Mpox

Mpox (previously called monkeypox) is a rare infectious disease caused by the mpox virus, which is related to smallpox and is endemic in parts of Central and West Africa.

In August 2024, the World Health Organization (WHO) declared mpox a public health emergency of international concern (PHEIC) due to the outbreak of clade 1b in the Democratic Republic of the Congo (DRC) and several other African countries. Clade 1b is a more severe disease than clade 2, which was associated with the original outbreak that spread around the world in 2022. 

Clade 2 has been found in West African nations such as Sierra Leone, Nigeria and Liberia. It is still occurring in many countries around the world, including Australia. After the initial outbreak in Australia was largely brought under control, numbers are again starting to rise. 99.9% of cases infected with this clade survive.

Clade 1b began in the DRC in late 2023. Most cases are still within the DRC, but smaller numbers of cases have been found in the Central African Republic, Gabon, Rwanda, Burundi and Uganda. Cases have been noted in 12 African countries since the beginning of 2024. The death rate is about 2.8%.

The primary reservoir for mpox is thought to be rodents, with humans and monkeys acting as secondary or "spillover" hosts. Individuals travelling in endemic countries can be infected by eating undercooked bushmeat (wild game) or handling infected animals.

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Symptoms

Mpox is spread from person to person by close contact with:

  • rashes, blisters and sores on the skin of an infected person
  • contaminated linen and towels used by an infected person
  • body fluids, including droplets from an infected person coughing or sneezing.

 

If a person has been exposed, the following symptoms may indicate potential infection:

  • Prodrome of fever, headache, muscle ache, sore joints and sore throat.
  • A rash or lesion on any part of the body, including inside the mouth and anus. Burning on urination or frequency and urgency of stools can also occur.

Prevention

Prevention during travel:

  • Preferably avoid sexual contact, but if necessary, use a condom.
  • Avoid physical contact with an infected person and anything they may have been in contact with, including bedding and towels.
  • Practice good hand hygiene.
  • Avoid contact with any wild animals or other animals that may carry the virus in Central and West Africa. Avoid eating bush meat (wild game).

 

The risk to travellers is extremely low, as most cases are in areas where travellers do not often venture, and it is much more of a risk to travellers who are in the high-risk groups for mpox exposure.

High-risk groups for mpox exposure include:

  • sexually active gay, bisexual or men who have sex with men (GBMSM)
  • sex workers or clients of sex workers
  • those living with HIV
  • partners of anyone in these groups.

 

Vaccination is available for those in these risk groups and is given as two doses 28 days apart. The vaccine can be accessed, for those in these eligible groups, at the government Sexual Health Clinic in each state. The vaccine currently in use in Australia, JYNNEOS®, has high international demand and a limited supply worldwide. According to the Australian Government Department of Health and Aged Care, access to vaccines will initially be prioritised for at-risk groups to enable good outbreak management. Read more from the Department.

It is not recommended to be used as a travel vaccination, except for travellers belonging to one of the high-risk groups.

Treatment

If there is concern regarding infection, an urgent visit with a medical practitioner is required for testing to be done on the lesions themselves.