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 45 cases now 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.

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 Professor of Global Biosecurity and a member of the Kirby Institute at UNSW C Raina 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. The incubation period – the time taken to develop the disease after exposure to the virus – is usually around 6-13 days.
  • 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).

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.

There are two distinct strains of monkeypox. These are the Central African and the West African types, the latter of which is believed to be one linked to the current global outbreak. But as reported by Jaya Dantas, Professor of International Health at Curtin University, in this outbreak we’re seeing human-to-human transmission.

According to US Centers for Disease Control and Prevention (CDC) data, 23,620 cases have been reported since May in 80 countries, with 73 countries that had no previous reported monkeypox cases. In Australia, as of July 28, 2022, there are 45 cases (confirmed and probable) of MPX in Australia. This includes 25 in New South Wales, 16 in Victoria, 2 in the Australian Capital Territory, 1 in Queensland and 1 in South Australia.

Monkeypox can affect anyone. But men who have sex with men are at higher risk at the moment. As Dantas points out, it’s important we provide as much information about the virus as possible, and it’s absolutely crucial we do this in a way that is not stigmatising.

How to prevent further monkeypox spread in Australia?

Australia has secured small supplies of two smallpox vaccines, which provide protection against monkeypox. The Australian Technical Advisory Group on Immunisation (ATAGI) has recommended key risk groups be administered the vaccines. Those identified as a high-risk monkeypox contact in the past 14 days, men who have sex with men, sex workers (with clients in high-risk categories) and anyone in the risk categories planning travel to a country experiencing a significant outbreak, with vaccination recommended four to six weeks prior to leaving.

ATAGI has also said that vaccination within four days of exposure to someone who’s infectious with monkeypox will provide the highest chance of preventing the disease.

Avoiding close contact with people who have the infection can help prevent transmission. Dantas adds that Monkeypox doesn’t spread as easily as COVID-19 and can be kept under control if we are cautious.

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.”

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