Health conditions

Monkeypox

Since May 2022, there has been a global increase in monkeypox cases reported in multiple countries where it is not usually seen, including Australia.

Vaccination offers the best protection against monkeypox for those at-risk.

2 dose vaccination offers long-term immunity.

Those who are at-risk of monkeypox should aim to start the 2 dose vaccination series 4–6 weeks prior to attending higher risk events or travelling to countries with high case numbers.

Book your free vaccine at Vaccinate WA (metro) or (regional).

What is monkeypox?

MPX belongs to the same family as the smallpox virus but generally causes a milder illness.

Most people who have MPX will experience a mild illness and recover within 2-4 weeks.

Severe illness and death can occur in a small percentage of people.

Who does monkeypox affect?

Most people are not at risk of MPX.

MPX can affect anyone who comes into close contact with someone with the virus.

People who have had skin-to-skin or sexual contact with people who have MPX are at highest risk.

Currently, most cases are among gay, bisexual and other men who have sex with men acquired through sexual contact. Those are highest risk are people who:

  • are travelling to outbreak areas
  • have multiple sexual partners
  • attend sex parties or sex on premises venues

Most cases in Australia have been acquired overseas. However, some have acquired their infection locally, usually from a recently returned traveller.

Places with high numbers of MPX include South America, United Kingdom, United States of America and some European countries.

People who may be at higher risk of severe disease with MPX include:

  • young children
  • pregnant women
  • older people
  • immunosuppressed people.
How does monkeypox spread?

MPX mainly spreads from person to person by:

  • direct skin-to-skin contact with someone with MPX rash, sores or scabs. This kind of contact is often during oral, anal or vaginal sex.

It can also be spread by:

  • contact with clothing or fabrics (clothing, bedding, or towels) that have been used by someone with MPX (this is usually only a risk if scabs have been shed onto the clothing or fabrics)
  • prolonged face-to-face contact through respiratory droplets or oral fluids from a person with MPX
  • contact with an infected animal (such as rodents).

It is not known how long MPX virus remains in semen and other sexual fluids. People who have recovered from MPX should use condoms when having oral, anal or vaginal sex for 8 weeks after recovery.

MPX can be spread from the time symptoms start up until the sores have healed, all scabs have fallen off, and a fresh layer of skin has formed. This can take several weeks.

Signs and symptoms of monkeypox

Symptoms usually start within 5 days - 3 weeks of exposure to the virus.

Sores, rash, bumps or pimples are commonly reported on the following areas of the body, but can present anywhere:

  • genitals
  • anus or inside rectum, which may cause rectal pain or bleeding
  • inside the mouth and throat as ulcers, lesions or sores, which may cause sore throat or difficulty swallowing
  • face, arms and legs.

The sores are flat and then become raised. Then they fill with fluid and eventually scab and fall off over a period of 2–3 weeks.

They can be very painful and may cause scarring.

People with MPX in the rectum or throat may not have a visible rash, but can pass the infection onto others.

General viral symptoms may be experienced initially such as:

  • fevers
  • chills
  • muscle aches
  • backache
  • swollen lymph nodes
  • exhaustion
  • headache.

Symptoms may resemble sexually transmissible infections (STIs) such as herpes or syphilis as well as other infections with a rash such as measles or chickenpox.

Treatment

Most people with MPX will recover without any specific treatments.

The illness is usually mild, and recovery takes a few weeks. However, in some people the sores can be very painful.

Simple pain medications and keeping up with oral fluids help to manage symptoms.

Severe illness can occur in a small percentage of people.

Antiviral medications may be used for people with severe illness, under the guidance of a specialist doctor.

Prevention

Considerations for preventing MPX:

  • Limit sexual partners and use condoms with lubricant (noting that condoms alone may not prevent MPX, but will protect against other STIs).
  • Get vaccinated against MPX.
  • Avoid skin-to-skin contact with people who have symptoms of MPX or are confirmed to have MPX.
  • Do not handle or touch the bedding, towels, or clothing of a person with MPX.
  • Wash your hands often with soap and water or use an alcohol-based hand sanitizer.
  • Maintain physical distance and avoid skin-to-skin contact when attending events. MPX higher risk events include sex parties and sex on premises venues, particularly at interstate or overseas locations where high numbers of MPX cases are occurring.
  • If you have recently attended a high-risk event interstate or overseas, you can reduce the risk of passing MPX to your sexual partners by:
    • avoiding unprotected skin-to-skin contact for 3 weeks, including avoiding sexual contact
    • monitoring your symptoms during this time
    • seeking health care as soon as possible if symptoms develop.
  • Be aware that your risk of getting MPX is likely to increase as the number of your sexual partners increases.

It would be helpful for you to know the contact details of your sexual partners to allow for sexual health follow-up, if needed.

Vaccination

WA Health is prioritising vaccination for people at highest risk of infection and/or severe disease.

The best time for eligible people to receive the monkeypox vaccine is before they are exposed to the virus.

Although one dose of the JYNNEOS® monkeypox vaccine provides substantial benefit, two doses given at least 28 days apart will ensure optimal protection against infection.

Those who are at-risk and planning to attend festivals, events, or to travel to a country experiencing a significant monkeypox outbreak, should aim to start the 2 dose vaccination series 4–6 weeks prior.

Widespread vaccination is not currently recommended due to the very low risk of infection for the general population.

Vaccination eligibility

Those who are at highest risk of getting monkeypox and/or experiencing severe illness due to monkeypox, can access the vaccine first, free-of-charge. This includes people who do not have a Medicare card.

Post exposure vaccination

  • Contacts of a case as determined by the Public Health Unit.

Pre-exposure vaccination

  • 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
  • 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

Register your interest in vaccination

Perth metropolitan area

If you wish to receive the monkeypox vaccine in the metropolitan area:

  • Register at VaccinateWA to be vaccinated for free at a state-run clinic.

Or

Contact any of the clinics below. They will assess your eligibility over the phone and assist with your booking.

Regional Western Australia

If you wish to receive the monkeypox vaccine in regional Western Australia:

Or

What to do if I am a close contact?

If you have been in contact with a person with MPX, your local public health unit may contact you to assess your risk of developing MPX and provide advice.

If you have had contact with a MPX case and have not been contacted by public health, you should call your local public health unit (see Contact details for population/public health units).

  • The public health unit will assess your level of risk and provide advice about anything you need to do.
  • You will be asked to monitor for symptoms of MPX for 21 days from last contact with a person with MPX.
  • You may be advised to:
    • Avoid physical or intimate contact with others including sexual activity.
    • Avoid contact with animals, particularly dogs and rodents (mice, rats, hamsters, gerbils, guinea pigs, squirrels etc)
    • Avoid contact with people who are at higher risk of severe disease, including people with low immunity, pregnant women, older people and young children.
    • Avoid settings with young or vulnerable people such as early childhood education and care services, schools, aged care, healthcare settings (unless seeking medical attention).
    • Wear a surgical mask when outside the home.
    • Receive post-exposure vaccination for MPX.
  • If you develop symptoms, you should stay at home and contact your local public health unit to arrange testing.
Information for people diagnosed with monkeypox virus

If your test is positive for monkeypox, you will be contacted by public health, who will provide advice about when you can be cleared. Public health may also contact you while you are staying at home to monitor your symptoms and ensure you are well.

Awaiting a test result

Information for people awaiting a monkeypox test result can be found here (PDF 97KB).

Where to get help

If you have monkeypox symptoms and have recently travelled overseas to an area with monkeypox:

  • call your GP for an appointment, or;
  • seek care at your nearest hospital.

If going to a GP or hospital it is important to call ahead and wear a mask.

Sexual health helpline

Metro 9227 6178
Country 1800 198 205

Sexual health clinic appointments

Sexual Health Quarters (SHQ)
70 Roe Street, Northbridge, WA 6003
(08) 9227 6178

M Clinic (for men only)
2 Clive Street, West Perth, WA, 6005
(08) 9227 0734

Sexual Health Clinic, Royal Perth Hospital
Ainslie House, Level 4, H Block, Victoria Square, PERTH, WA, 6000
(08) 9224 2178

South Terrace Sexual Health Clinic
A Block, South Terrace side of Fremantle Hospital
(08) 9431 3145 or (08) 9431 2149


Last reviewed: 13-10-2022
Acknowledgements

Public Health


This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.

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