This site works best on modern browsers. Please update your browser to microsoft edge for a better experience.

A-Z of Public Health Topics

Mpox

Mpox is a viral infection that spreads through close physical contact, including sex.

Anyone can get mpox, but those most at risk include sexually active gay, bisexual or other men who have sex with men (MSM).

Symptoms can include:

  • a rash on or near the genitals or near the anus, or on other parts of the body such as the hands, feet, chest, face, or inside of the mouth
  • fever
  • chills
  • headache
  • muscle aches.

The virus usually results in a mild illness however, symptoms can last for several weeks and can be severe and require hospitalisation.

If you are at risk of being exposed to mpox, you should:

  • if you develop mpox symptoms, particularly if you develop a rash
  • you should seek medical care and be tested at your GP clinic or Melbourne Sexual Health Centre.

Get vaccinated if you are eligible to receive the mpox vaccine

  • The mpox vaccine (JYNNEOS® vaccine) provides protection against mpox and is available free-of-charge for specific priority groups in Victoria.
  • Eligible groups include:
    • sexually active gay, bisexual or other men who have sex with men
    • sexually active transgender and gender diverse people, if at risk of mpox exposure
    • sex workers, particularly those whose clients are at risk of mpox exposure
    • sexual partners (including anonymous or intimate contacts) of the above groups
    • sex-on-premises venue staff and attendees
    • people living with HIV, if at risk of mpox exposure, and their partners 
    • laboratory personnel working with orthopoxviruses. 

For optimal protection get your first dose as soon as possible and then a second dose at least 28 days after the first dose.

See local mpox vaccination clinics below to book for your first or second dose.

Practice safe sex

  • use a condom when engaging in any sort of sexual activity
  • limiting the number of sexual partners can reduce your risk of exposure to mpox.

More information and FAQs on mpox and the mpox vaccine can be found below. Click here for information in your language about mpox. 

Mpox vaccination

Change to eligibility criteria for mpox vaccination

Mpox vaccination is widely available through sexual health clinics, general practitioners, community pharmacies, Aboriginal health services, and councils. The eligibility criteria have recently changed (6 June 2024).

In Victoria, the mpox vaccine (JYNNEOS®) is available free-of-charge for people who meet any of the following criteria: 

  • sexually active gay, bisexual or other men who have sex with men
  • sexually active transgender and gender diverse people, if at risk of mpox exposure
  • sex workers, particularly those whose clients are at risk of mpox exposure
  • sexual partners (including anonymous or intimate contacts) of the above groups
  • sex-on-premises venue staff and attendees
  • people living with HIV, if at risk of mpox exposure, and their partners 
  • laboratory personnel working with orthopoxviruses. 

The mpox vaccine requires two doses for optimal protection, given at least 28 days apart. See our FAQs below for further information on the vaccine and its effectiveness. 

Mpox vaccination after exposure – post-exposure preventative vaccination

Vaccination can also be given after exposure to protect against infection. This is known as post exposure preventative vaccination (PEPV) and is ideally given within four days of exposure. It is recommended for high-risk contactsof mpox cases and attendees of sex-on-premises venues and events (public or private) where sexual or intimate contact did occur who are not previously fully vaccinated for mpox (for example with two doses of JYNNEOS®).  

Local mpox vaccination clinics:

Vaccinations are widely available through sexual health clinics, general practitioners, community pharmacies, Aboriginal health services, and councils, including at the below clinics or pharmacies. Please contact clinics or pharmacies directly regarding opening hours and any consultation fees.  

Last updated 7 June 2024

Aberfeldie
Brunswick
Carlton
Caroline Springs
Footscray
Glenroy
Hillside
Hoppers Crossing
Kings Park
Maidstone
Melbourne CBD
Melton
Moonee Ponds
Oak Park
Sunshine
Taylor Lakes
Werribee
Williams Landing

For other mpox vaccination clinics in Melbourne, visit: Thorne Harbour Health 

Mpox vaccination frequently asked questions (FAQs)

How does the vaccine work?

The vaccine for mpox is a two-dose vaccine, preferably administered into the upper arm. There needs to be a minimum of 28 days between doses.   

Vaccination is highly effective, and a person will start to build protection in the days and weeks after their first dose, but it takes two weeks before it is effective. More information about the vaccine is available here

What are the common side effects of the vaccine?

Side effects can occur but are usually mild and do not last long. Common side effects include:

  • Pain where you received the injection, redness, swelling, hardening, or itch
  • Muscle aches
  • Headache
  • Fatigue
  • Nausea
  • Chills and fever

I have been exposed to mpox. Am I eligible for the vaccine?

Anyone categorised by public health authorities as a high-risk contact of someone with mpox should get the vaccine. Speak to your local public health unit, GP or healthcare professional about vaccine access if you have been told this could apply to you.   

I have symptoms of mpox. Am I eligible for the vaccine?

If you have symptoms of mpox it is important to be checked by a healthcare provider. Consult with your sexual health clinic or GP as soon as possible, and before accessing a vaccine appointment.   

Mpox frequently asked questions (FAQs)

How does mpox spread?

Mpox does not spread easily between people. Transmission may occur through:   

  • Close, personal contact including skin-to-skin contact with mpox skin rashes, sores, or scabs. This includes contact during intimate or sexual activity, such as:
    • Oral, anal, and vaginal sex
    • Touching and skin-to-skin contact
    • Hugging and kissing
  • Contact with clothing, bedding, towels or other objects used by an infected person
  • Respiratory droplets (from coughs and sneezes) from a person with mpox, usually from extended face-to-face contact.

It is unknown whether mpox is spread via sexual fluids. Although condoms do not provide complete protection against mpox, they can reduce the risk of developing sores on areas that are covered. It is important to practice safe sex and wear a condom when engaging in sexual activity to prevent the spread of other sexually transmitted infections.

Who is at risk?

Mpox can affect anyone who comes into direct contact with someone who is infected. However, currently mpox is largely impacting gay, bisexual or other men who have sex with men.   

People at increased risk of mpox infection include but are not limited to gay, bisexual and other men who have sex with me who:

  • are living with HIV
  • have multiple sex partners, participate in group sex or attend sex on premises venues
  • have had a sexually transmitted infection or have been advised to take HIV PrEP
  • have received a recommendation to receive vaccination from other service providers, such as sexual health clinics
  • are experiencing homelessness, use drugs or have psychiatric illness.

To lower the risk of infection, gay, bisexual or other men who have sex with men can:

  • Get vaccinated.
  • Avoid contact, including sexual contact, with people who are unwell or have compatible symptoms (such as sores).
  • Use a condom when engaging in any sort of sexual activity. This can reduce the chance of getting sores in sensitive areas and prevent other sexually transmitted infections.
  • Avoid skin-to-skin contact, especially with anyone with a rash or sores.
  • Wash hands often.

What are the symptoms of mpox?

People with mpox may get a range of symptoms throughout the illness. Symptoms usually start within 3 weeks of exposure to the virus and include:

  • A rash on or near the genitals or near the anus, or on other parts of the body such as the hands, feet, chest, face, or inside the mouth.
  • Fever, chills, headache, muscle aches and backache, exhaustion, and swollen lymph nodes.
  • Respiratory symptoms like sore throat, nasal congestion, or cough.

The rash can look different from person to person and during the different times of the illness. It can resemble a pimple or a blister, that can later develop a scab. It might have one spot or many. It may also be painful or itchy.

Usually if an infected person has flu-like symptoms, they will develop a rash 1-4 days later. However, some people may develop a rash-first, followed by other symptoms. Other people may only experience a rash.

What should I do if I think I have symptoms?

If you develop mpox symptoms, and particularly if you develop a rash, you should isolate away from others and seek medical care at your GP clinic, the Melbourne Sexual Health Centre, or your nearest sexual health service. Call ahead of time to let them know you will be attending so they can ensure you are isolated away from others. If you have a rash or blisters, make sure these are covered, and make sure you wear a mask to prevent spread to others. 

It is important that people with symptoms avoid close contact with others, including sharing beds, touching skin-to-skin, and sexual activity.  

Mpox can be spread from the time symptoms start until the rash has healed, all scabs have fallen off, and a fresh layer of skin has formed. The illness typically lasts 2-4 weeks. 

 

I am travelling overseas, or have recently returned from overseas, what should I do?

If you are travelling overseas and are sexually active whilst travelling, or if you attend large parties or other places where sex or intimate contact or other skin-to-skin contact occurs, vaccination is recommended 4-6 weeks before departure.  

Seek advice from local health authorities if you think you might have been exposed.  

If you have recently returned from overseas and were sexually active whilst travelling or attended large parties where sex or intimate or other skin-to-skin contact occurred, we advise you watch for symptoms. If you develop symptoms, you should seek medical attention and isolate away from others. 

 

If you have specific questions or concerns, please contact us, we are here to help you.

Mpox information and FAQs for clinicians

The key messages for clinicians are:

  • New locally acquired cases of mpox have been reported in Victoria, indicating local transmission is now occurring.
  • Be alert for unrecognised mpox acquired both locally and from overseas.
  • Request mpox PCR in all patients presenting with compatible symptoms, in particular those presenting with a genital rash, lesions, or proctitis.
  • Please collect a specimen using a dedicated dry swab, mark as “urgent” and send to the Victorian Infectious Diseases Reference Laboratory (VIDRL) via your normal pathology provider.  
  • WPHU strongly recommends that you vaccinate eligible patients with the mpox vaccine via subcutaneous administration. The vaccine is freely available to order via the OneLink portal. A second dose of vaccine is required for optimal protection, at least 28 days after the first dose.
  • Vaccination may also be considered for healthcare workers at risk of exposure to patients with mpox, based on local risk assessments. This may include primary care, sexual health clinics, hospital staff and others. The risk of transmission should also be minimised by using infection control measures.
  • Any suspected or confirmed cases of mpox must be immediately notified to the Western Public Health Unit (WPHU) by calling 1800 497 111 or the Department of Health on 1300 651 160.  
  • For further information about mpox and mpox vaccination see above information on this page.

The below FAQs have been created to ensure that clinicians across central and western Melbourne feel well-equipped to identify cases and manage mpox should they encounter it.

When do providers need to notify public health?

Mpox is an urgent notifiable condition, in accordance with Victorian statutory requirements. Medical practitioners and pathology services must notify cases to the Department of Health or your local public health unitby telephone upon initial diagnosis or clinical suspicion (which includes suspicion to test for mpox) as soon as practicable and within 24 hours. 

Notify any suspected or confirmed case to the Department of Health or your local public health unit by calling 1300 651 160 (available 24/7). 

 

Who is at the highest risk of mpox?

Mpox can affect anybody, although the current multinational outbreak has disproportionately affected gay, bisexual and other men who have sex with men. Whilst most cases diagnosed in Victoria have been acquired overseas, there has been local transmission. Mpox should be considered in anybody who has a consistent clinical syndrome (see below). 

 

How is mpox transmitted?

Mpox can be transmitted through direct contact (such as with lesions or scabs, bodily fluids or contaminated objects) or through respiratory droplets. People with mpox are infectious from the time they develop their first symptom until the vesicles have scabbed over and the scabs have fallen off. Isolate the case until all lesions have crusted, scabs have fallen off and a fresh layer of skin has formed underneath.

 

What are the clinical features of mpox infection?

Most – but not all – people who experience mpox experience an initial prodrome of symptoms that can include: a rash, fever, sore throat, aches and pains, fatigue, and/or swollen lymph nodes.  

The characteristic skin rash usually begins within 1-4 days of fever onset and progresses for a period of 2-3 weeks. The rash follows a similar progression to chickenpox; it can begin as macules that evolve to papules, vesicles and then pustules. The lesions eventually crust over; these crusts dry up and fall off.   

Some cases in the current global outbreak of mpox have had atypical presentations e.g. lack of prodrome, a single skin lesion only, or with proctitis or urethritis. A high index of suspicion should be applied to anybody presenting with skin lesions that are otherwise unexplained, or proctitis. 

 

How should samples be collected for testing?

Sampling procedures vary depending on the phase of the rash. Specific packaging and transport of samples are required. Appropriate personal protective equipment (PPE) should be worn while collecting samples from patients suspected of mpox virus infection. This includes fluid repellent surgical mask, gloves, disposable fluid resistant gown, and eye protection – face shields or goggles.  

Suitable sample types for mpox PCR include fluid or tissue from a suspected mpox lesion, the crust of a suspected mpox lesion, or skin biopsy of affected tissue. Swabs should be taken from the base of an affected lesion, which may need to be deroofed if a crust is present.  

In addition, nasopharyngeal or throat swab should be performed in all suspected cases, and rectal swab can be performed if proctitis is present.   

At the current time, given there is a significant overlap between mpox and other sexually transmissible infections (STIs), consider testing for concurrent STIs. Similarly, consider testing for mpox when testing for other STIs with similar signs and symptoms. A dedicated swab is needed for mpox testing so additional samples will be required for testing other STIs.  

See Mpox – Laboratory case definition for further advice on specimen collection, handling and transport. 

 

How can a clinician arrange testing?

Medical practitioners no longer need approval from the Department of Health to test for mpox. Work with your usual laboratory, who will forward specimens on to the Victorian Infectious Diseases Reference Laboratory (VIDRL). Remember to also notify either the WPHU by calling 1800 497 111 or the Department of Health by calling 1300 651 160 (available 24/7) 

All suspected mpox cases should be notified to either the WPHU by calling 1800 497 111 or the Department of Health by calling 1300 651 160 (available 24/7). Testing is discussed and arranged at that point. 

 

What personal protective equipment (PPE) should be worn when treating individuals with suspected and confirmed mpox?

Standard and transmission-based precautions – including contact and droplet precautions – are considered the minimum level of PPE when caring for a person with suspected, probable, or confirmed mpox. This includes:  

  • Fluid repellent surgical mask
  • Gloves
  • Disposable fluid resistant gown
  • Eye protection – face shields and gowns

Health workers may consider applying a fit-checked particulate filter respirator (PFR) – P2/N95 or equivalent, when providing certain care that might be higher risk, such as showering patients; handling contaminated linen, clothing, or towels; conducting procedures involving the oropharynx.  

See ICEG Interim Guidance on Mpox for Health Workers for more information. 

 

Should suspected and confirmed cases isolate?

Suspected cases should be advised to isolate until they receive their test results.

Confirmed cases should be advised to isolate in their home, away from others as much as possible. They should stay in a separate room and use a separate bathroom if possible. Due to the risk of onwards transmission, they should not share any household items such as towels, bed linen or clothes with others, and ensure any shared surfaces are disinfected after contact.

If a confirmed case must leave home (e.g. for medical care), they should wear a surgical mask and cover any lesions or rash.

Confirmed cases will be contacted by the local public health unit to ensure they are aware of the recommended precautions to take.

 

Do cases need clearance to leave isolation?

Cases are advised to isolate to prevent onward transmission.  

The decision to “clear” a person with mpox (that is, decide that they can safely leave isolation), can be made by the person’s treating clinician. A clinical review should be arranged once the patient reports their symptoms are improved. The clinician should inform the Department of Health or the local public health unit monitoring the case of the outcome of the assessment. WPHU can be contacted by calling 1800 497 111 or emailing wphu@wh.org.au.    

A person with mpox can be advised isolation is no longer recommended when the following criteria are met: 

  • They are clinically well, any symptoms (such as fevers, malaise, swollen lymph nodes) must be resolved, AND
  • There have been no new lesions for at least 48 hours, there are no mucous membrane lesions and all lesions in exposed areas have crusted, the scabs have fallen off, and an intact fresh layer of skin has formed underneath. Lesions on unexposed skin must also have crusted over but if not fully healed (e.g., where a scab is still present) must continue to be covered when in contact with other people.

Intimate or sexual contact should be avoided until the scabs have fallen off. Although it is not clear if transmission via sexual fluids is possible – it is recommended to use a condom during sex for 8 weeks after leaving isolation. In addition, patients should continue to avoid close contact with immunosuppressed people, pregnant women, and children aged under 12 years until all lesions are fully healed.  

Clearance letters can be provided to people with mpox if required (for example, to support their return to the workplace). 

 

What is the clinical management of mpox infection?

The management of a confirmed case of mpox is the responsibility of the treating doctor. This includes notifying the patient of the diagnosis, clinical management, and assessment for case clearance. If a case is diagnosed by an emergency department and subsequently discharged home, follow up should be handed over to the case’s usual GP, or an appropriate sexual health centre or infectious diseases unit.  

Mpox is generally a self-limiting infection. Most cases will not require specific treatment other than supportive management or treatment of complications (e.g. antibiotics for secondary cellulitis).  

Mpox skin and mucosal lesions can be painful, and adequate pain relief is a requirement of clinical care. Inadequate pain relief is the most common indication for emergency department presentation. It is also important to provide advice to minimise the risk of secondary infection of mpox lesions.  

For further advice, refer to the Australian Human Mpox Treatment Guidelines.  

Additional resources are available for managing symptoms at home, such as those produced by CDC and by BMJ

 

What is the role of antivirals?

Antivirals are generally not required.  If further information is required, please contact an infectious diseases physician or refer to the Australian Human Mpox Treatment Guidelines.    

 

What is the role of vaccination?

Postexposure Prophylaxis: Vaccination may be warranted for susceptible high-risk contacts following a risk benefit assessment within 4 days of exposure if there are no contraindications.  See Victorian Department of Health Mpox website for more information on vaccination eligibility criteria.   

High-risk individuals: Certain high-risk individuals are eligible for vaccination prior to exposure. See Victorian Department of Health Mpox website for information on current vaccination eligibility criteria and availability. 

Healthcare workers: Certain laboratory and healthcare workers may be eligible for vaccination. See Victorian Department of Health Mpox website for more information on current vaccination eligibility criteria.   

  

 

How can mpox be discussed with patients without applying stigma?

While mpox can affect anybody, a significant majority of cases in the current global outbreak are amongst gay, bisexual and other men who have sex with men (MSM). The MSM community has a longstanding history of experiencing stigmatisation, including in healthcare environments, and it is important to avoid applying further stigma.  

It is important to remember that mpox is not known to be a sexually transmitted infection, although we are still learning about this disease. Most cases in the current outbreak have been acquired through close physical contact, which includes activity with sexual partners. In addition, anybody can be affected, regardless of sexual preferences. 

  

 

Information for health professionals and partners