'We've got monkeypox in the community': Locally-acquired mpox infections up in Australia

Monkeypox

FILE - A vial containing the mpox vaccine and a syringe. Source: AAP / AP

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Health experts are calling for Australians to get vaccinated as an outbreak of mpox, formerly known as monkeypox, sweeps the country. Meanwhile, a deadly new subvariant is sweeping the Democratic Republic of Congo.


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TRANSCRIPT

Deadly new variants of mpox, formerly known as monkeypox, paired with a significant uptick of cases in Australia has experts fearing the worst is yet to come from the disease.

This week, the World Health Organisation has warned of a new, more deadly strain spreading in the South Kivu province of the Democratic Republic of Congo.
 
The Congo - one of the poorest countries in the world - has seen 20,000 cases and over 1,000 deaths from mpox, mainly among children, since last year.

Professor Andrew Grulich is from the Kirby Institute at the University of New South Wales, a world-leading research organisation working to eliminate infectious diseases.

He says Central Africa is struggling with mpox, especially a new subvariant of the disease or what's known as a clade.
 
"There's a lot of concern about what's happening in central Africa with an ongoing and probably expanding epidemic. There is a different clade that is happening in Central Africa, which we think has higher mortality, but this is also in an area where there's quite a lot of untreated HIV and that might explain some of the mortality."

Congolese doctors have reported a fatality rate of about 5 per cent in adults and 10 per cent in children, as well as high rates of miscarriages.

While mpox was first detected in monkeys in 1956, the first known human case was seen in the Congo in 1970.

The disease is a viral infection that spreads through close contact, causing flu-like symptoms and pus-filled lesions.
 
Most cases are mild but it can kill.

In 2022, an international outbreak of mpox marked the first time the disease had spread widely outside Africa.

And now, in Australia, there's been a significant uptick in cases over the last few months with 90 reported infections in 2024 according to the Department of Health's disease surveillance system.

This is more than triple the 26 cases seen throughout the entirety of 2023.
 
Simon Ruth is the C-E-O of Thorne Harbour Health in Melbourne which is one of Australia's largest LGBTIQ+ community-controlled organisations.

He says it's very concerning to see local transmission.

"The current outbreak started around Anzac Day in Melbourne, so it's been running for a couple of months now. Victoria's up at 50 cases currently, and then there's also been a significant number in Brisbane and then a few cases in Adelaide and in Sydney also. The difference between the outbreak this year and then the one that we had 12 months ago, 12 months ago, they were almost entirely overseas acquired. Currently, they're almost entirely locally acquired. So, we've got monkeypox in the community."

Professor Grulich says, while it may not prove deadly for most, mpox often causes pain and disfigurement.

“So, the type of monkeypox we have in Australia, what's called clade 2b, this has an extremely low mortality around the world but it certainly can cause a lot of pain and some disfigurement. Most people get pretty mild disease, but people who may get it more severely are those who have immune problems."

So far, the only Australians affected by the disease have been men and primarily those in the LGBTIQ+ community.

Jack Barlow was 26-years-old in 2022 when he contracted mpox during his travels in the United States amid the initial outbreak.

"I was on holiday and I went to Provincetown and I kind of had a romantic summer fling, and unfortunately I contracted mpox. Luckily my symptoms kicked in once I had already returned back to Australia a few days into being home, and I was like my jet lag just wasn't going anywhere. And that's when some of the other symptoms started to appear."

He spent 21 days in isolation as one of the first Australians to get the disease.

He considers himself lucky to have only had relatively mild symptoms but says it was a scary time.

"There wasn't a whole lot known about it at the time, and I was kind of scared I was going to end up having quite the serious kind of response, which is being covered head to toe in sores. I was pretty lucky. I only had a few pox. I had a bit of fatigue and tiredness. So, I do consider myself one of the lucky ones."

The main way to prevent mpox is to vaccinate using the mpox vaccine, which is estimated to be about 85 per cent effective at preventing the disease after the two-shot-course.

In 2023, 48 per cent of gay and bisexual men in Sydney and Melbourne reported having received at least one dose of mpox vaccine.
Simon Ruth from Thorne Harbour Health says we need to see those numbers increase.

“We would encourage people to come and get vaccinated. The vaccination is free, it's readily available at a large number of clinics in Victoria and some pharmacies."

He says the community needs to pull together to prevent the spread or else mpox may become a consistent presence in Australia.

"If you're symptomatic, getting it checked out, trying to prevent onward transmission, if you have lesions, keep them covered so that the disease can't spread onto further people. We really don't want it to become endemic in Australia. It possibly is becoming endemic in some other parts of the world, particularly through sexual transmission. And it's rare enough here that we can still get on top of it and prevent that."

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