Mpox signs, symptoms and treatment

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What is mpox?

Mpox (formerly known as monkeypox) is a disease caused by the monkeypox virus. It usually causes a mild illness and lesions in the genital or anorectal areas, or in the mouth. It’s mostly spread through prolonged physical or intimate (skin-to-skin) contact with someone who has mpox. Most people recover within a few weeks.

How mpox spreads

Mpox does not spread easily between people. It is usually spread from person-to-person by prolonged physical or intimate contact with someone who has mpox, especially with skin rashes, lesions, sores or scabs.

It can also spread through contact with clothing or objects (bedding or towels) used by an infected person and through respiratory droplets (coughs and sneezes).

It does not spread via casual contact.

People may be infectious up to 4 days before they develop their first symptoms until all lesions crust, dry and fall off with a new layer of skin forming underneath, and other symptoms have resolved.

Who is at risk

Anyone who has prolonged physical or intimate contact (skin-to-skin contact) with someone who has mpox can become infected.

People most at risk are gay, bisexual and other men who have sex with men, those who are travelling to countries with outbreaks, and those with multiple sexual partners or attending large parties or sex on premises venues.

Symptoms of mpox

Image source: DermNet

Symptoms of mpox may develop up to 21 days after contact with an infected person.

Symptoms can include a rash that can be painful and affect any part of the body including:

• genitals
• area around the anus and buttocks
• inside the mouth
• face
• hands and arms
• feet and legs.

The rash may involve vesicles, pustules, pimples or ulcers and the number of lesions can vary. The rash may change and go through different stages, like chickenpox, before finally becoming a scab that falls off.

Other symptoms that can occur before or alongside the rash, include:

• fevers
• chills
• muscle aches
• swollen lymph nodes
• exhaustion
• headache
• sore throat
• anal and rectal pain
• pain during urination.

Symptoms can resemble sexually transmitted infections (STIs) like herpes or syphilis as well as other diseases with a rash such as measles or chickenpox.

Most people have a mild illness and recover within a few weeks but some people may develop severe disease and require hospitalisation.

Children, pregnant persons and people with a weakened immune system are considered at higher risk of developing severe disease.

What to do if you develop symptoms of mpox

If you develop symptoms of mpox you should stay home, restrict your contact with others, and seek medical care and testing.

If you develop symptoms, contact your healthcare provider or nearest health service for advice. Make sure any rashes, lesions, sores or scabs are covered if you attend an appointment.

If you have been tested for mpox, please see Advice for people with mpox.

What to do if you are diagnosed with mpox

People with mpox should avoid contact with others, especially children, pregnant people and people with weakened immune systems.

Avoid contact with animals including pets, due to the risk of human-to-animal spread.

Have a follow up appointment with your doctor as they will provide clearance and further advice if needed, like how long to use a condom when having sex after recovery.

Your Local Public Health Unit (LPHU) will contact you to see how you are doing. They will help identify other people you may have been in contact with while you were infectious, to alert them of the risk of developing mpox. They will inform your contacts without disclosing your identity.

You may be asked to change some of your daily activities until you are recovered to reduce the risk of spreading mpox to other people. Occasionally, your LPHU may ask you to stay home and isolate from other people if there is a higher risk of spreading mpox.

More information for people with suspected or confirmed cases of mpox can be found at Advice for people with mpox.

What to do if you are identified as a contact of mpox

If you are identified as a contact, watch for symptoms. Your LPHU will contact you to provide advice (such as monitoring for symptoms).

Prevention of mpox

Vaccination against mpox is an important preventative measure. Two doses are required for optimal protection against severe disease. No vaccine is 100 per cent effective, and infection may occur in people who are vaccinated.

Avoid contact with people with suspected or confirmed mpox. This includes touching potentially contaminated materials, like bedding or towels.

Consider limiting your number of sexual partners and swap contact details. Consider limiting sexual partners for three weeks after returning from countries where there are mpox outbreaks.

Maintain good hygiene by washing your hands with soap and water or using alcohol-based sanitiser.

If you are unvaccinated, or have only had one dose, and have been exposed to someone with mpox, getting a vaccine (preferably within four days after exposure), may reduce your risk of getting mpox. Speak to your GP or sexual health clinic about getting vaccinated.

Treatment of mpox

Most people usually have mild illness and recover within a few weeks. Antiviral treatments are available for severe disease so early testing is important.

Mpox immunisation

In Victoria, the mpox vaccine (JYNNEOS® vaccine) is available free-of-charge for eligible people who meet at least one 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
• 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
• health care and humanitarian workers at risk of occupational exposure to patients with mpox, especially workers who will be caring for patients in a country where Clade I transmission is occurring
• prior to travel for any individual (regardless of sexual orientation or gender identity) who may undertake sexual risk activities in countries with transmission of Clade I mpox.

Two doses of the vaccine, given 4 weeks apart, are required to lower your risk or chance of catching mpox.

The mpox vaccine takes approximately 2 weeks before it is effective.

If you have received your first dose at least 4 weeks ago, make sure you get your second dose.

Free mpox vaccine is widely available for eligible people through Sexual Health Clinics, general practitioners (GPs), Aboriginal Health Services, public hospitals, community pharmacies and some local councils. People eligible for mpox vaccine can contact their Local Public Health Unit.

Please note, while the mpox vaccine is free, consultation may not be available. Speak to the immunisation provider to verify consultation-related fees and vaccine availability.

Where to get help

• Always call an ambulance in an emergency (Triple Zero) Tel. 000
• Emergency department of your nearest hospital
• Your GP (doctor)
• Nurse-on-Call Tel. 1300 60 60 24 (24 hours, 7 days) – for confidential health advice from a registered nurse
• Melbourne Sexual Health Centre Tel. (03) 9341 6200 or 1800 032 017 or TTY (for the hearing impaired) Tel. (03) 9347 8619
• Victorian Sexual Health Network – where to get tested – visit Melbourne Sexual Health Centre's GP partner clinics for STI check-ups and treatment
• Thorne Harbour Health (formerly Victorian AIDS Council) Tel. (03) 9865 6700 or 1800 134 840
• Emen8 – Find your nearest sexual health centre
• Find my Local Public Health Unit