There have been 52 cases of monkeypox identified in NSW since 20 May 2022.

Last updated: 16 September 2022
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What is monkeypox (MPXV)?

Monkeypox is a viral infection that causes a rash. It is 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 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 as short as 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 then form crusts or scabs and fall off.

The risk of severe disease and complications such as secondary infection, sepsis and encephalitis is likely to be increased in people with immunocompromise, young children and pregnant women.

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, some people have been infected in Australia.

How is monkeypox prevented?

Stay alert for symptoms and take steps to prevent infection

Prevent the spread of monkeypox

  • Avoid physical or sexual 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 contact with any rashes or sores you see on others and minimise skin-to-skin contact.
  • Consider minimising numbers of sexual partners, particularly casual sex contacts
  • 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 
  • Practice good hand hygiene. Wash your hands with soap and water or use an alcohol-based hand sanitiser. 

Monitor for symptoms

  • Men who have sex with men who are returning from Europe, North America or other places where outbreaks have been occurring, or who have attended dance parties, sex parties, saunas, or sex on premises venues should monitor for signs or symptoms of monkeypox
  • 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 rash 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, avoid close contact with other people and call your local public health unit on 1300 066 055. 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 a surgical mask, gloves, disposable fluid-resistant gown and eye protection.

Vaccination

Smallpox vaccines can provide protection against monkeypox because the two viruses are closely related. NSW Health secured limited 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 those who are immunocompromised. It is also the vaccine of choice in those who are pregnant or breastfeeding. Although data in children is currently limited, JYNNEOS® can be offered off-label to children on a case-by-case basis, depending on risk.

For optimal protection in people at high risk of monkeypox, two doses of the vaccine are required, at a minimum of 28 days apart. Maximum protection is reached around two weeks after the second dose and likely persists for years.

JYNNEOS® may also be given to those who are high or medium-risk contacts of those with confirmed monkeypox as post-exposure prophylaxis (PEP) depending on an individual risk assessment. This is given as one dose, ideally within 4 days but sometimes up to 14 days after exposure. 

NSW Health began vaccinating people at highest risk from monkeypox from 8 August 2022.

Many people will not be eligible during the initial rollout. NSW Health is working to ensure the most vulnerable people access the vaccine first.

NSW Health expects to receive up to 30,000 doses at the end of September and 70,000 doses in early 2023.

Initially, doctors and other community partners are identifying people who are most at risk of monkeypox to receive the vaccine first

NSW Health will provide more information about eligibility and access to the vaccine at that time.

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

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?

People with monkeypox usually recover without specific treatment in 2-4 weeks. 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. A few people may need supportive management such as 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 surgical mask when attending the clinic.

For further information on how to stay safe and prevent monkeypox infection, visit MPXV (Monkeypox) Prevention on ACON's website.

If you have questions about monkeypox,


Current as at: Friday 16 September 2022
Contact page owner: Health Protection NSW