anus
Clothing, linens, or objects that have come into contact with a person who has MPXV can also present as a risk for onward transmission.
You can also acquire MPXV when a person with MPXV has respiratory symptoms and sneezes or coughs and you inhale infected droplets.
While MPXV has not previously been described as a sexually transmitted infection, it can spread in sexual networks through direct contact during sex or contact with bedding, clothing and sex toys used by someone with MPXV.
Who is at risk of MPXV?
MPXV can infect anyone, regardless of race, sexuality, gender or age. However, many of the recent cases have been detected among gay, bisexual and other men who have sex with men. One reason for this is the proactive health seeking behaviour that many gay, bisexual and other men who have sex with men adopt around their sexual health. Because MPXV rashes can be mistaken for some STIs, such as herpes or syphilis, cases are being detected in sexual health clinics around the world.
How is MPXV treated?
MPXV is typically a self-limiting disease meaning that it usually resolves within a few weeks without specific treatment.
As most cases of MPXV are mild, medical treatment is not usually required. There are some therapies available to treat MPXV, particularly for people at higher risk such as those with compromised immune systems.
Is there a vaccine for MPXV?
MPXV is closely related to the virus that causes smallpox. So, while a specific vaccination has not been developed for MPXV, two varieties of smallpox vaccines offer protection from MXPV.
The JYNNEOS vaccine is what is being offered to community members during the monkeypox vaccination program. It is a two-dose vaccine given four weeks apart. It is administered by injection, usually in the upper arm, and is safe to use in immunocompromised people.
The other vaccine, ACAM2000, is associated with rare but serious side effects and adverse events, especially in certain groups of people such as those who are severely immunosuppressed. Because of this, ACAM2000 is not recommended for mass vaccination.
A targeted vaccination program using the JYNNEOS vaccine is underway. This program focuses on high risk groups and is now being rolled out by NSW Health.
People considered at high risk of acquiring MPXV are encouraged to register their interest to receive a vaccine.
Am I at greater risk if I’m HIV-positive?
Evidence on MPXV in people living with HIV is very limited. Most is based on research in countries where access to treatment is low and where people experience far negative health outcomes than in Australia.
At the moment, people living with HIV should follow the same health advice as the general population. Should new evidence emerge that impacts people living with HIV, then updated information and advice will be made available.
What should I do if I develop symptoms or have been exposed to MPXV?
If you develop any symptoms or have been exposed to MPXV:
- Avoid contact with others and seek medical attention immediately.
- Call your GP or local sexual health clinic via phone or use telehealth services.
- Call the NSW Sexual Health Infolink on 1800 451 624.
- Do not attend a health service in the first instance – call first.
- Avoid public transport.
- Wear a surgical mask.
- Cover any lesions with clothing or dressings. Ask your GP or clinic what type of skin dressing to use.
- Avoid sex or being intimate with anyone until examined.
- Avoid gatherings, particularly if they involve close, skin-to-skin contact with other people.
If you have recently returned from overseas …
If you have recently returned from overseas, have attended any dance parties, sex parties or saunas – especially in Europe and North America – keep an eye out for symptoms for 21 days.
If you develop any symptoms, particularly an unusual rash, lesions or sores, seek medical advice immediately. During this time, consider having a break from sex until the end of the incubation period.
Call the NSW Sexual Health Infolink on 1800 451 624 or call your GP or local sexual health clinic via phone or telehealth.
Remember: do not attend a health service in the first instance – be sure to call first.
If you are planning to travel overseas …
The situation with MPXV is changing rapidly. If you are planning to travel overseas, especially to a known MPXV hotspot such as areas in Europe or North America, it is important to stay informed and remain aware of developments:
- Consider registering your interest in receiving an MPXV vaccination as soon as possible before your departure. Find out more information here.
- Follow public health alerts and advice from local health authorities of the countries you are visiting.
- Keep alert of any event updates (before and after) from organisers if you are visiting festivals or large events.
- Be aware and exercise caution if you plan to attend sex parties or SOPVs, particularly in places where there are identified cases of MPXV. If attending these, consider adopting safe sex strategies to reduce your risk of MPXV transmission.
- Visit WHO for an updated list of affected destinations.
- Visit Smart Traveller for travel alerts.
You can reduce your risk of contracting MPXV overseas:
- Avoid contact, including sexual contact, with people who are unwell or have MPXV symptoms.
- Avoid skin-to-skin contact, particularly with any rash, lesions or sores.
- Avoid contact with clothing, bedding or objects that have been in contact with or used by people with MPXV.
- Always practise good hygiene.
If you develop any symptoms overseas, self-isolate and seek local medical attention immediately.
Where can I get more information?
Here are some sources of information:
You can also call the NSW Sexual Health Infolink on 1800 451 624.
NSW Health have translated information factsheets available in: