Western Australia has recorded six cases of monkeypox, all have been travelers returning from overseas. The situation in Victoria however is quite different, where there has been community spread with over 40 cases of local transmission.
Globally there have now been over 58,000 cases, Australia has reported 131 cases according to the latest data from the World Health Organisation. In the USA there have been over 22,000 cases, and they sadly recently reported their first death from the virus.
To find out more about what’s been done to limit the spread of the virus in Australia OUTinPerth chatted to Professor Michael Kidd, the Deputy Chief Medical Officer of the Australian Department of Health.
Where do we stand in Australia at the moment in terms of monkeypox, who? What’s the outlook?
We’ve now had 131 reported cases of monkeypox in Australia. Two thirds of those cases have been acquired in people who returned from overseas. One third have been people who were infected in Australia.
But to put that in a global context, there’s been almost 58,000 cases reported globally in about 95 countries where monkeypox has not been present in the past. So, we’ve had a very small number of cases so far, and of course, we now have the vaccines rolling out which are proving to be very effective in protecting people from being infected.
Looking at it on a state-by-state basis, it’s quite dramatically different. Here in Western Australia, I think we currently have only a few cases, which have all been people returning from overseas, but in Victoria, there’s many more cases, and a lot of community transmission.
Why the difference? What do we attribute this strikingly difference to?
Two thirds of cases in Australia have been acquired overseas, but what we’ve been worried about is the risk of people returning from overseas not being aware that the symptoms that they have could be monkeypox, or them not attending a sexual health clinic, or GP, or emergency department, to get to get tested and diagnosed.
Then there is the risk of someone with monkeypox having close contact with someone else, which then sets up transmission occurring in the community. So, we have had a couple of outbreaks which have been picked up in Victoria, which affected a number of people. Then within those outbreaks, you get you get more local transmission.
But outbreaks could occur anywhere, because with monkeypox anyone who’s coming into close intimate contact with someone who is currently infected is at risk of contracting.
We have a lot of images which appear in the media, pictures of these sort of chickenpox looking pus-filled sores. Is that misleading? Is that what it’s going to look like for people when they are in the early stages of finding out they’ve caught this virus?
The symptoms and signs can be different in different people. That’s why it’s important that people who are at higher risk of coming in contact with someone who is infected with monkeypox are aware that there is a spectrum of symptoms and signs.
What we’re seeing is the majority of people have sores, which start as small red bumps, and then turn into pustules. They become full of fluid and then they burst and form an ulcer, which can be eat quite a large, painful and sore and eventually that will scab over. People are still infectious until the scabs have dropped off and the skin has completely recovered underneath.
But some people may not have those sores appearing, they may have fever, or they may have swollen lymph glands. It can be different in different people.
What we’re seeing mainly is the rash occurring on people’s genitals around the anus or in or around the mouth. Some people have had the sores appearing inside the rectum, and that can be very painful as can the sores which appear inside the mouth and in in the throat.
It’s important that all gay, bisexual, and other men who have sex with men – who are being sexually active – are on the lookout for these symptoms both in themselves, but also in any potential sexual partners.
Do we know much about how this virus interplays with other medical conditions people might have, especially people living with HIV? Are they more at risk of being affected by monkeypox?
People who are living with HIV are not necessarily more at risk. It’s coming into close intimate contact with someone which results in the transmission and if you have HIV, you’re not more likely to contract the virus, but what we’re worried about is that if people significantly immune compromised, then they may be at risk of becoming more unwell.
If they contract, the monkeypox virus and what we’ve seen is some people have become very unwell with monkeypox. Not necessarily people are HIV positive, but some people become very unwell, they can develop secondary bacterial infection in the sores. They can become quite septic.
We’ve had some people who have developed encephalitis, viral inflammation of the lining of the brain, and that can be very serious.
As you probably know, there’s been a very small number of people who have become seriously ill and died from monkeypox, nowhere in Australia, but there’s been estimates vary that there’s probably been about 15 or 16 cases where people have died this year from monkeypox.
With the opening of Australia’s borders, we’re all rushing back overseas for holidays, does that present a challenge in keeping this virus under control?
Of course. This current monkeypox outbreak has been moving around the world very rapidly. It’s appeared in 95 countries so far, since May of this year. And partly that’s been through more people traveling internationally and things getting back to normal with international travel.
The important thing is for people to be aware that monkeypox is out there, be aware of what the symptoms and signs are, and be aware of how to protect yourself against becoming infected with monkeypox.
Particularly for people who are traveling overseas and who may be maybe engaging in sexual activity with new partners while they’re traveling. Just be aware that this virus is out there at the moment, and do all you can to protect yourself, and in turn protecting others.
There’s a vaccine available. Where do we stand with that vaccine getting to the people who need to get it? Because I know it’s hard to come by, we have a lot coming, but where do we stand at the moment?
We’ve had 22,000 doses of the vaccine it’s called JYNNEOS. Each of the states and territories has received an allocation of the vaccine and is rolling out the vaccines through sexual health services, through some general practices, and through some other clinics.
We are expecting further stock to arrive in Australia and other 78,000 vials of vaccine are due to arrive between now and the end of the year, and then we have over 350,000 vials to arrive through 2023.
We have had a change in how the vaccine can be administered over the last couple of weeks. The vaccine previously was given subcutaneously, which means under the skin, we now can give the vaccine intradermally. Which means a much smaller dose of the vaccine actually into the skin layers, and what that means is that we can get up to four to five doses from the one vial.
So that opens up the vaccine to be available to a lot more people at this time. At the moment each state and territory has determined who are the priority populations for getting the first doses of the vaccine, and so the health department in Western Australia was decided who were the priority populations.
As more vaccine becomes available, more and more people will become eligible to receive the vaccine. But at the moment the focus is on the highest risk groups of people and encouraging those people to come forward and get vaccinations.
I guess the positive of the Covid era is we’ve all got very good at contact tracing, and we’ve all got very good at taking vaccines. Are there any side effects from this vaccine?
We are tracking very closely with this vaccine to see if people are experiencing any side effects at all.
Apart from the usual side effects of with any vaccine of having a little bit of redness and discomfort at the site where the vaccine is administered in some people, we’re not finding any other significant side effects are being reported, which is good to see.
We have a system in Australia called AusVax Safety, which invites people who receive vaccines to report whether they’re experiencing any side effects. We’ve had over 1,300 people who have sent in details after vaccination. We haven’t had any safety signals come through from anyone who’s received the vaccine and took taking part.
For the latest information on Monkeypox, including registering for vaccination, head to Healthy WA.
Graeme Watson
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