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Australia is experiencing a resurgence of mpox, with infections this year surpassing the 2022 outbreak.
So far, 152 cases have been recorded across the country, prompting alerts from state health departments.
Victoria is experiencing the largest outbreak with 83 cases.
Of those, 25 per cent were reported in the last fortnight, the state’s Chief Health Officer (CHO), Clare Looker, said.
Mpox, formerly known as monkeypox, spreads through close physical contact, and anyone can contract it.
But infections are most common in men who have sex with men.
In addition to vaccinations, health officials are advising people to limit their sexual partners and keep details for contact tracing.
What is mpox?
Mpox is a viral disease which until recently had rarely been seen outside central and west Africa.
Rhonda Stuart, director of public health and infection prevention at Monash Health, described it as a cousin of smallpox.
It mainly causes a rash, alongside other symptoms including fever, headaches and muscle aches and pains.
“The mpox rash tends to occur where the contact has been made,” Professor Stuart said.
“The rash can become very painful in certain areas, but most people don’t require hospitalisation.”
Similar to chickenpox, the rash will disappear after two to four weeks and most people don’t need medical treatment to recover.
Anyone who has been in close and usually prolonged intimate contact with someone with the virus is at risk.
Transmission is also possible through body fluids, coughing or sneezing, and objects such as linen and towel, but it is less common.
Mpox symptoms
- A distinctive rash, lesions (bumps that turn into pimples, blisters or sores)
- Swollen lymph nodes
- Fever
- Headache
- Muscle aches
- Joint pain
- Back pain
- Chills
- Exhaustion
Thorne Harbour Health, which provides wellbeing services for LGBTIQ+ communities and people living with HIV, said symptoms associated with the current outbreak appeared to be less obvious.
People are not always presenting with the rash, so the virus can be mistaken for a sexually transmitted infection (STI).
Testing for mpox is not part of a standard sexual health screen, so people are being advised to specifically ask doctors to be tested for the virus.
Where are the clusters?
Australia experienced its first mpox outbreak in 2022 when the virus started emerging in multiple countries where the illness had not usually been seen.
It triggered The World Health Organization (WHO) to declare the disease a global health emergency, which was rescinded after about a year.
There were 144 cases recorded in Australia in 2022, which were mainly driven by international travellers bringing the virus into the country.
The outbreak was brought under control, and last year there were only 26 cases.
“We had a little peak, and that sort of decreased with a number of interventions, including routine contact tracing, getting people vaccinated and some behavioural changes,” Professor Stuart said.
“That really put an end to the outbreak, and we only saw a handful of cases in 2023.”
This year, local transmission has been causing most of the infections, and health alerts have been raised across several states.
NSW issued a safety notice last week with 22 cases reported over three weeks, compared with one in the previous six months.
As of July 25, there were 43 cases reported, according to the health department’s National Notifiable Disease Surveillance System (NNDSS).
Queensland raised the alert in May when 10 locally acquired cases were recorded that month in the state’s largest ever mpox cluster. It now has 17 cases.
Victoria’s outbreak has climbed to 83 infections this year, of which about 90 per cent have been locally acquired.
Professor Stuart said the virus re-emergence was likely due to the public dropping their guard, rather than a new virus strain.
“There’s a fear when something new comes so it initially creates behavioural change, but like with COVID we got vaccines and then got on with our normal lives,” she said.
Who should get vaccinated?
Getting vaccinated is the best way to protect against the virus.
Vaccinations are recommended for gay, bisexual, and other men who have sex with men, sex workers and people with HIV who may be at risk of exposure to mpox.
Peter Locke, Thorne Harbour’s director of HIV and clinical support services, said the community has been quick to respond to health advice.
The organisation has established free vaccination pop-up clinics across Melbourne, and hundreds of people have come through in recent weeks.
“Like we saw with the initial mpox outbreak in 2022, we’ve seen a fantastic response from our communities as they’re keen to take control of their sexual health and wellbeing,” Mr Locke said.
“We now have plenty of vaccine available across Australia, and eligibility for vaccination has recently been expanded … The vaccine is free, and you don’t need Medicare.”
The vaccine is given in two doses about 28 days apart, which decreases both the chances of contracting mpox and its severity.
But, it doesn’t eliminate the risk completely.
“It’s important to know that some people still get mpox,” Professor Stuart said.
“So just because you’re double vaccinated doesn’t mean you won’t get it. That’s an important message for the community.”
Should you limit intimate partners?
In addition to vaccines, health departments are advising people to reduce their risk through behavioural changes.
Dr Looker, Victoria’s CHO, has suggested maintaining contact details of sexual partners.
“The recent rise in cases means we also want people to think about reducing their risk in other ways, which could mean limiting the number of intimate partners, and ensuring they’re sharing contact details to help with contact tracing if needed,” Dr Looker told the ABC.
Mr Locke said advice around intimate partners “really comes down to what works for the individual”.
“If you’re immunocompromised or unvaccinated, mpox can lead to serious health complications,” he said.
“If that’s the case for you, then yes limiting sexual partners might be a good way to reduce your risk in the short term.”
He added that certain messaging could generate stigma for gay and bisexual communities, but the reality was anyone could acquire mpox.
“Men who have sex with men have proven they’re very capable of looking after their sexual health and played a central role in stopping the outbreak of mpox in 2022,” he said.
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