Following several reported cases across European countries, the Australian government has issued statements confirming the presence of the rare Monkeypox (MPX) disease in Australia (57 confirmed cases as of August 4, 2022).

While Australia's health authorities have stated that the cases are not a cause for panic, it's important to stay vigilant, especially if you've just returned from overseas. Don't worry, Sonder is here to help you understand what the disease is, what to look out for, and how to stay safe.


What is Monkeypox (MPXV)?

MPXV is a rare but potentially serious viral illness caused by infection with the monkeypox virus, which is very similar to the virus that causes smallpox (Variola virus).

Where is it found?

This disease is endemic in Central and West Africa, and is sometimes exported to other regions. It is usually a self-limited disease with symptoms lasting from two to four weeks, and are usually identified in returned travellers who have visited endemic areas.

What are the symptoms?

The incubation period of MPXV can range from five to 21 days. Symptoms can be divided into two periods. The first symptoms of monkeypox are usually:

  • Fevers

  • Chills

  • Muscle aches

  • Backache

  • Swollen lymph nodes

  • Chills

  • Exhaustion.

After one to three days of the appearance of fever, the disease's characteristic rash develops on the body, usually beginning in the mouth and face before spreading. The distinctive monkeypox rash involves vesicles or pustules that are deep-seated, firm, and have clear boundaries. The rash changes and goes through different stages similar to chickenpox before finally becoming a scab that falls off.

The rash may appear on the:

  • Face (in 95% of cases)

  • Palms of the hands and soles of the feet (in 75% of cases)

  • Inside of the mouth (in 70% of cases)

  • Genitalia (30%)

  • Eyes (20%).

How do people get it?

MPX generally doesn't spread easily between people, but the virus can enter the body through broken skin (even if it's not visible), the respiratory tract or mucous membranes (eyes, nose, or mouth) through respiratory droplets.

Person-to-person transmission is possible through situations including:

  • Sexual or intimate contact with an infected person.

  • Contact with clothing or linen used by an infected person.

  • Direct contact with monkeypox skin lesions or scabs.

  • Respiratory transmission from an infected person.

Is there treatment?

MPXV is usually mild and will resolve itself within a few weeks, though there's a chance for severe symptoms to develop. If you develop symptoms, make sure you isolate and seek medical attention, ensuring that you wear a face mask while covering up any lesions or blisters.

Vaccination with the smallpox vaccine and antivirals can be used to control outbreaks and may be given pre or post exposure to the disease.

What about vaccines?

At the time of writing (August 9, 2022), NSW and Victoria are rolling out MPXV vaccinations for those at highest risk of contracting the disease. The vaccine that will be offered is the JYNNEOS smallpox vaccine, which is the latest vaccine available to provide protection against MPXV.

It's important to note that while one dose will offer some protection against MPXV, the vaccine won't be fully protective until at least two weeks after the full vaccine administration (which is after the second dose).

We'll provide updates on the rollouts for each state as they are announced.

NSW

NSW Health has managed to secure a limited supply of vaccine doses and will begin vaccinating people who are most at risk first from August 8, 2022, onwards.

An expected 30,000 vaccine doses is expected at the end of September, with a further 70,000 in early 2023. Due to this limited supply, NSW Health is working to ensure the most vulnerable people access the vaccine first.

Those who may be eligible first include:

  • People who have booked travel overseas to Europe or North America before 31 October 2022 and will have multiple sex partners while overseas.

  • Some sexually active HIV-positive or negative gay and bisexual men.

Those eligible can register their interest in receiving the initial batches of the MPXV vaccine here: MPXV Vaccine Online Assessment.

Victoria

Due to the limited supply of vaccines in Victoria, vaccines will be given to the most vulnerable people and certain at-risk health professionals first. This includes:

  • Post-exposure vaccination for high-risk close contacts of monkeypox cases.

  • Laboratory workers who analyse specimens from monkeypox cases.

  • Some sexually active HIV-positive gay, bisexual, or other men who have had sex with men (including cis and trans men):

    • With an STI in the last 12 months; OR

    • Intending to engage in sexual practices that put them at higher risk of STIs during overseas travel to Europe or North America before 31 October; OR

    • Who attend sex on premises venues.

  • Some sexually active HIV-negative gay, bisexual, or other men who have had sex with men (including cis and trans men):

    • With an STI in the last 12 months; OR

    • Intending to engage in sexual practices that put them at higher risk of STIs during overseas travel to Europe or North America before 31 October; OR

    • Who attend sex on premises venues.

  • Sex workers who have high-risk clients.

Head over to Victoria Health here for the full description of who is eligible for the initial MPXV vaccine rollout.

For those eligible for the initial MPXV vaccine rollout in Victoria, vaccination will be largely available in the following locations:

  • Melbourne Sexual Health Centre

  • Thorne Harbour Health

  • Northside Clinic

  • Collins Street Medical Centre

  • Prahran Market Clinic

Always check with your doctor if you have any worries or questions. If you need some extra information or you're not sure what to do, you can always chat to a Sonder support team member.

How do I protect myself?

It's important to stay vigilant with hygiene measures, which includes regularly washing hands thoroughly with soap and water, and using alcohol-based hand sanitiser.

Overseas Travel

For those travelling to endemic countries, contact with sick animals that could harbour the monkeypox virus (rodents, marsupials, and primates) should be avoided, and avoid eating or handling wild game. Be sure to:

  • Follow public health alerts and advice from local health authorities of the countries you are visiting. Visit WHO for an updated list of affected destinations and Smart Traveller for travel alerts.

  • Keep alert of any event updates (before and after) from organisers if you are visiting festivals or large events.

  • Be aware and exercise caution if you plan to attend sex parties or sex on premises venues (SOPVs), particularly in places where there are identified cases of MPXV. If attending these, consider adopting safe sex strategies to reduce your risk of MPXV transmission.

Upon returning from overseas, monitor for symptoms for 21 days, especially if you may have had contact with a confirmed MPX case, have attended any dance parties, sex parties or saunas - especially in Europe. If you develop symptoms, make sure you isolate and seek medical attention, ensuring that you wear a face mask while covering up any lesions or blisters.

Festivals, clubs and parties

Always seek advice from sources by trusted health authorities (especially when travelling both interstate and overseas), and check yourself for symptoms before you go out. If you feel unwell, or have any rashes or sores, do not attend events. Self-isolate and seek medical attention.

Consider the type of event you are planning to attend and how much direct skin-to-skin contact is likely to happen:

  • Low risk - Festivals and concerts where people are fully clothed and less likely to have skin-to-skin contact. Close physical contact such as kissing may spread MPXV.

  • High-risk - Party or club settings where less clothing is worn and more likely to have direct skin-to-skin contact, and events held in enclosed spaces (such as sex parties, saunas and SOPVs).

MPXV and sex

It’s important to be self-aware when it comes to our health, so always monitor for symptoms before, during and after sex. If you or a partner has MPXV, the best way to protect yourself and others is to avoid any skin-to-skin contact, especially with any rash, lesions or sores. Self-isolate and seek medical attention immediately.

Always remember to practice good hygiene after sex by washing your hands and sex toys, and exchange contact information with your sexual partners to assist with contact tracing if needed.

Some safe sex strategies to reduce your risk of MPXV include:

  • Use virtual methods (eg. phone, webcam)

  • Masturbate together without touching each other

  • Leave on clothing to reduce as much skin-to-skin contact

  • Avoid kissing

  • Avoid sharing sex toys

  • Use a condom during sex for at least 8 weeks after recovery from MPXV.

MPXV, HIV, and the LGBTQI+ community

There is very limited evidence on MPXV in people living with HIV as most cases are based on research in countries where access to treatment is low, and people experience far more negative health outcomes than in Australia.

At the moment, people living with HIV should follow the same advice as the general population. Should evidence emerge that people with suppressed immune systems are at greater risk of MPXV, or ill-health from catching the virus, we'll provide you with all the updated information and advice.

It is very important to note that the risk of MPXV is NOT limited to gay, bisexual and men who have sex with men, or anyone in the LGBTQI+ community.

MPXV doesn't discriminate and anyone who has close contact with someone who is infectious with the virus is at risk of contracting and passing on MPXV regardless of their sexual preference.

If you're part of the LGBTQI+ community and you need some support, you can contact ACON Support Services here, or Q Life at 1800 184 527 or webchat here. Our Sonder support team is also available 24/7 if you need some help or just want to chat to someone.

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If you have any questions or need extra support, we're here to help you anytime in any language. Simply start a chat with us via the home screen of the Sonder app.

Information sourced from: Australian Department of Health, ACON Health, Better Health, The Conversation, Napwha, and Victoria Department of Health

Image credit: Wikimedia Commons

All content is created and published for informational purposes only. It is not intended to be a substitute for professional advice. Always seek the guidance of a qualified health professional.

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