Learn more about Monkeypox and what you can do if travelling overseas or if you've just returned, and with cases acquired locally, it's time for everyone to become familiar with Monkeypox.
NOTE: Second MPX vaccinations are now available
Get To Know Monkeypox (MPX)
What is Monkeypox (MPX)?
MPX is a viral infection caused by the monkeypox virus. While MPX was first identified several years ago, cases of MPX were rarely seen outside of Central and West Africa until recently. MPX is usually a self-limited disease with symptoms lasting from 2 to 4 weeks.
What are the symptoms of MPX?
Initial symptoms can include fever, headache, muscle aches, low energy, and swollen lymph nodes (similar to COVID or the flu) before progressing to a skin rash or lesions. The rash usually begins within one to three days of the start of a fever. The rash or lesions can also be found on the face, arms, and legs as well as in the mouth and around the genitals/anus.
Some cases develop proctitis (presenting with rectal pain, bloody stools, diarrhoea) or urethritis (presenting with pain while urinating or during sexual intercourse, itchiness at the tip of the urethra, penile discharge, including pus and/or blood).
Because MPX rashes can resemble some STIs, and in particular, herpes-like symptoms, it is important to contact your GP or local sexual health clinic and let them know about your symptoms when you make an appointment.
The incubation period (the time from infection to the onset of symptoms) of MPX is usually 7-14 days, but it can be as short as 1-2 days or as long as 21 days.
While symptoms are typically mild, for some people with moderate to serious cases MPX can be quite painful.
How is MPX transmitted?
MPX is transmitted through close physical contact with someone who has the virus - in particular through sexual or intimate contact.
While MPX is not classified as a sexually transmitted infection (STI), sexual contact with someone who has the virus poses a high risk of transmission.
Bodily fluids (such as fluid, pus or blood from skin lesions) and scabs are particularly infectious. Ulcers, lesions or sores in the mouth can also be infectious, meaning the virus can spread through saliva.
How is MPX treated?
Most people with MPX have a mild self-limiting illness and recover within a few weeks without specific treatment.
There are some therapies available for the treatment of MPX, particularly for people at high-risk such as those who are immunosuppressed.
Am I at greater risk if I’m HIV-positive?
HIV positive people on effective antiretroviral treatment are at no greater risk than HIV-negative people.
However, if a person is severely immunocompromised and not on HIV antiviral medication, MPX can be of greater severity and duration.
There is very limited evidence on MPX in people living with HIV. The research that we do have is from countries where access to treatment is low and health experiences are poorer than in Australia. Should evidence emerge that people with suppressed immune systems are at greater risk of MPX, or ill-health from catching the virus, then updated information and advice will be made available.
Why are cases of MPX being detected among gay, bisexual and men who have sex with men?
Currently, a large number of MPX cases are among gay, bisexual, and other men who have sex with men (MSM) and the current outbreak appears to be moving quickly amongst sexual networks.
One reason we're seeing more cases amongst MSM is due is their proactivity seek out sexual health advice. MPX rashes and lesions can resemble some STIs, such as herpes or syphilis. Consequently, MPX cases are being detected in sexual health clinics around the world.
However, the risk of MPX is not limited to gay, bisexual, and other men who have sex with men. Anyone who has close intimate or sexual contact with someone infectious is at risk.
Stigmatising people because of a disease is never okay. Anyone can get or pass on MPX regardless of their sexuality.
It's also really important you're aware of your HIV status. Experiencing MPX alongside untreated HIV or STIs may make your symptoms worse. Find out more about getting tested here.
What if I have recently returned from overseas?
If you recently returned from overseas, in particular if you've been having casual sex while overseas or attended sex-on-premises venues, it's important that you monitor for symptoms. The MPX rash can appear at multiple sites across the body, so check around your mouth, genitals and anus for any new spots or lesions.
People who have recently returned from overseas and developed symptoms, particularly an unusual rash or swollen lymph nodes, should seek medical advice immediately.
You should stay at home and remain isolated until given further advice by your treating doctor. If you are presenting to a clinic or emergency department, call to let them know you are coming, wear a mask, inform the reception staff on arrival, and wait to be isolated until you can be seen by a clinician.
MPX can be transmitted to pets. If you are isolating and experiencing symptoms, it is recommended that you isolate away from any pets.
MPX can also be transmitted via clothing and other materials, so it is recommended that you wash all clothing items, towels and sex toys that you took overseas.
Where can I get tested for MPX?
There are clinics who have been trained to test for MPX. These are located across Victoria.
Find your local testing clinic here.
How is Monkeypox (MPX) prevented?
To reduce your risk of acquiring MPX there are some practices and behaviours you can adopt.
If you are planning to travel overseas, it is important to stay informed and remain aware of developments. The situation with MPX is changing rapidly.
- Book an appointment to get your MPX vaccine. Ensure two weeks between getting the vaccine and engaging in behaviour that may expose you to MPX. It takes at least two weeks to offer initial protection against MPX.
- Follow public health alerts and advice from local health authorities of the countries you are visiting.
- If visiting festivals or large events, keep alert of any event updates (before and after) from organisers.
Be aware and exercise caution if you plan to attend any large-scale pride events, sex parties or SOPVs, particularly in places where there are identified cases of MPX.
If you are staying home, when it comes to sex:
- Limit the number of sexual partners you have. MPX is moving through sexual networks. Limiting the number of partners you have reduces your risk of coming into contact with someone who has the virus.
- Swap contact information with your hook-ups. If either of you develops symptoms, you can contact each other to go and get tested.
- When having sex there are ways to limit skin-to-skin contact and contact with bodily fluids. So maybe don’t kiss or cuddle, avoid using spit for lube, use condoms, and be sure to wash your face, hands, and body parts after sex. Some may want to consider using condoms for receptive anal sex to reduce the risk of anal infection.
- Create a 'sex bubble'. Similar to what some people did during COVID, you can have a select group of people where you are only having sex with each other. Each person agrees that they’d be happy to be part of the bubble and won’t have sex outside of that group. This limits the risk that you and your sex bubble come into contact with the virus.
- If you have an open relationship, you might want to consider making it a closed relationship for a small period of time. The fewer people you play with, the less likely you are to come into contact with the virus.
- Explore ways to get off by yourself or at a distance from others. Looking for ideas? Check out tips our community came up with for Sex & COVID or listen to WellWellWell's episode on Sex, Intimacy & COVID-19.
When it comes to going out, some activities can put you at greater risk than others. There are some simple steps you can take to protect yourself from monkeypox:
- Check yourself for symptoms before heading out. If you are unwell or have a rash - stay home and seek a medical opinion.
- Consider the type of event and venue you're going to. Close skin-to-skin contact in spaces where people may be wearing little-to-no clothes or spaces where sex is happening puts you at a greater risk of exposure.
- Don’t share personal items, such as towels, toothbrushes or sex toys.
- Better to stay in your own bed than to sleep on someone else’s bed sheets.
The most effective way to prevent monkeypox is to limit your sexual partners and get vaccinated when you can.
Tell me about the Monkeypox (MPX) vaccine?
Monkeypox (MPX) vaccine appointments are now available in Victoria.
As there is a very limited supply of the vaccine, they will be limited people in Victoria who meet the following eligibility criteria:
- Post-exposure prophylaxis for close contacts of Monkeypox cases (within 4 days);
In Victoria, the MPX vaccine is available free-of-charge for eligible people who meet any of the following criteria:
- Post exposure prophylaxis (PEP) for high-risk close contacts of monkeypox cases, preferably within 4 days.
- 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) at increased risk of monkeypox infection.
- Proxy markers for increased risk of monkeypox infection may include:
- Those living with HIV.
- A recent history of multiple sexual partners, participating in group sex, or attending sex on premises venues.
- Other proxy markers, such as recent sexually transmitted infection or those being advised to take HIV PrEP due to number of sexual partners.
- Sex workers, particularly those whose clients are in high-risk categories listed above.
- Anyone in the above high-risk categories who is planning travel to a country experiencing a significant outbreak, with vaccination recommended 4-6 weeks prior to departure.
- Anyone at greater risk of a poor clinical outcome from monkeypox infection, such as individuals with immunocompromise.
- 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.
Where can I get the vaccine?
Currently, vaccines are in limited supply across Australia. In metropolitan Melbourne, vaccinations are now offered through the local public health units (LPHUs), each listing the various sites and pop-up clinics.
- Western Public Health Unit https://www.wphu.org.au/mpx/
- North Eastern Public Health Unit https://www.austin.org.au/NEPHU/
- South Eastern Public Health Unit https://sephu.org/monkeypox/
For individuals who fulfil the criteria for vaccination and reside in regional Victoria, email your closest regional Local Public Health Unit (LPHU).
|Local Public Health Unit (LPHU)||Contact|
|Barwon South West||https://bswphu.org.au/news/item/health-alert-monkeypox|
What vaccine is available?
The vaccine that is currently available to prevent MPX is the JYNNEOS vaccine.
JYNNEOS is one of two vaccines approved for use for MPX in Australia.
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.
How does the JYNNEOS vaccine work?
The JYNNEOS vaccine is a two-dose vaccine. There needs to be a minimum of 28 days or four weeks between doses.
At the moment, Australia is focusing on providing the first shot to as many at risk people as possible.
While supply is limited, second doses can be administered to people who meet the criteria for 'immunocompromised'. The JYNNEOS vaccine is safe to use in people who are immunocompromised.
Vaccination is highly effective, and a person will start to build protection in the days and weeks after their first dose. It takes four weeks for someone to reach their highest level of protection following their first dose. It should be noted that studies have been limited and there is a need to grow the evidence in this area.
Who is considered 'immunocompromised' with regard to the MPX vaccine?
At least 28 days after receiving the first dose, second doses of the MPX vaccine can be administered to people who meet the criteria for 'immunocompromised'.
The Victorian criteria for ‘immunocompromise’ in relation to monkeypox vaccination eligibility has been informed by expert opinion and is subject to updates by the Australian Technical Advisory Group on Immunisation (ATAGI). The criteria include:
- Primary immunodeficiency or acquired immunodeficiency: HIV/AIDS with CD4 count <200, or uncontrolled viraemia
- Haematologic neoplasms: leukaemias, lymphomas, myelodysplastic syndromes, multiple myeloma and other plasma cell disorders, post-transplant: solid organ (on immunosuppressive therapy), haematopoietic stem cell transplant (within 24 months), primary immunodeficiency,
- Receipt in the last 3 months any of:
- Chemotherapy or whole-body radiotherapy
- High-dose corticosteroids (≥ 20 mg of prednisone per day, or equivalent) for at least 14 days in 1 month, or pulse corticosteroid therapy
- Biological agents and other treatments that deplete or inhibit B- or T-cell function (anti-CD20 antibodies, BTK inhibitors, JAK inhibitors, sphingosine 1-phosphate receptor modulators, anti-CD52 antibodies, anti-complement antibodies, anti-thymocyte globulin)
- Selected conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) including mycophenolate, methotrexate (more than 0.4 mg/kg/week), leflunomide, azathioprine (at least 3 mg/kg/day), 6-mercaptopurine (at least 1.5 mg/kg/day), alkylating agents (eg, cyclophosphamide, chlorambucil), and systemic calcineurin inhibitors (eg, cyclosporin, tacrolimus)
What are the common side effects of the JYNNEOS vaccine?
Side effects are common but usually mild. Most people have redness, swelling and pain in the spot where they received the injection. Tiredness, headache and muscle pain can also occur after vaccination.
Do I need a Medicare card to receive the vaccine?
No. While some vaccination sites may ask you to bring a Medicare card along to your appointment, MPX vaccines are available at no charge to everyone regardless of their Medicare status.
I have been exposed to MPX. Am I eligible for the JYNNEOS vaccine?
Anyone categorised by public health authorities as a high risk MPX contact in the past 14 days should get the vaccine. Speak to your GP or healthcare professional about vaccine access if you are a close contact.
I have symptoms of MPX. Am I eligible for the JYNNEOS vaccine?
If you have symptoms of MPX it is important to speak to a healthcare provider first before accessing a vaccine appointment.
Are more supplies of the JYNNEOS vaccine on their way?
Yes. The federal and state governments are working to secure more supplies of the vaccine. As more vaccines become available, more people can get vaccinated against MPX.
For more information about Monkeypox, head to https://www.health.vic.gov.au/infectious-diseases/monkeypox