What is mpox (monkeypox)?

Mpox is a viral infection mainly spread by direct skin-to-skin contact with someone who has mpox, including during sexual activity. The virus can also spread by contact with infected bodily fluids or contaminated items like, towels, clothing, objects, or by respiratory droplets.

Mpox symptoms can 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.
• Fever, headache, muscle aches, backache, swollen lymph nodes and chills/exhaustion, which may occur before the rash or lesions develop.

It’s important to highlight that while anyone can acquire mpox, the majority of cases have been identified among gay, bisexual men and other men having sex with men.

Since May 2022 there has been a global increase in mpox cases in countries where the virus is not usually seen, including in Australia. While most cases in NSW have been acquired overseas, a small number have acquired their infections in Australia. NSW Health is encouraging venue owners and communities to remain vigilant.

Preventing the spread of mpox

Ensure your staff know the symptoms. If any staff or patrons report these symptoms, advise them not to attend the venue, to self-isolate and to seek medical advice.

People with the virus are infectious from when they first get symptoms until all lesions have crusted, the scabs have fallen off and a fresh layer of skin has formed underneath. People with mpox are required to self-isolate from others and not have sex for the duration of their infection. A doctor will advise when they are cleared and can resume their usual activities. Most people recover within a few weeks.

People who have recovered from mpox should use condoms when engaging in sexual activity (including oral and anal sex) for 8 weeks, as the virus may remain present in semen.

Cleaning advice

As with COVID-19, frequent cleaning of SOPVs can reduce the risk of spread from the environment and does not require specialist services or equipment. Cleaning should be conducted using a detergent solution (soap and water) to remove materials from surfaces, and disinfection (for example, with bleach solution) to kill any viral particles. A single combined product can also be used (for example, combined cleaning and disinfection wipes).

Existing protocols for cleaning of SOPVs should be strengthened with additional measures including:

• More frequent cleaning of areas where semen, faeces, blood, urine or lubricant may be present.
• Spot cleaning at least hourly (or more frequently during busy periods), with targeting of high touch surfaces, that come in contact people’s skin such as lockers, keys, mattresses, swings, benches, chairs, walls, beds and sofas.
• Washing linen and textiles (for example, towels and sheets) with standard laundry detergent in a warm or hot wash. Do not shake these items before washing.

Personal Protective Equipment (PPE) should be worn while cleaning and handling laundry and waste, including:

• Disposable gloves
• Surgical mask
• Eye protection (such as goggles).

Practice regular hand washing using soap and water or an alcohol-based hand sanitiser, particularly before and after cleaning and after contact with potentially contaminated surfaces or items.

Ensure that hand washing facilities or sanitiser are readily available for staff and patrons.

Waste such as tissues, condoms and paper towels should be double bagged and disposed in a general waste bin.

Contact tracing

Public Health Units interview people diagnosed with mpox to identify where they may have acquired the infection and any contacts who may have been exposed. High-risk contacts (for example, sexual partners and household members) and medium-risk contacts (for example, social or workplace contacts) are contacted by public health staff to provide advice and monitor for symptoms. Protective vaccination is also considered for contacts on a case-by-case basis.

If a person has likely acquired their infection at a SOPV or attended a SOPV while infectious, Public Health Units will contact the SOPV to provide information to staff and request assistance with identifying contacts and/or providing information to people who may have been exposed.

SOPVs can assist NSW Health with contact tracing by collecting a first name, contact number and the time and date of patron’s entering the venue.

Ensuring that NSW Health can contact trace patrons entering your venue will limit any direct calls to the public and the need to name affected venues.

Vaccination

NSW Health began vaccinating high-risk groups against mpox in August 2022. Encourage your staff and patrons to get vaccinated against mpox if they're eligible. People can check their eligibility and book an appointment at a clinic near them. 

Further information

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

Further information and community resources about mpox can be found on ACON's website.