Monkeypox jabs will be available from this week after the Australian Government ordered 450,000 doses of the Bavarian-Nordic vaccine, of which 5,500 have been earmarked for vulnerable groups in NSW.
A first batch of 22,000 does of the third-generation smallpox vaccine, one of two recently extended by ATAGI (the Australian Technical Advisory Group on Immunisation) for use to treat and protect against monkeypox, will be distributed nationally.
As of August 4, the most recent reporting date, there have been 57 domestic cases of monkeypox, with 31 cases in NSW. All but two of the cases came from overseas transmission. The disease has been reported in all states and territories excluding the Northern Territory. Globally there have been 23,000 cases reported in the current outbreak and at least 10 deaths.
What is monkeypox?
Found mostly in the tropics of Central and West Africa, monkeypox is a zoonotic virus that can spread between humans and animals. It is part of the same family as smallpox, and is typically mild amongst adults, with those infected often recovering with two to four weeks.
Since the 1970s, monkeypox has been somewhat endemic in 11 African nations, with a few notable breakaway cases appearing in Singapore, the UK and the USA. With the global eradication of the similar smallpox virus in the 1970s, widespread vaccination no longer became necessary, creating an opportunity for the monkeypox virus to take hold in the wider population.
What to look for
Monkeypox has a wide range of symptoms that can appear five to 21 days after exposure, but also infected cases can display no symptoms at all. Common symptoms can include:
- Rash, lesions (bumps that turn into pimples, blisters or sores, and may burst to form ulcers or scabs)
- Swollen lymph nodes
- Fever
- Headaches
- Muscle aches
- Joint pain
- Back pain
- Chills
- Exhaustion
As the virus mutates, lesions around the genitals and anus are becoming increasingly common, which contrasts previous outbreaks with lesions mostly found on the hands and face.
The current outbreak
In May of 2022, monkeypox began appearing in non-endemic countries, including the USA, and particularly among men who have sex with men (MSM). Domestically in the US, 98 per cent of the current outbreak is amongst this community. While not classified as an STI, monkeypox is transmissible through prolonged skin-to-skin contact, creating opportunities for the virus to spread through sexual contact.
The current Australian outbreak is largely contained to the MSM community, however, there have been cases in children in the USA and Europe. Children, infants, pregnant women and the immunocompromised are at highest risk of becoming severely unwell if infected.
The vaccine
Vaccines for smallpox have been found to be effective against monkeypox and are becoming increasingly available in Australia. Doses will be prioritised for those that are deemed most vulnerable, including:
- Intimate and household contacts of confirmed cases
- Gay, bisexual and MSM who have a high number of sexual contacts, or who are planning to travel to areas were monkeypox is prevalent
- Those living with HIV
- Sex workers
- Immunisation providers
Vaccination is most effective when provided before infection, however ‘receiving a vaccination within four days after the first exposure, will provide the highest chance of avoiding disease’.
There is the possibility of mild to serious side effects, and more information can be accessed here.
GPs and doctors will be able to address individual patients to ascertain if vaccination is a necessary option.
Main image supplied by Bavarian-Nordic.