About Monkeypox
What is Monkeypox?
Monkeypox is a disease caused by a virus called Monkeypox. It’s a relative of a virus that causes smallpox, an orthopoxvirus. The disease is much milder than smallpox and rarely fatal.
How is Monkeypox spread?
Monkeypox can be spread from an infected patient through
- touching objects, clothing, bedding or towels they use
- touching their skin blisters or scabs
- direct contact with bodily fluids
- coughing or sneezing
- prolonged skin to skin contact including hugging, massage, and kissing
- sexual contact- oral, anal, and vaginal sex or touching the genitals or anus.
How is it diagnosed? Do I need any other testing?
Monkeypox is diagnosed by taking a swab from one of the skin lesions taken from the skin rash or from a nasopharyngeal swab or a blood test. These swabs are then tested at the laboratory for genetic material from the monkey pox virus.
There is a blood test which can identify monkeypox antibodies, but this test is currently not available in Australia.
The Monkeypox rash can look like rashes caused by other illnesses e.g., chicken pox, shingles, severe impetigo, herpes virus and syphilis so swabs will also be taken to test for these and other viruses and bacteria. Monkeypox can be transmitted through close body contact including sexual activity so when Monkeypox testing is done, testing of blood, urine for other sexually transmitted diseases should also be included.
How serious is Monkeypox?
The illness is usually mild and most of those infected will recover within a few weeks without treatment. The following patients are believed to be higher risk of severe disease – immunocompromised patients, including HIV infection, pregnant women and children. The mortality for the strain of monkeypox we are currently seeing is very low.
What are the possible complications of Monkeypox?
Common
Pain, Secondary bacterial infection (boils, abscesses, skin dermatitis)
Rare
Sepsis, corneal ulceration, constipation, urinary retention, deteriorating mental state, pneumonia, epiglottitis, myocarditis
What is the treatment for Monkeypox?
In most cases, no specific treatment is required.
Mild symptoms such as fever and pain can be managed with paracetamol and ibuprofen as required. It is also important to stay hydrated with regular fluids, particularly if you are eating less than normal.
You may require additional medications (such as antibiotics if you develop a skin infection) but this will be decided by a doctor when they review you.
For people with very severe and life-threatening infection, there are a few additional treatments that can be considered, but these are in limited supply – using these drugs will require discussion with an Infectious Disease Specialist.
Is there a vaccine?
Yes, there is a vaccine available. The vaccine is injected intradermally between the layers of the skin on the forearm. A smaller dose (0.1 ml) of the vaccine is used. Studies show that this still produces an immune response as good as by intramuscular injection. You will require a second dose of the vaccine 28 days apart to obtain maximum protection.
Side effects are mild and can include redness, swelling or itchiness at the injection site.
Post exposure prophylaxis:
The current recommendations by ATAGI are limited to people with confirmed or likely exposure to Monkeypox. Ideally vaccination should be given within first 4 days of exposure, but vaccination up to 14 days may be effective.
Pre-exposure vaccination
Gay, bisexual, and other men who have sex with men remain the priority group, in particular those living with HIV, those who have a recent history of multiple sexual partners, participating in group sex or attendance at sex on premises venues.
People who are severely immunocompromised may not respond as well to the vaccine but are still advised to be vaccinated if at risk of contracting Monkeypox.