Mpox (monkeypox) in Brisbane

Since 1 January, there have been 117 confirmed cases of mpox notified in Queensland in 2024 (as at 19th November 2024).

Please be aware unlinked community transmission is now occurring. Clinicians are encouraged to offer vaccination to all eligible patients and to follow-up patients who have not had their second vaccination at least 28 days following their first vaccine. 

• The most recent case had an onset date of 11 November 2024 and was notified on 14 November 2024
• Most cases were acquired in Australia, with the primary transmission route being sexual transmission between men who have sex with men.

Cases have been identified in 8 Hospital and Health Service catchments: Darling Downs, Gold Coast, Metro North, Metro South, Sunshine Coast, Townsville, West Moreton and Wide Bay.

Health providers are being advised to be vigilant for symptoms of mpox and encouraging those who have not received their vaccination, or not returned for their second dose, to consider doing so.

Presentation

Mpox is a viral infection that typically involves rash and mild illness, from which most people recover within a few weeks. More severe cases may require hospitalisation.

Symptoms generally develop 5 to 21 days following close or intimate contact with someone with mpox or contaminated material such as bedding, towels and clothing. Symptoms of mpox include:

• Rash or skin lesions (pimples, pustules or vesicles) appearing anywhere on the body but commonly anogenital region
• Fever
• Lymphadenopathy
• Headache
• Myalgia
• Fatigue
• Urethritis or rectal pain (proctitis), discharge or bleeding

Testing and clinical recommendations

Test for mpox in patients with a compatible illness, even if fully vaccinated
Request PCR testing for mpox from suitable samples:

• Lesion specimens are preferred, ideally from more than one lesion - fluid from a vesicle or pustule using a dry swab, or lesion tissue or crust in a dry container
• Anorectal swab from patients presenting with proctitis
• Nasopharyngeal/throat swab

Consider alternative diagnoses such as syphilis, herpes simplex virus, or varicella zoster virus, and offer routine STI screening. Wear personal protective equipment (PPE) including a gown, surgical mask, gloves, and eye protection when examining and collecting samples.

Patients with suspected mpox should be advised to stay at home and limit contact with others whilst awaiting testing results. Cover lesions with dressings or clothing.

Call Metro North Public Health Unit to report suspected cases of mpox on 07 3624 1111.

Vaccination

There is a safe and effective vaccine for mpox called Jynneos.

Mpox vaccination is free* (a Medicare card is not required) and recommended for the following groups:

• all sexually active gay, bisexual and other men who have sex with men (cis and trans) and their sexual partners (including anonymous or intimate contacts)
• sex workers
• people living with HIV who are at risk of exposure to mpox
• people whose occupations might put them at increased risk, including, but not limited to:
  • sex-on-premises venue staff
  • laboratory staff who analyse mpox specimens, based on a local risk assessment
  • healthcare workers at higher risk of exposure to individuals with mpox, including workers in primary care, sexual health clinics, hospital staff and others, based on a local risk assessment. The risk of transmission should also be minimised by using appropriate infection control measures.

Two doses of the mpox vaccine, administered by subcutaneous injection (at least 28 days apart) reduces infection risk and disease severity.

Encourage the second dose in people who have only received one dose and promote recording to the Australian Immunisation Record.

Mpox vaccination is not recommended as a routine travel vaccine, including for travel to endemic Africa where clade Ib is circulating, unless an individual is eligible for an mpox vaccination in Queensland. Travellers should be aware of the risk of mpox if travelling overseas where cases have been reported, Destination travel advice can be found on the Australian Government Smartraveller webpage.

There is good supply of mpox vaccine in Queensland and it is available free of charge to vaccine providers. Should mpox vaccine providers require additional stock, please submit an order form to QHIP-ADMIN@health.qld.gov.au.

A Queensland Health mpox vaccination centre locator tool is available online.