Monkeypox in Australia: What You Need To Know

Monkeypox in Australia: What You Need To Know
Image: Steve Adams/iStock

Monkeypox is raising alarms in other countries, and with two cases reported in Australia, it’s likely that the virus will continue to make headlines.

But of course, it’s best to avoid panic and be as educated on the topic as possible. We don’t quite yet know just how the situation will develop internationally, but here’s what we know so far about monkeypox in Australia, according to C Raina MacIntyre, a Professor of Global Biosecurity and a member of the Kirby Institute at UNSW.

Monkeypox in Australia: What you need to know

  • Monkeypox is caused by an orthopoxvirus and is closely related to variola, the virus that caused smallpox. It’s a virus that only infects humans, however, it is typically caused by a monkey or some other animal biting or scratching a human.
  • As a respiratory virus, it can spread without contact with other humans. Typically it will only spread to close contacts (3 per cent of contacts to a person with monkeypox end up infected, according to studies cited by MacIntyre).
  • Symptoms include fever, headache, swelling of the lymph nodes and muscle ache (these can occur a week or two after infection). Skin eruptions can appear after one to three days, across the face, hands and feet. Monitor for these symptoms if you’ve been in contact with somebody recently in Europe or if you have just returned.
  • There are two types of this virus, one with a fatality rate of 1 per cent and the other at 10 per cent (it is more severe in children). The outbreak in the UK appears to be of the less severe type, however, a 1 per cent fatality rate is similar to COVID.

Why is monkeypox emerging right now?

Monkeypox was first identified in 1970, in the Democratic Republic of Congo. It has been reemerging since 2017 and outbreaks have been observed in Nigeria (the outbreak in the UK is traced back to an individual that travelled from Nigeria). It’s currently puzzling scientists as to why it’s coming back, however research indicates that waning immunity from smallpox could be a part of it.

Additionally, this is the first time that travel-related spread has been observed from outside the African continent.

“This is an unusual outbreak, with unrelated cases in different locations in the UK. This could be explained by substantial numbers of asymptomatic infection, but asymptomatic infection is uncommon and usually in people who have had the smallpox vaccine,” MacIntyre says.

An interesting thing to note is that the smallpox vaccination also protects against monkeypox, however, most vaccination programs against smallpox have ceased since the 1970s (meaning there are not many people under the age of 50 that are protected against it).

“In a well-studied outbreak in the U.S. linked to imported animals, only three in 20 cases were asymptomatic, and they had been vaccinated. The other 17 cases all had the rash,” MacIntyre added.

Are Australians at risk of monkeypox?

At the moment, only two cases of monkeypox have been detected in Australia, with both cases being men who have returned from Europe. If you have just returned from Europe (or have been around somebody who has just returned from Europe) you must stay vigilant of symptoms. It is suspected that only 10 per cent of Australians are vaccinated against monkeypox (the vaccine may last between five to 20 years).

How to prevent further monkeypox spread?

MacIntyre says that it’s best to identify contacts and vaccinate them against the virus, rather than mass vaccination (this is called “ring vaccination” and was used to eradicate smallpox). The second-generation smallpox vaccine is effective against monkeypox, however it can have serious side effects in some people (especially people with compromised immune systems).

The third-generation vaccine doesn’t replicate in the body and can be used in those that are immunocompromised, however it’s expensive. MacIntyre advises the use of the third-generation vaccine on health workers. Effective antivirals are also an option.

“Given the unusual nature of this epidemic, it would be wise to ensure we have a stockpile of antivirals and enough of both types of vaccines, together with regulatory processes to use them against monkeypox,” MacIntyre adds.

“Isolation of cases and quarantine of contacts works to curtail epidemics. We would also do well to draw on the contact tracing infrastructure developed during COVID, so contacts can be rapidly identified and quarantined, and the spread of the virus curtailed.”

You can read more about monkeypox here.

Monkeypox is a developing concern and we will continue to update this page as we learn more about the outbreak in Australia.