Mpox (monkeypox)

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

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

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

Most people are not at risk of mpox.

Mpox 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 mpox 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.

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

• young children
• pregnant women
• older people
• immunosuppressed people.

Mpox mainly spreads from person to person by:

• direct skin-to-skin contact with someone with mpox 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 mpox (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 mpox
• contact with an infected animal (such as rodents).

It is not known how long the monkeypox virus remains in semen and other sexual fluids. People who have recovered from mpox should use condoms when having oral, anal or vaginal sex for 12 weeks after recovery.

Mpox 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.

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 mpox 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.

Most people with mpox will recover without needing 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.

Considerations for preventing mpox:

• Limit sexual partners and use condoms with lubricant (noting that condoms alone may not prevent mpox, but will protect against other STIs).
• Get vaccinated against mpox.
• Avoid skin-to-skin contact with people who have symptoms of mpox or are confirmed to have mpox.
• Do not handle or touch the bedding, towels, or clothing of a person with mpox.
• 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. Mpox higher risk events include sex parties and sex on premises venues, particularly at interstate or overseas locations where high numbers of mpox cases are occurring.
• If you have recently attended a high-risk event interstate or overseas, you can reduce the risk of passing mpox 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 mpox 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.

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 mpox vaccine is before they are exposed to the virus.

Although one dose of the JYNNEOS® mpox 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 an mpox 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 mpox and/or experiencing severe illness due to mpox, 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

The following people are recommended to be vaccinated against mpox:

• 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
• 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.

How to access the vaccine

Perth metropolitan area

If you wish to receive the mpox vaccine in the metropolitan area contact any of the clinics below. They will assess your eligibility over the phone and assist with your booking.

• Royal Perth Hospital Sexual Health Clinic phone: 9224 2178
• GP on Beaufort (external site) phone: 9262 8600
• M Clinic (external site) phone: 9227 0734
• Sexual Health Quarters (external site) phone: 9227 6177
• South Terrace Sexual Health Clinic (external site) phone: 9431 2149
• Central City Medical Centre (external site) phone: 9225 1188
• View St Medical (external site) phone: 9227 0170

Regional Western Australia

If you wish to receive the mpox vaccine in regional Western Australia contact your local regional Public Health Unit.

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

If you have had contact with a mpox 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 mpox for 21 days from last contact with a person with mpox.
• 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 at risk 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 mpox.
• If you develop symptoms, you should stay at home and contact your local public health unit to arrange testing.

If your test is positive for mpox, 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.