About mpox
Mpox is a viral zoonotic disease that historically occurred mostly in tropical rainforest areas of Central and West Africa and has spread to other regions. Zoonotic diseases can spread between animals and humans.
The mpox virus is part of the same family of viruses as variola virus which causes smallpox. It is a rare viral illness that can become serious. For most people, symptoms will clear up on their own after 2 to 4 weeks.
Since May 2022, there has been a global increase in mpox infections in multiple countries where the illness is not usually seen. Mpox was first reported in Australia May 2022.
On 28 July 2022, Australia’s Chief Medical Officer declared monkeypox to be a Communicable Disease Incident of National Significance. The World Health Organization (WHO) declared the mpox outbreak a public health emergency of international concern on 23 July 2022.
On 25 November 2022, the Chief Medical Officer (CMO) stood down Australia's CDINS declaration for mpox. While there remains a risk of cases of mpox in Australia, the need for a nationally coordinated and dedicated response has decreased in line with the current situation.
States and territories will continue to manage the risk of mpox in line with local arrangements, and people should remain vigilant and aware of mpox symptoms.
Case definitions
Signs and symptoms
Mpox illness is usually mild and people typically recover within a few weeks.
Signs and symptoms of mpox infection can include:
- a distinctive rash, lesions (bumps that turn into pimples, blisters or sores, and may burst to form ulcers or scabs)
- swollen lymph nodes
- fever
- headache
- muscle aches
- joint pain
- back pain
- chills
- exhaustion.
The rash changes and goes through different stages, before forming a scab and falling off. It can appear as lesions (pimples, blisters or sores, which can then burst to form ulcers or scabs). These can vary in size and number with as little as a single lesion to several thousand. The lesions look like blisters similar to chickenpox, but larger.
The rash may occur on any part of the body, including the face and inside the mouth, the torso, arms and hands, legs and feet, and the genital and perianal regions. Some people have reported a rash appearing in the genital and perianal regions without spreading to other areas of the body. Some only experience this rash or pain in their mouth or anus with no other symptoms. The rash can be painful, especially if the lesions join or appear in the mouth or rectum.
Symptoms begin 5 to 21 days after exposure to the virus. You should seek medical advice straight away if you develop any of these symptoms after:
- returning from overseas
- being in contact with a case in Australia or overseas.
Transmission
A person with mpox is thought to be infectious from the time they develop any symptoms until all scabs have healed and a fresh layer of skin has formed. This may take several weeks.
Transmission between people can occur through:
- close contact with rashes, blisters or sores on the skin
- body fluids, including respiratory droplets from coughing or sneezing
- contaminated objects such as linen and towels.
Transmission through respiratory droplets (for example coughing or sneezing) is less common and usually only happens if there is prolonged face-to-face contact.
Transmission can occur through intimate physical contact during sex. In this case, it is likely that infectious skin rashes, blisters or sores are the mode of transmission.
The virus can also pass to the foetus via the placenta during pregnancy.
Who is at risk
- People who have had close physical contact with an mpox case
- Australian travellers returning from, or going to, countries with confirmed cases
If you are in these groups and think you may be at risk, we urge you to be aware of the symptoms and to seek medical help straight away if you develop any of those symptoms.
If infected, infants, young children, pregnant women and people who are immunocompromised are at higher risk of becoming severely unwell.
Prevention
There are measures people can take to help prevent infection:
- People who have mpox should isolate from others until the sores fully clear.
- Household members should avoid physical contact with the infected person. This includes any objects such as linen or towels that have been in contact with an infected person.
- Careful hand and respiratory hygiene are recommended for the infected person and everyone in the household. Wash hands with soap and water or use an alcohol-based hand sanitiser.
- If an infected person cannot isolate alone, they should wear a face mask when around other people. This includes when receiving medical care.
For more information on the public health management of people with mpox, and on infection prevention and control for health workers, visit mpox resources.
Isolation
People with probable or confirmed mpox should immediately isolate until all blisters or sores have healed and a fresh layer of skin has formed to prevent further spread of the disease. If you are a suspected case, you should isolate until you return a negative result.
Healthcare providers with inpatients in acute settings with confirmed or probable mpox should isolate them in a room with a private bathroom.
For more information on the public health management of people with mpox, see the CDNA Monkeypox virus infection national guidelines for public health units.
For more information on infection prevention and control, see the ICEG interim guidance on Monkeypox for health workers.
Diagnosis
Mpox is confirmed by laboratory testing.
If you think you may be infected, seek medical advice straight away.
Treatments and vaccines
Most people require no, or only supportive, treatment for mpox. This may include simple pain relief. Antiviral treatment may be needed in patients with more severe disease. Guidance on the use of treatments for mpox in Australia is available in the Monkeypox treatment guidelines.
Vaccines can be given either before or after a person is exposed to the virus, but before exposure is recommended for the best protection.
For more information on vaccines against mpox, visit mpox vaccines.
More vaccination information is available in the ATAGI clinical guidance on vaccination against Monkeypox.