With monkeypox now declared a public health emergency of international concern, we’ve put together this special feature to support you in providing care and information to your patients.
The feature includes information about who’s at risk, symptoms, specimen collection, how far it has already spread, vaccines and treatment, educational webinars and other resources which may be of interest.
What is it?
Monkeypox, also known as MPX, is a disease caused by the monkeypox virus and is part of the same family of viruses as variola virus which causes smallpox.
It is a viral zoonotic disease which occurs primarily in tropical rainforest areas of Central and West Africa and is occasionally exported to other regions.
Since May 2022, there has been a global increase in MPX infections in multiple countries where the illness is not usually seen.
What are its symptoms?
The symptoms of monkeypox are similar to those of smallpox but are generally milder. They include:
- fever
- headache
- muscle aches
- backache
- swollen lymph nodes (swollen glands)
- chills
- extreme tiredness
A rash may appear one to five days after the fever starts. Usually the rash begins as flat, red spots, often in the mouth or on the face first. Then the rash spreads to other parts of the body — usually the arms and legs, rather than the trunk. The rash may also appear on the palms and soles, inside the mouth, on the genitals and on the eyes.
Infection can be confirmed by testing a swab collected from the base of a blister from the skin rash.
Find advice on specimen collection and handling
How does it spread?
MPX spreads from one person to another by direct contact with infected bodily fluids such as contact with the sores, or scabs on the skin, or through touching contaminated objects the infected person has used, such as linen or clothes.
It may also be transmitted during close physical contact, including sex.
It can also be spread through prolonged face-to-face contact by inhaling infected respiratory droplets (for example coughing or sneezing close to another person’s face for a length of time).
Who is at risk of monkeypox?
While the current outbreak has disproportionately impacted men who have sex with men, anyone who has been in close and usually prolonged contact with someone with monkeypox is at risk.
What’s it’s status in the world today?
The World Health Organization (WHO) has declared MPX public health emergency of international concern.
According to the Centers for Disease Control and Prevention, as of 15 August 2022 there have been 31,799 confirmed cases of monkeypox reported in 89 countries.
How many cases are there in Australia?
MPX was declared a Communicable Disease Incident of National Significance in Australia in July.
As of 11 August 2022:
- There were 70 cases (confirmed and probable) of MPX in Australia, reflecting cases which have been diagnosed in Australia and reported to the National Notifiable Diseases Surveillance System (NNDSS) by states and territories.
- This includes 33 in NSW, 30 in Victoria, two in the Australian Capital Territory, two in Queensland, two in Western Australia, and one in South Australia.
On 1 June 2022, MPX became a nationally notifiable disease for six months.
GPs, 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.
You can contact the local public health unit on 1300 066 055 for more information.
What vaccines are available?
There are smallpox vaccines available which are thought to be effective against MPX. Vaccines can be given either before or after a person is exposed to the virus but vaccinating before exposure is recommended for the best protection.
There are two vaccines approved for use in Australia: JYNNEOS and ACAM2000.
JYNNEOS is the preferred vaccine for use in Australia because it has fewer side effects than previous smallpox vaccines and can be safely used by all groups of people, including those who are immunocompromised.
How do patients access the vaccines?
There is a globally limited supply of the JYNNEOS vaccine and high international demand.
NSW Health has begun vaccinating people at highest risk from monkeypox with an initial supply of JYNNEOS.
Doctors and other community partners are identifying people who are most at risk from monkeypox to receive a vaccine when the first supplies of vaccine become available.
NSW Health expects to receive a further 30,000 doses at the end of September and 70,000 doses in early 2023. NSW Health will provide more information about eligibility and access to the vaccine at that time.
If you have patients seeking a monkeypox vaccination, they can register their interest online via NSW Health. Please note: completing the form does not guarantee vaccine access.
What treatment is available?
Most people require no, or only supportive, treatment for MPX. This may include simple pain relief. Antiviral treatment may be needed in patients with more severe disease. Guidance on the use of treatments for MPX in Australia is available in the Monkeypox treatment guidelines.
What resources are available to support GPs manage monkeypox patients?
- Monkeypox resources for health professionals
- Monkeypox fact sheet – symptoms, risks and treatment
- About monkeypox, including translated information
- Monkeypox laboratory case definition
- Infection Prevention and Control Expert Group Interim Guidance on Monkeypox for Health Workers
- Updated ATAGI clinical guidance on vaccination against monkeypox
- Monkeypox (MPX) vaccines
Who do you talk to for more information?
You can call the Public Health Unit on 1300 066 055 for more information.
Webinars
Monkeypox Update
Deputy Chief Medical Officer, Professor Michael Kidd, held a webinar last Wednesday (10 August 2022) to provide general practices with information about monkeypox. The webinar provided key updates and gave participants the opportunity to answer questions.
Infection prevention updates
SWSPHN will host a webinar, Infection prevention control updates, for GPs, practice nurse, practice managers and other practice staff, on Thursday, 8 September, 7pm to 8pm.
Presented by microbiologist and infection prevention and control consultant/educator, Margaret Jennings, the webinar will address:
- The spread of COVID-19’s current Omicron BA4/5 variants, infectivity, the probability of future variants and the new Moderna vaccine due this month (August)
- Tips for making face-to-face consultations safer, including improved safer air in your clinic, waiting room safety and the correct use of masks
- Precautions to reduce transmission of influenza and monkeypox
- A reviewed 5th Edition RACGP IPC Standards ready for late 2022/early 2023
Information sources: Department of Health and Ageing; NSW Health; Healthdirect; Department of Health – Victoria