Mpox (monkeypox)

Mpox mainly spreads from person to person by direct skin-to-skin contact with someone with mpox rash, sores, or scabs. This kind of contact is often during oral, anal, or vaginal sex. It can also be spread by:

• prolonged face-to-face contact through respiratory droplets or oral fluids from a person with mpox (e.g. talking, singing, breathing)
• mouth-to-mouth contact (e.g. kissing)
• contact with contaminated materials (e.g. clothes, linens, towels, fabrics, or surfaces) that have been used by someone with mpox – (this is usually only a risk if scabs have been shed onto the clothes or fabrics)
• contact with an infected animal (such as rodents).

Mpox can spread from when symptoms first appear until all the scabs have fallen off and a fresh layer of new skin has formed. This can take several weeks.

Symptoms of mpox can start 5 - 21 days after contact with the virus, such as after contact with a person with mpox or contact with contaminated materials.

People who have received a vaccine for mpox may experience a milder illness that may be very subtle (e.g. one pimple-like lesion).

Sores, rash, bumps, or pimples (lesions) can be found anywhere on the body but are commonly found on:

• genitals
• anus or inside rectum, which may cause anal or rectal pain, bleeding, or bloody diarrhoea
• inside the mouth and throat as ulcers, lesions or sores, which may cause a sore throat or difficulty swallowing
• face, arms, buttocks, and legs.

Lesions often change and go through different stages before forming a scab and falling off over a period of 2 to –4 weeks. They can appear as pimples, blisters, or sores, which can then burst to form ulcers or scabs. The lesions can sometimes be very painful and may cause scarring. Some people do not experience any pain which may make the symptoms less noticeable.

Lesions can vary in size and number, with as little as a single lesion to several lesions.

People with mpox in the rectum or throat may not have a visible rash or lesion but can still pass the infection onto others.

Symptoms of mpox may resemble sexually transmitted infections (STIs), such as herpes or syphilis, and other infections with a rash, such as measles or chickenpox.

Some people may also experience general viral symptoms at the start of their infection, such as:

• fevers or chills
• muscle or joint aches
• backache
• swollen lymph nodes
• tiredness or exhaustion
• headache.

Severe illness and death can occur in a very small percentage of people, such as:

• young children
• pregnant women
• older people
• immunosuppressed people.

If you develop symptoms or are a close contact of someone with mpox, you should stay at home and contact your local public health unit to arrange testing.

To test for mpox, a healthcare worker will swab the sore or blister and send it to a laboratory. Ask them to request for a herpes and syphilis tests on the same swab because these infections also cause sores or ulcers in and around the genitals and mouth.

If you are going to a GP clinic, other healthcare clinic, or hospital, it is important to call ahead to let them know you have symptoms of mpox, wear a surgical mask, and cover any rash and lesions.

Most people with mpox recover without needing any specific treatment.

The illness is usually mild, and recovery will take a few weeks. However, the sores can be very painful for some people. Simple pain relief medicines and drinking plenty of fluids can help manage symptoms.

Severe illness can occur in a very small percentage of people. Antiviral medications may be given to treat them, under the guidance of a specialist doctor.

If you have tested positive for mpox, you will be contacted by your local Public Health Unit, who will provide advice about when you are considered no longer at risk of passing on mpox to other people. The Public Health Unit might also contact you while you are staying at home to monitor your symptoms and ensure you are well.

The Public Health Unit may provide you with the advice below:

• Avoid physical or intimate contact with others, including sexual activity.
• Stay at home unless you need to leave for essential reasons.
• Cover any lesions and wear a mask if you must leave home.
• Follow infection prevention and control advice, such as sleeping in a separate room away from others, not sharing clothes, bedding, towels, dishes and cutlery, and always practicing good hand and respiratory hygiene.
• Avoid people or place where you might be around those may be at greater risk of severe disease.

It is not known how long the monkeypox virus remains in semen and other sexual fluids. After recovering from mpox, for the next 12 weeks people:

• should use condoms when having oral, anal, or vaginal sex
• should not donate blood, cells, tissue, breast milk, semen, or organs.

Vaccination

The best time to receive the mpox vaccine is before you are exposed to the virus.

Two doses of mpox vaccine received at least 28 days apart are required for optimal protection.

The mpox vaccine takes approximately 2 weeks to be effective.

If you are exposed to mpox, receiving a vaccination within 4 days after first exposure to mpox will provide the highest chance of avoiding the disease.

Widespread vaccination is not currently recommended due to the very low risk of infection for the general population.

Who can get the mpox vaccine for free?

Those who are at risk of getting mpox and/or experiencing severe illness due to mpox can access the vaccine, free-of-charge. This includes people who do not have a Medicare card.

Post exposure vaccination

• Contacts of a case as determined by the Public Health Unit.

Primary preventative vaccination

The following people are recommended to be vaccinated against mpox:

• All sexually active gay, bisexual, or other men who have sex with men (including cis and trans).
• Sex workers, particularly those whose clients are at risk of mpox exposure.
• People living with HIV, if at risk of mpox exposure.
• Sexual partners of the people above.
• Laboratory personnel working with orthopoxviruses.
• Healthcare workers who are at risk for mpox (e.g. people working at sexual health clinics and administering vaccinations to individuals requiring post exposure vaccination).

Mpox vaccination is not currently recommended for travel unless one or more of the above eligibility criteria are met.

Where can I get vaccinated?

Please contact your local immunisation provider if they provide mpox vaccinations.

Perth metropolitan area

Free mpox vaccine is available for eligible people through participating immunisation providers and sexual health clinics. You can call to make an appointment. 

The following public hospital clinics provide free services.

• Royal Perth Hospital Sexual Health Clinic phone: 9224 2178
• South Terrace Sexual Health Clinic (external site) phone: 9431 2149

You can find a service for location of other clinics offering mpox vaccination. Some may charge for a consultation – make sure you discuss this with the clinic before your appointment.

Regional Western Australia

Free mpox vaccine is available for eligible people through regional Public Health Units or participating immunisation providers.

More information on mpox vaccine

• Mpox immunisation FAQ (PDF 240KB)

Other ways to prevent mpox

You can reduce your risk of getting mpox by:

• avoiding skin-to-skin and close contact with people who have symptoms of mpox or are confirmed to have mpox
• getting vaccinated against mpox
• avoiding handling or touching bedding, towels, or clothing of a person with mpox
• using condoms with lubricant (condoms alone may not prevent mpox, but will protect against other STIs)
• washing your hands often with soap and water or using an alcohol-based hand sanitizer
• exchanging contact details with your sexual partners. If a sexual partner later develops mpox, this will allow you to be contacted and be given advice and/or be recommended vaccination to prevent mpox.

If you have recently attended a high-risk event (such as sex parties or a sex-on-premises venue, especially in affected locations with an mpox outbreak), you can reduce the risk of passing mpox to your sexual partners by:

• avoiding unprotected skin-to-skin contact for 3 weeks following the high-risk event, including avoiding sexual contact
• monitoring your symptoms
• seeking health care as soon as possible if symptoms develop.