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Mpox (formerly monkeypox) is a disease caused by infection with the monkeypox virus and is an urgent notifiable condition in Victoria. There is an ongoing global mpox outbreak, mostly impacting gay, bisexual and other men who have sex with men. 

Mpox may be spread from person-to-person through skin-to-skin contact, contact with contaminated surfaces or items, and respiratory droplets. Local transmission is occurring in Australia, and anyone developing symptoms that may be consistent with mpox should seek medical care.

Mpox may be spread from person-to-person through skin-to-skin contact, contact with contaminated surfaces or items, and respiratory droplets. Local transmission occurring in Australia, and anyone developing symptoms that may be consistent with mpox, should seek medical care. Note female cases have also been reported. 

Check that your patients who are gay, bisexual or other men who have sex with men have had two doses of mpox vaccine and encourage vaccination for those at risk.

It is important to note that mpox can affect anyone who comes into prolonged contact with someone with mpox. Healthcare workers should note that mpox is an urgent notifiable condition. Medical practitioners must notify the department of any suspected or confirmed cases by calling 1300 651 160 (24/7). Provide the mpox factsheet to patients who are tested for mpox. 

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

Updated advice recommends:

  • Test all sexually active people with compatible symptoms, regardless of sexual orientation, vaccination status or travel history. If testing for herpes simplex virus, test for mpox. 
  • Presentations can vary and may include lesions (particularly in the anogenital area and mouth but may occur anywhere) and proctitis. 

Updated Victorian pages on case and contact advice: 

We're here to help

General practice staff can contact their Provider Support Officer, or SEMPHN's Provider Support team by emailing providersupport@semphn.org.au or call on 1300 331 981 (option 3). 

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Prevention

Infection control for health workers

Health workers caring for patients with suspected or confirmed mpox virus infection, or handling specimens from them, should implement standard infection control precautions.

Prevention for your patients

The Victorian Department of Health recommends the following precautions:

  • Avoiding close contact with people with suspected or confirmed mpox. This includes any potentially contaminated materials, such as bedding and towels, that have been in contact with an infected person. 
  • Maintaining good hygiene practices like washing hands with soap and water or cleaning hands with alcohol-based sanitiser. 
  • Considering limiting the number of sexual partners during local outbreaks and ensuring that contact details are collected. 
  • Considering limiting sexual partners for three weeks after returning from overseas countries that have active outbreaks. 

Vaccines

In Victoria, mpox vaccine are available free-of-charge for specific priority groups. Visit the Department of Health's Mpox page to view the full eligibility criteria.

Please note that while the vaccine is free of charge, consultation may not be. Please speak to the relevant clinic to verify consultation-related fees.

Further resources include: 

Signs and symptoms

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.

Typically, the rash starts on the face, including in the mouth, and spreads to other parts of the body including the hands, feet, and chest. In this outbreak, some people have reported a rash appearing in the genital and perianal regions without spreading to other areas of the body. Some people only experience this rash with no other symptoms. Other people have had anorectal pain with no other symptoms. The rash can be painful, especially if the lesions join together or appear in the mouth or rectum.

Symptoms begin 5 to 21 days after exposure. Mpox illness is usually mild and people typically recover within a few weeks.

Testing

Testing should be performed on all people suspected of being infected with mpox. Acceptable sample types include lesion fluid, tissue, or skin biopsy, and nasopharyngeal or throat swabs.

Medical practitioners must notify the department of any suspected or confirmed cases by calling 1300 651 160 (24/7).

Consider testing for other sexually transmitted infections such as HSV, syphilis, chlamydia, and gonorrhoea.

Treatment

You can refer to the Australian STI Management Guidelines – Mpox.

Most infections are mild, and treatment is generally supportive and symptomatic.

Refer to the Australian mpox treatment guidelines for indications for antivirals.

If hospitalisation is required, please contact your local emergency department beforehand to ensure that the patient can be managed in appropriate PPE.

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