Mpox (monkeypox)
Since May 2022, there has been a global increase in mpox cases reported in multiple countries where it is not usually seen, including Australia.
Vaccination offers the best protection against mpox for those at-risk.
Two dose vaccination offers long-term immunity.
Those who are at-risk of mpox should aim to start the 2 dose vaccination series 4–6 weeks prior to attending higher risk events or travelling to countries with cases being reported.
See Vaccination section below for more information
What is mpox?
Mpox belongs to the same family as the smallpox virus but generally causes a milder illness.
Most people who have mpox will experience a mild illness and recover within 2-4 weeks.
Severe illness and death can occur in a very small percentage of people.
Who does mpox affect?
Most people are not at risk of mpox.
Mpox can affect anyone who comes into close contact with someone with the virus.
People who have had skin-to-skin or sexual contact with people who have mpox are at highest risk.
Currently, most cases are among gay, bisexual and other men who have sex with men acquired through sexual contact. Those are highest risk are people who:
- are travelling to outbreak areas
- have multiple sexual partners
- attend sex parties or sex on premises venues.
People who may be at higher risk of severe disease with mpox include:
- young children
- pregnant women
- older people
- immunosuppressed people.
How does mpox spread?
Mpox mainly spreads from person to person by:
- direct skin-to-skin contact with someone with mpox rash, sores or scabs. This kind of contact is often during
oral, anal or vaginal sex.
It can also be spread by:
- contact with clothing or fabrics (clothing, bedding, or towels) that have been used by someone with mpox (this is
usually only a risk if scabs have been shed onto the clothing or fabrics)
- prolonged face-to-face contact through respiratory droplets or oral fluids from a person with mpox
- contact with an infected animal (such as rodents).
It is not known how long the monkeypox virus remains in semen and other sexual fluids. People who have recovered from mpox
should use condoms when having oral, anal or vaginal sex for 12 weeks after recovery.
Mpox can be spread from the time symptoms start up until the sores have healed, all scabs have fallen off, and a fresh
layer of skin has formed. This can take several weeks.
Signs and symptoms of mpox
Symptoms usually start within 5 days - 3 weeks of exposure to the virus.
Sores, rash, bumps or pimples are commonly reported on the following areas of the body, but can present anywhere:
- genitals
- anus or inside rectum, which may cause rectal pain or bleeding
- inside the mouth and throat as ulcers, lesions or sores, which may cause sore throat or difficulty swallowing
- face, arms and legs.
The sores are flat and then become raised. Then they fill with fluid and eventually scab and fall off over a period of 2–3 weeks.
They can be very painful and may cause scarring. Some people don't experience any pain which may make the symptoms less noticeable.
People with mpox in the rectum or throat may not have a visible rash, but can pass the infection onto others.
General viral symptoms may be experienced initially such as:
- fevers
- chills
- muscle aches
- backache
- swollen lymph nodes
- exhaustion
- headache.
Symptoms may resemble sexually transmissible infections (STIs) such as herpes or syphilis as well as other infections with a rash such as measles or chickenpox.
Treatment
Most people with mpox will recover without needing any specific treatments.
The illness is usually mild, and recovery takes a few weeks. However, in some people the sores can be very painful.
Simple pain medications and keeping up with oral fluids help to manage symptoms.
Severe illness can occur in a small percentage of people.
Antiviral medications may be used for people with severe illness, under the guidance of a specialist doctor.
Prevention
Considerations for preventing mpox:
- Limit sexual partners and use condoms with lubricant (noting that condoms alone may not prevent mpox, but will
protect against other STIs).
- Get vaccinated against mpox.
- Avoid skin-to-skin contact with people who have symptoms of mpox or are confirmed to have mpox.
- Do not handle or touch the bedding, towels, or clothing of a person with mpox.
- Wash your hands often with soap and water or use an alcohol-based hand sanitizer.
- Maintain physical distance and avoid skin-to-skin contact when attending events. Mpox higher risk events include
sex parties and sex on premises venues, particularly at interstate or overseas locations where high numbers of
mpox cases are occurring.
- If you have recently attended a high-risk event, you can reduce the risk of passing mpox
to your sexual partners by:
- avoiding unprotected skin-to-skin contact for 3 weeks, including avoiding sexual contact
- monitoring your symptoms during this time
- seeking health care as soon as possible if symptoms develop.
- Be aware that your risk of getting mpox is likely to increase as the number of your sexual partners increases.
It would be helpful for you to know the contact details of your sexual partners to allow for sexual health follow-up,
if needed.
Vaccination
The best time to receive the mpox vaccine is before you are exposed to the virus.
Two doses of mpox vaccine received at least 28 days apart, are required for optimal protection.
The mpox vaccine takes approximately 2 weeks to be effective.
If you are exposed to mpox, receiving a vaccination within 4 days after first exposure to mpox will provide the highest chance of avoiding the disease.
Widespread vaccination is not currently recommended due to the very low risk of infection for the general population.
Who can get the mpox vaccine for free?
Those who are at risk of getting mpox and/or experiencing severe illness due to mpox, can access
the vaccine, free-of-charge. This includes people who do not have a Medicare card.
Post exposure vaccination
- Contacts of a case as determined by the Public Health Unit.
Primary preventative vaccination
The following people are recommended to be vaccinated against mpox:
- all sexually active gay, bisexual or other men who have sex with men (including cis and trans)
- sex workers, particularly those whose clients are at risk of mpox exposure
- people living with HIV, if at risk of mpox exposure
- sexual partners of the people above
- laboratory personnel working with orthopoxviruses
- healthcare workers who are at risk for mpox. For example, working at sexual health clinics and administering vaccinations to individuals requiring post exposure vaccination
Mpox vaccination is not currently recommended for travel unless one or more of the above eligibility criteria are met.
Where can I get vaccinated?
Please contact your local immunisation provider if they provide mpox vaccinations.
Perth metropolitan area
Free mpox vaccine is available for eligible people through participating immunisation providers and sexual health clinics. This includes, but are not limited to, the following clinics below.
Regional Western Australia
Free mpox vaccine is available for eligible people through regional Public Health
Units or participating immunisation providers.
More information on mpox vaccine
What to do if I am a close contact?
If you have been in contact with a person with mpox, your local public health unit may contact you to assess your risk
of developing mpox and provide advice.
If you have had contact with a mpox case and have not been contacted by public health, you should call your local
public health unit (see
Contact details for population/public health units).
- The public health unit will assess your level of risk and provide advice about anything you need to do.
- You will be asked to monitor for symptoms of mpox for 21 days from last contact with a person with mpox.
- You may be advised to:
- Avoid physical or intimate contact with others including sexual activity.
- Avoid contact with animals, particularly dogs and rodents (mice, rats, hamsters, gerbils, guinea pigs,
squirrels etc)
- Avoid contact with people who are at higher risk of severe disease, including people with low immunity,
pregnant women, older people and young children.
- Avoid settings with young or at risk people such as early childhood education and care services,
schools, aged care, healthcare settings (unless seeking medical attention).
- Wear a surgical mask when outside the home.
- Receive post-exposure vaccination for mpox.
- If you develop symptoms, you should stay at home and contact your local public health unit to arrange testing.
Information for people diagnosed with mpox
If your test is positive for mpox, you will be contacted by public health, who will provide advice about when you can be cleared. Public health may also contact you while you are staying at home to monitor your symptoms and ensure you are well.
Awaiting a test result
Information for people awaiting a mpox test result can be found here (PDF 97KB).
Where to get help
If you have mpox symptoms and have recently travelled overseas to an area with mpox (external site):
- call your GP for an appointment, or;
- seek care at your nearest hospital.
If going to a GP or hospital it is important to call ahead and wear a mask.
Sexual health helpline
Metro 9227 6178
Country 1800 198 205
Sexual health clinic appointments
Sexual Health Quarters (SHQ)
70 Roe Street, Northbridge, WA 6003
(08) 9227 6178
M Clinic (for men only)
20 Colin Street, West Perth, WA, 6005
(08) 9227 0734
Sexual Health Clinic, Royal Perth Hospital
Ainslie House, Level 4, H Block, Victoria Square, PERTH, WA, 6000
(08) 9224 2178
South Terrace Sexual HealthClinic
A Block, South Terrace side of Fremantle Hospital
(08) 9431 3145 or (08) 9431 2149
Last reviewed: 31-07-2024
Acknowledgements
Public Health
This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.