Mpox (monkeypox) in Brisbane

Since April 2024, local transmission of mpox (previously called monkeypox) has been recorded in Queensland and Victoria.

• Local transmission of mpox has been reported in Queensland and interstate.
   
• Encourage 2 doses of mpox vaccine to eligible high-risk groups.
   
• Be alert and test for mpox in patients with compatible signs and symptoms, particularly in men who have sex with men (MSM) regardless of previous mpox vaccination or travel.

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

Government funded mpox vaccination (JYNNEOS) is recommended for:

• sexually active gay, bisexual or other MSM (cis and trans) and their sexual partners
• sex workers
• people living with HIV who are at risk of mpox exposure
   

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.

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.