Mpox cases continue to rise

Mpox (previously called monkeypox) is an infection caused by a virus belonging to the same family as smallpox viruses. Mpox has historically occurred mainly in Central and West Africa, but since May 2022, there has been an increase in mpox infections in many parts of the world where the illness has not previously been seen. Local transmission of mpox Clade IIb has occurred in Queensland and interstate. Mpox is mainly spread through very close or intimate contact with someone infected with mpox¹.

Mpox on the Gold Coast

Mpox cases have been increasing in the Gold Coast area. Cases to date have been largely unrelated and likely acquired locally, hence it is expected that cases will continue to rise. All cases to date in Queensland have been among gay, bisexual men and other men who have sex with men.

Identify your patients that are eligible for primary preventative vaccination (PPV)

Clinicians should identify patients that are eligible for preventative vaccination. In Queensland, mpox vaccination is free (a Medicare card is not required) and recommended for the following groups¹:

• all sexually active gay, bisexual and other men who have sex with men (cis and trans) and their sexual partners (including anonymous or intimate contacts)
• sex workers
• people living with HIV who are at risk of exposure to mpox
• people whose occupations might put them at increased risk, including, but not limited to:
  • sex-on-premises venue staff
  • laboratory staff who analyse mpox specimens, based on a local risk assessment
  • healthcare workers at higher risk of exposure to individuals with mpox, including workers in primary care, sexual health clinics, hospital staff and others, based on a local risk assessment. The risk of transmission should also be minimised by using appropriate infection control measures.

Mpox vaccination is not recommended as a routine travel vaccine, including for travel to endemic Africa where clade Ib is circulating, unless an individual has current eligibility for an mpox vaccination in Queensland. Travellers should be aware of the risk of mpox if travelling overseas where cases have been reported.

Two doses of the vaccine, given subcutaneously at least 28 days apart are required for best protection against mpox.

Be aware that patients may be referred for post-exposure preventative vaccination (PEPV)

Vaccination will be offered to high-risk close contacts if identified, available and clinically

appropriate, ideally within 4 days. Vaccinated contacts may still develop mpox however are likely to experience milder disease.

Administering the mpox vaccine
Currently, JYNNEOS® is the preferred mpox vaccine for use in Australia for patients 16 years and older. Jynneos is currently provided as under s19A of the TGA Act. Jynneos is a modified vaccinia virus Ankara – Bavarian Nordic (MVA-BN). The vaccine is made using weakened live vaccinia virus and cannot cause smallpox or mpox.  Jynneos must only be administered by subcutaneous injection. The preferred site is over the deltoid².

For more information including contraindications and precautions see: Mpox (previously known as monkeypox) | The Australian Immunisation Handbook (health.gov.au) and ATAGI interim statement on the use of vaccines for prevention of mpox in 2024 | Australian Government Department of Health and Aged Care

Queensland Health mpox vaccine provider finder³ can be found here: https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/immunisation/monkeypox-vaccination-centres

If your service would like to register to be a mpox vaccine provider, please contact QHIP-ADMIN@health.qld.gov.au.

References:

1. Queensland Health. Mpox (previously known as monkeypox) Fact Sheet. Updated 16 July 2024. Accessed 6 September 2024. Available from: https://www.qld.gov.au/health/condition/infections-and-parasites/viral-infections/mpox-monkeypox
2. Australian Immunisation Handbook. Administration of vaccines. Updated 16 August 2024. Accessed 20 September 2024. Available from: https://immunisationhandbook.health.gov.au/contents/vaccination-procedures/administration-of-vaccines
3. Queensland Health. Mpox (monkeypox) vaccination centres. Queensland government. Updated August 7, 2024. Accessed September 5, 2024. Available from: https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/immunisation/monkeypox-vaccination-centres