This fact sheet covers the symptoms, risk factors and diagnosis of monkeypox.

Visit our monkeypox hub for information on how many monkeypox cases have been identified in NSW since 20 May 2022, as well as how to reduce your risk of catching and spreading the virus.

Last updated: 23 November 2022
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What is monkeypox (MPXV)?

Monkeypox is a viral infection that causes a rash. It is mainly spread by skin-to-skin contact with someone who has monkeypox. Most people recover within a few weeks.

Since May 2022, there has been a global increase in monkeypox cases reported from multiple countries where monkeypox is not usually seen. Most of the cases are in gay, bisexual and other men who have sex with men.

The situation with monkeypox in NSW is changing rapidly. While most cases have been acquired overseas, a small number have acquired their infections in Australia.

What are the symptoms?

Symptoms usually begin 7-14 days after exposure. This can be a few days or as long as 21 days.

Monkeypox symptoms may include: 

  • rashes, pimple-like lesions or sores, particularly in areas that are hard to see such as the genitals, anus or buttocks, and on the face, arms and legs
  • ulcers, lesions or sores in the mouth.

People can experience fever, headache, muscle aches, backache, swollen lymph nodes, chills and/or exhaustion prior to the rash or lesions developing.

The lesions start as a flat red rash that develops into pustules, which form crusts or scabs and fall off.

How does monkeypox spread?

Monkeypox mainly spreads from one person to another by direct skin-to-skin contact. It may be spread by breathing in droplets breathed out by someone who has monkeypox during prolonged close contact, but this is rare. It can also be spread through contact with infected bodily fluids or contaminated objects, such as bedding or clothes.

Monkeypox may be passed on during sex. It is not known how long the monkeypox virus remains present in semen and other genital excretions. People who have monkeypox should abstain from sex for the duration of their infection. People who have recovered from monkeypox should use condoms when engaging in sexual activity for 8 weeks after recovery.

People with monkeypox are infectious from the time they first get symptoms until all the lesions have crusted, the scabs have fallen off and a fresh layer of skin has formed underneath.

Who is at risk of monkeypox?

Most people are not at risk of monkeypox.

People at highest risk are men who have sex with men, particularly those who are travelling to outbreak areas, have multiple sexual partners or attend large parties or sex on premises venues.

To date most people with monkeypox in Australia have been infected while overseas. However, a small number of people have been infected in Australia.

How is monkeypox prevented?

Staying alert for symptoms and taking steps to prevent infection

Vaccination is only one way to prevent monkeypox infection.

As there is still a risk of infection following vaccination, it’s still important to take steps to reduce the chance of catching or spreading monkeypox.

Prevent the spread of monkeypox

  • Avoid close contact with people who have monkeypox.
  • Events such as parties or clubs where there is less clothing worn, and therefore a higher likelihood of direct skin-to-skin contact, carry risk of monkeypox exposure. Avoid any rashes or sores you see on others and minimise skin-to-skin contact.
  • Exchange contact information with your sexual partners to assist with contact tracing if needed.
  • Avoid contact with any materials, such as bedding or towels, that may have been in contact with an infected person.
  • Practise good hand hygiene. Wash your hands with soap and water or use an alcohol-based hand sanitiser.

Monitor for symptoms

  • Gay, bisexual and other men who have sex with men should monitor for symptoms. In particular, those who are returning from known outbreak hotspots such as Europe and North America should monitor for signs or symptoms of monkeypox, particularly those who have attended dance parties, sex parties, saunas, or sex on premises venues
  • Check yourself for symptoms before you leave home. If you feel unwell or sick, or have any rashes or sores, do not attend events or venues.
  • If signs or symptoms develop, self-isolate immediately and seek care by calling ahead to make an appointment with your local GP or sexual health clinic.
  • Limit sexual partners for three weeks following your return from overseas.

Take action if you are exposed

  • If you are advised that you are a close contact of someone with confirmed monkeypox, self-isolate immediately and call your GP or local sexual health clinic. If you have questions about monkeypox, contact the NSW Sexual Health Infolink on 1800 451 624.
  • If you are caring for someone with monkeypox, use personal protective equipment (PPE), including gloves and a N95 mask.
  • Use a condom during sex for at least 8 weeks after you recover from monkeypox.

For further information on how to stay safe and prevent monkeypox infection, visit the NSW Health monkeypox information hub and the ACON website

Vaccination

About monkeypox vaccination

Smallpox vaccines can provide protection against monkeypox because the two viruses are closely related.

NSW Health has secured supplies of a new vaccine against smallpox (JYNNEOS) which has fewer side effects than previous smallpox vaccines and can be safely used by all groups of people, including people aged over 18 years, who are immunocompromised and who have HIV. Vaccine supply is currently limited due to global demand.

Two doses of the vaccine are required for maximum protection, given at least 28 days apart. The vaccine is most effective two weeks after the second dose and gives an 80% protection against monkeypox. Monkeypox vaccines are free in NSW, and you can be vaccinated without a Medicare card.

The vaccine does not transmit monkeypox or any other pox virus to other people.

Learn more about the monkeypox vaccine.

Vaccine rollout in NSW

NSW Health began vaccinating high-risk groups against monkeypox in August 2022. Up to 70,000 further doses are expected to arrive in 2023. This will allow more people in NSW to be vaccinated against monkeypox.

Vaccine eligibility in NSW has been expanded to include:

  • all sexually active gay and bisexual men (cis and trans)
  • sexual partners of the people above
  • sex workers.

NSW Health is working closely with partner agencies such as NSW Sexual Health Infolink and ACON on the vaccine rollout.

Booking your vaccine

People who are eligible for the vaccine are able to book an appointment through the NSW Health online booking system. The new booking system gives people who need the vaccine more choice over where, and when, they receive the vaccine.

There is a limited number of appointments and vaccine supply available so eligible members of the community who aren’t yet fully vaccinated are encouraged to book an appointment as soon as possible.

If you are not yet eligible for the vaccine, please continue to check the NSW Health monkeypox vaccine page for the latest information on the vaccine rollout in NSW. We thank you for your patience.

How is monkeypox diagnosed?

Diagnosis depends on the doctor suspecting monkeypox in someone who has monkeypox symptoms. Infection can be confirmed by testing the blister fluid or scabs from the skin rash.

How is monkeypox treated?

The illness typically lasts for 2−4 weeks and is mild. Most people with monkeypox only need regular over-the-counter pain medicines and oral fluids and can be monitored by their GP or treating clinician.

Severe illness can occur, particularly in immunocompromised people. A few people may need intravenous fluids and treatment to control fever or pain.

There are antiviral medications available that may help to treat people with severe illness.

What is the public health response?

Doctors, hospitals and laboratories must notify any suspected cases to the local public health unit immediately. Public health unit staff will initiate a public health investigation, contact tracing and control measures.

Further information

If you think you might have symptoms of monkeypox, please call ahead to your GP or local sexual health clinic. Wear a mask when attending the clinic.

If you have questions about monkeypox, contact the NSW Sexual Health Infolink on 1800 451 624.

For free help in your language, call the Translating and Interpreting Service on 13 14 50.

Current as at: Wednesday 23 November 2022
Contact page owner: Health Protection NSW