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With the global outbreak of monkeypox (MPX), international travellers need to be aware of MPX and how it's spread; however, there have also been locally acquired cases here in Australia.

It’s time for everyone to become familiar with MPX and how to prevent it.

MPX VACCINATION

Updated 15 November 2022

MPX vaccinations (including second doses) are now available through your local public heath unit (LPHU). Check out the Emen8 'Find a Service' interactive map and filter by 'Monkeypox Vaccination' to find a clinic near you.

Find a Service via Emen8

In Victoria, the MPX vaccine (JYNNEOS® vaccine) is available free-of-charge for people who meet the Victorian Department of Health eligibility criteria.

Where can I get vaccinated?
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Vaccinations are now offered through the local public health units (LPHUs).

Not sure what LPHU you're in? Head to https://www.health.vic.gov.au/local-public-health-units for a detailed map.

In metropolitan Melbourne, these include:

In regional Victoria, these include:

Whilst the vaccine is free of charge, consultation may not be. Speak to the relevant clinic to verify consultation related fees.

DROP-IN CLINICS

All of the below vaccination sites are drop-in clinics only. You cannot book to make an appointment. You can get vaccinated at any of the sites listed below – you do not need to live in the local area.

In the Western suburbs, the following vaccination sites will be operating weekly:

  • cohealth, 98 Abbotsford St, West Melbourne.
    • Thursday and Friday 12-8pm
    • Saturday and Sunday 10am-6pm
  • cohealth, 575A Barkly St, West Footscray.
    • Thursday 10am-4pm
  • Glenroy Community Hub, 50 Wheatsheaf Rd, Glenroy

In the South Eastern suburbs, the following vaccination sites will be operating weekly:

  • Prahran Town Hall, 180 Greville Street, Prahran

In the North Eastern suburbs, the following vaccination sites will be operating weekly:

  • Your Community Health Preston, 300 Bell St, Preston
    • Wednesday 2:30-4:30pm
  • Your Community Health Northcote, 42 Separation St, Northcote
    • Thursday 4-8pm
  • Your Community Health East Reservoir, 125 Blake St, Reservoir
    • Friday 2:30-4:30pm
  • Preston Market, 30A The Centreway, Preston
    • Wednesday 8:30am-1pm

For more information, head to:https://www.yourch.org.au/monkey-pox-mpx-vaccinations/

For a full list of additional upcoming pop up clinics in the North Eastern suburbs, go to: https://thewellresource.org.au/news/vaccination-sites

How does the vaccine work?
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The JYNNEOS vaccine is a two-dose vaccine. There needs to be a minimum of 28 days or four weeks between doses.

Vaccination is highly effective, and a person will start to build protection in the days and weeks after their first dose, but it takes two weeks for someone to reach their highest level of protection following each dose. It should be noted that studies have been limited and there is a need to grow the evidence in this area.

The JYNNEOS vaccine is safe to use in people who are immunocompromised.

What vaccine is available for MPX?
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The vaccine that is currently available to prevent MPX is the JYNNEOS vaccine.

JYNNEOS is one of two vaccines approved for use for MPX in Australia.

The other vaccine, ACAM2000, is associated with rare but serious side effects and adverse events, especially in certain groups of people such as those who are severely immunosuppressed. Because of this, ACAM2000 is not recommended for mass vaccination.

Am I eligible for my second dose?
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There needs to be a minimum of 28 days or four weeks between your first and second dose to optimise the level of protection from the vaccine. And for most people, the first dose will give considerable protection after roughly two weeks.

The second dose does not need to be administered immediately after 28 days. Waiting longer than 28 days to receive the second dose does not compromise the level of protection from the first dose.

What are the common side effects of the vaccine?
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Side effects are common but usually mild. Most people have redness, swelling and pain in the spot where they received the injection. Tiredness, headache and muscle pain can also occur after vaccination.

Do I need a Medicare card to receive the vaccine?
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No. While some vaccination sites may ask you to bring a Medicare card along to your appointment, MPX vaccines are available at no charge to everyone regardless of their Medicare status.

Whilst the vaccine is free of charge, consultation may not be. Speak to clinic staff to verify any consultation related fees.

UNDERSTANDING MPX

What is Monkeypox (MPX)?
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MPX is a viral infection caused by the monkeypox virus (MPXV). While MPXV was first identified several years ago, cases of MPX were rarely seen outside of Central and West Africa until recently. MPX is usually a self-limited disease with the symptoms lasting from 2 to 4 weeks.

What are the symptoms?
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Initial symptoms can include fever, headache, muscle aches, low energy, and swollen lymph nodes (similar to COVID or the flu) before progressing to a skin rash or lesions. The rash usually begins within one to three days of the start of a fever. The rash or lesions can also be found on the face, arms, and legs as well as in the mouth and around the genitals/anus.

Because MPX rashes can resemble some STIs (for example herpes), it is important to contact your GP or local sexual health clinic and let them know about your symptoms when you make an appointment.

The incubation period (the time from infection to the onset of symptoms) of MPX is usually 7-14 days, but it can be as short as 1-2 days or as long as 21 days.

While symptoms are typically mild, for some people with moderate to serious cases MPX can be quite painful.

How is it transmitted?
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MPX is transmitted through close physical contact with someone who has the virus - in particular through sexual or intimate contact.

While MPX is not classified as a sexually transmitted infection (STI), sexual contact with someone who has the virus poses a high risk of transmission.

Bodily fluids (such as fluid, pus or blood from skin lesions) and scabs are particularly infectious. Ulcers, lesions or sores in the mouth can also be infectious, meaning the virus can spread through saliva.

How is it treated?
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Most people with MPX have a mild self-limiting illness and recover within a few weeks without specific treatment.

There are some therapies available for the treatment of MPX, particularly for people at high-risk such as those who are immunosuppressed.

How many cases have there been?
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For the latest numbers of confirmed cases, you can head to:

Why are many cases of being detected among men who have sex with men?
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Currently, a large number of MPX cases are among gay, bisexual, and other men who have sex with men (MSM) and the current outbreak appears to be moving quickly amongst sexual networks.

One reason we're seeing more cases amongst MSM is due is their proactivity seek out sexual health advice. MPX rashes and lesions can resemble some STIs, such as herpes or syphilis. Consequently, MPX cases are being detected in sexual health clinics around the world.

However, the risk of MPX is not limited to gay, bisexual, and other men who have sex with men. Anyone who has close intimate or sexual contact with someone infectious is at risk.

Stigmatising people because of a disease is never okay. Anyone can get or pass on MPX regardless of their sexuality.

It's also really important you're aware of your HIV status. Experiencing MPX alongside untreated HIV or STIs may make your symptoms worse. Find out more about getting tested here.

Am I at greater risk if I’m HIV-positive?
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HIV positive people on effective antiretroviral treatment are at no greater risk than HIV-negative people.

However, if a person is severely immunocompromised and not on HIV antiviral medication, MPX can be of greater severity and duration.

There is very limited evidence on MPX in people living with HIV. The research that we do have is from countries where access to treatment is low and health experiences are poorer than in Australia. Should evidence emerge that people with suppressed immune systems are at greater risk of MPX, or ill-health from catching the virus, then updated information and advice will be made available.

What if I have recently returned from overseas?
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If you recently returned from overseas, in particular if you've being having casual sex while overseas or attended sex-on-premises venues, it's important that you monitor for symptoms. The MPX rash can appear at multiple sites across the body, so check around your mouth, genitals and anus for any new spots or lesions.

People who have recently returned from overseas and developed symptoms, particularly an unusual rash or swollen lymph nodes, should seek medical advice immediately.

You should stay at home and remain isolated until given further advice by your treating doctor. If you are presenting to a clinic or emergency department, call to let them know you are coming, wear a mask, inform the reception staff on arrival, and wait to be isolated until you can be seen by a clinician.

MPX can be transmitted to pets. If you are isolating and experiencing symptoms, it is recommended that you isolate away from any pets.

MPX can also be transmitted via clothing and other materials, so it is recommended that you wash all clothing items, towels and sex toys that you took overseas.

How is it prevented?
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To reduce your risk of acquiring MPX, there are some practices and behaviours you can adopt.

When it comes to sex:

  • Limit the number of sexual partners you have. MPX is moving through sexual networks. Limiting the number of partners you have reduces your risk of coming into contact with someone who has the virus.
  • Swap contact information with your hook-ups. If either of you develops symptoms, you can contact each other to go and get tested.
  • When having sex there are ways to limit skin-to-skin contact and contact with bodily fluids. So maybe don’t kiss or cuddle, avoid using spit for lube, use condoms, and be sure to wash your face, hands, and body parts after sex. Some may want to consider using condoms for receptive anal sex to reduce the risk of anal infection.
  • Create a 'sex bubble'. Similar to what some people did during COVID, you can have a select group of people where you are only having sex with each other. Each person agrees that they’d be happy to be part of the bubble and won’t have sex outside of that group. This limits the risk that you and your sex bubble come into contact with the virus.
  • If you have an open relationship, you might want to consider making it a closed relationship in the short term. The less people you play with, the less likely you are to come into contact with the virus.
  • Explore ways to get off by yourself or at a distance from others. Looking for ideas? Check out tips our community came up with for Sex & COVID or listen to WellWellWell's episode on Sex, Intimacy & COVID-19.

If you are planning to travel overseas:

  • Book an appointment to get your MPX vaccine. Ensure there are two weeks between getting the vaccine and engaging in behaviour that may expose you to the virus. It takes at least two weeks to offer the initial levels of protection against MPX.
  • Follow public health alerts and advice from local health authorities of the countries you are visiting.
  • If visiting festivals or large events, keep alert of any event updates (before and after) from organisers.
  • Be aware and exercise caution if you plan to attend any events or venues that may include dark rooms, play spaces, or sex-on-premises.

Additional behaviours or practices that may limit the risk of MPX:

  • Check yourself for symptoms before heading out. If you are unwell or have a rash - stay home and seek a medical opinion.
  • Consider the type of event and venue you're going to. Close skin-to-skin contact in spaces where people may be wearing little-to-no clothes or spaces where sex is happening puts you at a greater risk of exposure.
  • Don’t share personal items, such as towels, toothbrushes, and sex toys.
  • Better to stay in your own bed than to sleep in someone else’s bed sheets.

These strategies may help reduce your risk of MPX, but the most effective tool for prevention is vaccination.

We spoke with Dr Vincent Cornelisse to unpack what we know about the MPX outbreak - including vaccines and other ways to limit your risk of acquiring MPX.

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