Monkeypox

Monkeypox

Monkeypox is a viral infection that causes a rash. It is spread through close skin-to-skin physical contact with someone who has symptoms. There is currently a global outbreak of Monkeypox. So far there have been a handful of confirmed cases in New Zealand, however each case was acquired overseas and there has yet to be any cases of community transmission within New Zealand.

What are the symptoms?

The mean incubation time is 7 days with initial symptoms of a flu-like illness with fever, malaise, headache, and fatigue often accompanied by swelling of lymph nodes.

Shortly after a rash can appear with lesions before scabbing. Most persons have fewer than 10 lesions and almost 10% present with only a single genital lesion. Hospitalisation is uncommon and the major reason for admission is usually for pain control, typically for anorectal or oral pain.
People with monkeypox should remain in isolation for the duration of illness, which typically lasts 2 to 4 weeks. The symptoms usually resolve by themselves within a few weeks, but you are considered infectious while you have symptoms.

If you think you may have symptoms, you should isolate and seek medical advice from your primary care physician, sexual health clinic or contact Healthline on 0800-611-116.
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How is it transmitted?

Monkeypox is transmitted through skin-to-skin contact, contact with the skin lesions, and transfer of bodily fluids such as saliva. Contaminated objects such as bedding, clothing, or sex toys can also carry the virus.

It is not classified as a sexually transmitted infection, but sex can make its transmission easy and is considered to be a common driver of transmission in the current outbreaks. However non-sexual skin-to-skin contact can also transmit the virus.

A recent study (The Lancet), found that monkeypox transmits most efficiently when lesions come into contact with mucus membranes in the anus, rectum, genitals, mouth and throat. Monkeypox is more likely to transmit through oral or anal sex than through contact with external skin, which would need some sort of defect, such as a wound, to allow entry of the virus.

Monkeypox & HIV

People with advanced HIV infection or who are not taking antiretroviral drugs might be at increased risk for severe disease if they get monkeypox.

However there does not appear to be more severe monkeypox illness in people who have HIV, are on antiretroviral medication and are virally suppressed.

What treatment is available?

There are no treatments specifically for monkeypox virus infections. However, monkeypox and smallpox viruses are genetically similar, which means that antiviral drugs and vaccines developed to protect against smallpox may be used to prevent and treat monkeypox virus infections.

For most patients, treatment for Monkeypox is mainly supportive, such as pain medication. Most people with monkeypox recover fully within 2 to 4 weeks without the need for medical treatment.
The main vaccine for Monkeypox being used around the world is Jynneos, it is also safe for people living with HIV. (Jynneos is currently not yet available in New Zealand)

What is New Zealand's response to Monkeypox?

Many countries around the world have begun a vaccine rollout to combat the Monkeypox outbreak. Australia recently secured 450,000 doses of the 3rd generation Monkeypox vaccine Jynneos, with the first 22,000 doses due to arrive in the next few weeks.
At this stage, New Zealand’s response is still testing, isolating and contact tracing. The Ministry of Health has not yet confirmed if they have ordered or secured a guaranteed supply of vaccine for the illness.
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