Monkeypox is a rare viral infection which is endemic to Central and West Africa. However, since May 2022, there has been a global increase in the number of monkeypox cases reported in multiple countries where the disease is not usually seen. Professor Bill Rawlinson AM, Senior Medical Virologist and Fellow of the RCPA says that although monkeypox has been identified in Australia, case numbers remain low.

“Monkeypox is a rare but potentially serious viral illness. In the current outbreak, the clinical presentation is often atypical. We are mostly seeing few lesions localised to the genital, perineal/perianal or around the mouth, that do not spread further, and a rash that appears prior to the development of symptoms such as swollen lymph nodes or fever. Infants, young children, pregnant women, and people who are immunocompromised are more at risk of developing severe disease.

“It is important to be alert about monkeypox but equally to realise that the case numbers in Australia are currently very low. We are not seeing the same spread and increase in numbers that other countries are experiencing, such as in the US, UK, Europe, and Canada, where monkeypox has emerged in larger numbers,” said Prof Rawlinson.

Monkeypox is genetically a close relative of smallpox although it is less clinically severe. The difference is that smallpox only affected humans and has been eliminated through vaccination. However, monkeypox is carried by an animal viral reservoir, most often in squirrels and other rodents. It is usually spread by prolonged close contact with someone with monkeypox, direct contact with bodily fluids, lesions or scabs, or contaminated objects. Most people recover within a few weeks.

“In the current outbreak, the symptoms suggest that most transmission has occurred during sexual contact. While monkeypox is not usually considered a sexually transmissible infection, physical contact during sex carries a risk of transmission and intimate physical contact represents a risk of infection, with infectious skin lesions being the likely mode of transmission.

“We are very well prepared for monkeypox in Australia. We have assays and diagnostics, along with access to testing for ‘pox’ viruses that have been available for many years through the Commonwealth and state jurisdictions, as well as through the Public Health Laboratory Network (PHLN). These diagnostic tools have been developed over a long period of time, therefore is a mature diagnostic program.

“Travellers who are returning from, or going to, countries where cases have been identified are urged to be aware of the signs of infection and seek medical help if they think they are at risk,” said Prof Rawlinson.

Due to the unusual behaviour of monkeypox, spreading to countries outside those considered endemic, the World Health Organization convened an emergency committee of experts on 23 June. The WHO Director-General did not determine that the event constitutes a Public Health Emergency of International Concern (PHEIC) at this time.