Mpox

For live information on the case numbers for mpox in Australia, visit the National Notifiable Diseases Surveillance System (NNDSS) webpage.

Disease type:

Zoonoses

Vaccination available under NIP:

Notifiable disease:

Yes

About mpox

Mpox (formerly called monkeypox) is caused by infection with the monkeypox virus (MPXV). It 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.

MPXV is in the same family of viruses as variola virus which causes smallpox. It is a 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.

The World Health Organization (WHO) declared the mpox outbreak a public health emergency of international concern (PHEIC) on 14 August 2024. Mpox was previously declared a PHEIC on 23 July 2022.

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

Symptoms

Mpox illness can be mild and people typically recover without specific treatment within a few weeks. Some people may experience more severe symptoms that require management by a doctor.

Symptoms of mpox infection can include:

a rash, with one or more lesions anywhere on the body
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 may look like blisters similar to chickenpox or shingles, but larger. In genital regions, the rash can look like herpes (cold sores, genital herpes).

The rash may occur on any part of the body and face, including:

inside the mouth,
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 3 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 up to 4 days before 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 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.

Transmission through respiratory droplets (for example coughing or sneezing) is less common but may happen if there is prolonged face-to-face contact.

The virus can also pass to the foetus via the placenta during pregnancy.

Who is at risk

Cases of mpox in some countries, including Australia, have mostly been identified in the gay, bisexual, and other men who have sex with men population, although anyone can be affected.

People who are at risk of mpox include:

People who have had close physical contact, including sexual contact, with an mpox case.

People in these groups who think they may be at risk, should be aware of the symptoms. People who develop any of these symptoms should seek medical help straight away.

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 or are suspected of having mpox should avoid contact with others, including sexual contact and follow the advice provided by their treating clinician and public health unit.
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.
an infected person should keep lesions covered and wear a face mask when around other people. This includes when receiving medical care.

Further general information is available on the Emen8 website. For more information, visit the mpox resources.

For more information on infection prevention and control in health care settings, see the Australian Guidelines for the Prevention Control of Infection in Healthcare.

Diagnosis

Mpox is confirmed by laboratory testing.

Anyone who thinks they may be infected, should 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 mpox 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.

People at risk of exposure to mpox are recommended to receive the mpox vaccine.

For more information on vaccines against mpox, visit the Australian Immunisation Handbook and the ATAGI clinical guidance on the use of vaccines for prevention of mpox in 2024.

Mental health and wellbeing support

It is important to take care of your mind as well as your body. Stay in touch with family and friends virtually and reach our for help or support if you ever need it.

QLife – A national and anonymous phone and online counselling service staffed by LGBTQ+ community members – 1800 184 527
Beyond Blue helpline – 1800 512 348
Lifeline – 13 11 14.

Travelling support

ATAGI recommends that individuals who are planning to travel to countries with MPXV clade I transmission, and who are planning to have sexual risk activity in those countries, to consider vaccination ahead of travel.

It's important to read and understand the advice level for each country you're travelling to or through. Before departure, visit the SMARTraveller website to find out about the travel advice, which could include potential mpox cases/outbreak.

Resources

For general information on mpox please visit: