What is mpox (monkeypox)?

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

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

While most cases in NSW 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.

Mpox 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 mpox spread?

Mpox 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 mpox 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.

Mpox may be passed on during sex. It is not known how long the mpox virus remains present in semen and other genital excretions. People who have mpox should abstain from sex for the duration of their infection. People who have recovered from mpox should use condoms when engaging in sexual activity for 12 weeks after recovery.

People with mpox 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 mpox?

Most people are not at risk of mpox.

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 mpox in Australia have been infected while overseas. However, a small number of people have been infected in Australia.

How is mpox prevented?

Staying alert for symptoms and taking steps to prevent infection

Vaccination is only one way to prevent mpox 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 mpox.

Prevent the spread of mpox

• Avoid close contact with people who have mpox.
• 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 mpox 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 mpox, 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 mpox, self-isolate immediately and call your GP or local sexual health clinic. If you have questions about mpox, contact the NSW Sexual Health Infolink on 1800 451 624.
• If you are caring for someone with mpox, use personal protective equipment (PPE), including gloves and a N95 mask.
• Use a condom during sex for at least 12 weeks after you recover from mpox.

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

Vaccination

About mpox vaccination

Smallpox vaccines can provide protection against mpox 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 mpox. Mpox vaccines are free in NSW, and you can be vaccinated without a Medicare card.

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

Learn more about the mpox vaccine.

Vaccine rollout in NSW

NSW Health began vaccinating high-risk groups against mpox 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 mpox.

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 mpox vaccine page for the latest information on the vaccine rollout in NSW.

How is mpox diagnosed?

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

How is mpox treated?

The illness typically lasts for 2−4 weeks and is mild. Most people with mpox 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 mpox, please call ahead to your GP or local sexual health clinic. Wear a mask when attending the clinic.

If you have questions about mpox, 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.