Department of Health

Health warning on monkeypox (MPX)

Health alert

Status:
Active
Alert number:
220826
Date issued:
25 Aug 2022 - update to Alert issued 20 August 2022
Issued by:
Associate Professor Deborah Friedman, Deputy Chief Health Officer Communicable Disease
Issued to:
Health professionals and the public

Key message

  • The number of people diagnosed with monkeypox (MPX) in Victoria is increasing due to local transmission.
  • Preventive measures including limiting sexual partners are very important for people who are not vaccinated.
  • Clinicians should test for monkeypox all patients presenting with compatible symptoms, in particular those presenting with a genital rash, lesions, or proctitis.
  • The existing vaccine supply has been largely rolled out through sexual health clinics in Victoria.
  • The eligibility criteria and supply are however limited during August and September as we await a larger supply.

What is the issue?

There is currently a multi-country outbreak of monkeypox.

While many Australian cases acquired their infection overseas, the number of people acquiring their infection in Victoria is increasing.

Severe illness is unusual but may develop in a small percentage of people with monkeypox.

Early diagnosis, isolation of cases and timely contact tracing are essential to prevent secondary cases.

Who is at risk?

While the current outbreak has disproportionately impacted men who have sex with men, anyone who has been in close and usually prolonged intimate contact with someone with monkeypox is at risk.

Symptoms and transmission

Symptoms of monkeypox can include prodromal viral symptoms (including fever, sore throat, muscle aches), a rash and swollen lymph nodes. However, the rash varies in appearance from blisters or pimples to ulcers and may be limited in distribution to the genital or anal areas with sometimes no other symptoms.

Some cases present with urethritis or proctitis (presenting with pain on urinating, or rectal pain, or bloody stools, and diarrhoea) and there may be no visible rash on the skin.

Monkeypox may be spread from person-to-person through skin-to-skin contact, contact with contaminated items or surfaces, and respiratory droplets.

People with monkeypox are infectious from the time that they develop their first symptoms (which may be a fever or a rash) and until rash lesions crust, dry or fall off.

If you develop any symptoms of monkeypox, you should immediately isolate from others and seek medical care. You should attend your GP or sexual health clinic, wear a mask and call to let them know you will be attending. If you have a rash or blisters, you need to make sure these are covered.

Recommendations

For clinicians

Clinicians should test for monkeypox all patients presenting with compatible symptoms, in particular those presenting with a genital rash, lesions, or proctitis.

Recommended samples include swabs of lesion material (fluid or base of lesion) and throat, as well as anorectal swab in patients presenting with proctitis. Samples should be marked “Urgent” and sent to VIDRL via your routine pathology provider.

Medical practitioners no longer require approval from the Department of Health to test for monkeypox.

In patients presenting with genital or anal lesions or symptoms, testing for other sexually transmitted infections including herpes simplex virus (HSV), syphilis, chlamydia and gonorrhoea is recommended

Notify any suspected or confirmed case to the Department of Health by calling 1300 651 160 (24/7).

For more information about monkeypox clinical and public health management see the Factsheet for clinicians.

For the public

It is important that people with monkeypox isolate from others and abstain from sex while symptomatic, from the onset of symptoms and until their lesions have healed and the scabs have dried and fallen off. People should, as a precaution, use condoms with all sexual partners for eight weeks after infection.

People who are returning from outbreak hotspots such as Europe and North America should monitor for signs or symptoms of monkeypox particularly those who have attended sex on premises venues, dance venues, sex parties or saunas.

It is recommended that you limit your sexual partners, particularly if you are not vaccinated.

It is recommended that you exchange contact information with your sexual partners to assist with contact tracing if needed.

It is recommended that before you go to an event or venue, that you check yourself for symptoms before you leave home. If you feel unwell, particularly if you have any rashes or sores, do not attend.

For more information for men who have sex with men visit Thorne Harbour Health website.

Vaccine eligibility

  • Post exposure vaccination for high-risk close contacts of MPX cases.
  • Laboratory workers who analyse specimens from monkeypox cases.
  • Sexually active HIV positive or negative gay, bisexual and other men, trans people or non-binary people assigned male at birth who have sex with men (including cis and trans men) who fulfill additional criteria. See monkeypox disease information and advice for more information.
  • Sex workers who have high-risk clients.

Vaccination is largely available in the following locations:

  • Melbourne Sexual Health Centre
  • Thorne Harbour Health
  • Northside Clinic
  • Collins Street Medical Centre
  • Prahran Market Clinic

Clinics may not always be able to accept new patients. Please note that while the vaccine is free of charge, consultation may not be. Please speak to the relevant clinic to verify consultation-related fees.

More clinics and access points will be able to provide the vaccine as additional stock becomes available.

For those who are eligible and reside in regional Victoria, vaccination may be accessed via a regional local public health unit. See monkeypox disease information and advice for more information.

The Department of Health will facilitate vaccination for post-exposure protection of contacts at high-risk of acquiring monkeypox.

Clinicians must notify any suspected or confirmed case to the Department of Health by calling 1300 651 160 (24/7).

Further information on testing, sample collection, treatment and infection control for clinicians managing monkeypox cases:

Reviewed 26 August 2022

Health.vic

Contact details

Communicable Disease Prevention and Control Department of Health

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