The government is now operating in accordance with the Guidance on Caretaker Conventions, pending the outcome of the 2025 federal election.

Mpox for health professionals

Mpox is caused by monkeypox virus (MPXV). It is a nationally notifiable disease. We monitor and report on national case numbers and epidemiological trends. We publish case definitions and national guidelines to support health professionals and health authorities.

For health professionals For everyone

Disease

  • MPXV is an enveloped, double-stranded deoxyribonucleic acid virus of the genus Orthopoxvirus, which also includes variola virus (which causes smallpox).

    MPXV has 2 distinct genetic clades – I and II, each with 2 subclades – a and b. 

    The natural reservoir of MPXV is unknown. The virus has been isolated from several species of African rodents and primates.

    Read more about the different clades of MPXV.

  • Mpox is usually self-limiting with symptoms lasting 2 to 4 weeks.

    The illness may start with prodromal symptoms including: 

    A maculopapular rash usually appears 1 to 5 days after the fever starts. It can be widespread or localised.

    The rash progresses through several stages:

    • flat spots (macules) 
    • raised bumps (papules)
    • clear fluid-filled blisters (vesicles)
    • pus-filled sores (pustules). 

    These sores eventually crust over and scab, usually within 14 to 21 days. They often leave behind scars. 

    The mpox rash can involve very few or no visible lesions, especially for clade IIb infections. When sexually acquired, lesions might only appear in the oral or anogenital regions. 

    Mpox can cause severe pain, especially if lesions are in sensitive areas like the mouth or rectum. 

    Complications of mpox can include: 

    Reinfections and infections in vaccinated people can occur, but the clinical presentation might be milder.

    Read more about the clinical features of mpox.

Public health importance

  • Mpox can spread widely and cause severe illness, particularly in children and people who are immunocompromised.

    The World Health Organization (WHO) has declared mpox a Public Health Emergency of International Concern twice since 2022. This is due to changes in disease epidemiology, including increasing case numbers and spread to new countries. 

    Over time, the virus that causes mpox has mutated to spread more easily between humans. Surveillance and prevention activities, including vaccination and public health communications, help control outbreaks and protect priority populations. 

    Mpox primarily spreads through close contact, including sexual contact, and can spread quickly through sexual networks. Anyone who is exposed to mpox can be infected. 

    In Australia, a high proportion of cases have been among gay, bisexual and other men who have sex with men.

    Reducing stigma around mpox infection is an important public health priority to ensure priority populations and people exposed to mpox:

    • have access to appropriate and accessible information and support
    • seek testing and treatment
    • can access mpox vaccination. 

  • Since 2022, a global outbreak of mpox clade IIb has resulted in more than 100,000 cases in 127 countries. Many cases in this outbreak have been in males, primarily gay, bisexual and other men who have sex with men.

    Since late 2023, an outbreak of clade Ib cases has been reported in the Democratic Republic of the Congo and neighbouring countries. Cases have been reported in several countries outside Africa, among people who travelled to epidemic regions.

    Globally, infections with clade Ia have been associated with higher mortality rates than other subtypes.

    In Australia:

    • the first mpox cases were reported in 2022
    • 144 cases were reported during a 2022 outbreak
    • more than 1,400 cases were reported during a 2024 outbreak
    • cases have all been MPXV clade IIb
    • most reported infections have been acquired in Australia.

    For the latest information on cases of mpox in Australia see the National Communicable Disease Surveillance data visualisation tool.

    See more global mpox case data, including deaths.

Spread of infection

  • Mpox mainly transmits directly through close or intimate contact with an infected person. This can be through broken skin or via mucous membranes in the: 

    • respiratory tract – including nose and mouth
    • conjunctiva
    • genitalia
    • perianal region.

    This includes through sexual contact.

    It can also be spread through:

    • indirect contact via materials or objects contaminated with the virus, such as towels, clothes or bed linen
    • respiratory droplets, particularly during prolonged face-to-face contact
    • other body fluids, such as blood or semen
    • aerosol generating procedures and aerosol dispersing activities 
    • vertical transmission 
    • contact with animals.

  • The incubation period ranges from 3 to 21 days.

    A very small proportion of people might develop symptoms after 21 days from exposure.

  • People can be infectious from 4 days before the onset of symptoms until both:

    • symptoms have resolved
    • all scabs have fallen off and a fresh layer of skin has formed. 

    This normally takes 2 to 4 weeks.

    People with no visible lesions are considered infectious until 21 days after the start of their symptoms, provided all symptoms have resolved.

    Asymptomatic people are considered infectious for 21 days after a positive test. 

Priority populations

  • Mpox poses a greater risk of severe illness for people who are:

    • unvaccinated
    • immunocompromised
    • living with poorly controlled HIV infection 
    • pregnant
    • children.

    Children aged less than 10 years are at higher risk of:

    • more extensive skin lesions
    • complications such as secondary bacterial infections
    • severe disease and poor outcomes.

    Pregnant people with mpox are at higher risk of miscarriage and stillbirth.

    Read more about mpox in:

  • People are more likely to be exposed to mpox if they:

    • live in the same house as an infected person
    • travel to areas where mpox is endemic 
    • work with orthopoxviruses in a laboratory 
    • are caring for mpox cases or handling contaminated items, such as healthcare workers.

    When mpox is circulating in the community, people may be at greater risk of exposure if they are:

    • gay, bisexual and other men who have sex with men (GBMSM), including transgender and gender-diverse people
    • any gender and have sex with people who are GBMSM
    • sex workers.

    See what measures can prevent mpox infection.

  • Mpox can spread in settings where there is likely to be close, sustained physical contact between people.

    These include:

    • households 
    • venues that offer sex-on-premises
    • parties or other social events where intimate contact occurs
    • healthcare settings where mpox cases are being cared for. 

    Aboriginal and Torres Strait Islander communities might be at greater risk of spread due to:

    • overcrowded housing
    • reduced access to healthcare. 

    Depending on the nature of cases and disease spread, public health units may take extra steps to reduce the risk to people in the community. Community actions must be co-designed and culturally appropriate.

Prevention

  • Primary preventive vaccination is recommended for people at greater risk of exposure to mpox, including:

    • sexually active gay, bisexual and other men who have sex with men (GBMSM)
    • sex workers
    • people living with HIV, if they are at risk of mpox exposure
    • people who work in a laboratory with orthopoxviruses
    • people of any sexual orientation or gender identity travelling to countries with transmission of MPXV clade I, who may undertake sexual risk activities.

    Primary preventive vaccination can also be considered for:

    • healthcare or humanitarian workers at risk of occupational exposure to mpox
    • sexual partners of:
      • GBMSM
      • sex workers
      • people living with HIV.

    Post-exposure preventive vaccination may be offered to contacts of an mpox case to reduce their risk of becoming infected.

    See the Australian Immunisation Handbook for more information about mpox vaccination and what is available in your state or territory.

  • When mpox is circulating in the community, prevention measures include: 

    • educating people on the symptoms of mpox and what to do if they develop them
    • advising people to:
      • use barrier methods such as condoms during sex – but be aware they may not prevent transmission
      • avoid close contact with anyone with mpox or mpox symptoms
      • exchange contact information with sexual partners to assist with contact tracing 
      • avoid sex-on-premises venues or events where intimate contact occurs
      • follow Smart Traveller guidance if considering travel to a country where mpox is endemic.

  • People at greater risk of exposure should:

    See more mpox resources.

Diagnosis and clinical management

Notification and reporting

Public health response

  • The CDNA national guidelines for public health units inform the public health response to mpox, including how mpox cases, contacts and outbreaks are managed.

  • Public health units urgently investigate all confirmed, probable and suspected mpox cases. The public health management of cases focuses on:

    • identifying the likely source of infection 
    • assessing the likelihood of MPXV clade I infection
    • identifying any contacts
    • preventing transmission.

    Public health units generally advise people with mpox to:

    • avoid close or intimate contact with others, including all sexual activity
    • avoid contact with animals
    • keep lesions covered with a waterproof dressing when around people or animals
    • avoid entering high-risk settings such as health and aged care settings, unless seeking medical attention
    • wear a mask when around other people or animals if they have lesions in the mouth or any respiratory symptoms
    • avoid contact with people who are at higher risk of severe disease
    • practice careful hand and respiratory hygiene.

    To help prevent spread of mpox within households, people with mpox should:

    • limit contact with other household members as much as possible
    • sleep in a separate bedroom and use a separate bathroom, if they can
    • not share clothing, bedding or towels
    • clean and disinfect any shared spaces or items after use.

    Public health units may recommend extra precautions, such as isolation, where there is a reasonable suspicion of infection with MPXV clade I.

    The public health unit or treating clinician will advise the person when they have been cleared to resume normal activities. 

    For 12 weeks after clearance, people who have had mpox should:

    • wear a condom during all types of sexual activity
    • not donate blood, cells, organs, breastmilk, tissue or semen.

  • Public health units undertake contact tracing to:

    • identify all potential contacts
    • provide advice and public health education
    • provide post-exposure preventive vaccination, if appropriate.

    Post-exposure prophylaxis (PEP) may be offered to contacts of an mpox case to reduce their risk of becoming infected. This may involve vaccination or antiviral medication.

    Read more about PEP with vaccination and antiviral medications.

    Other contact management actions may include:

    • monitoring for mpox symptoms
    • urgent testing if symptoms develop
    • vaccination (if not already fully vaccinated)
    • advice to:
      • abstain from sexual activity for 21 days from the last exposure
      • avoid contact with people at increased risk of severe disease
      • not donate blood, cells, tissue, breast milk, semen or organs
      • avoid high-risk settings, such as childcare and aged care facilities, where possible.

    Exclusions and restrictions may apply for workers in some high-risk settings.

    Public health units may recommend extra precautions, such as advice to work from home, where there is a reasonable suspicion of contact with a case infected with MPXV clade I.

  • The way public health units respond to mpox outbreaks depends on the setting and nature of the outbreak.

    In some special situations and high-risk settings, specific control measures, including post-exposure preventive vaccination, may be implemented to manage outbreaks.

    Enhanced infection prevention and control measures may also reduce the risk of transmission. This may include:

    • ensuring access to handwashing facilities 
    • providing training in the use of appropriate personal protective equipment 
    • increasing cleaning and disinfection
    • laundering or disposing of soiled items.

  • Extra public health actions may be implemented in some special situations and high-risk settings when mpox is circulating in the community or a case is identified. These include:

    Prevention and control measures in these settings can include:

    • providing information about mpox and its symptoms
    • asking people who were at the venue to monitor for symptoms and get tested if they develop symptoms
    • considering post-exposure preventive vaccination
    • tailored health education and messaging.

    See the CDNA National guidelines for public health units for more information.

Resources

We are adding new content to this website and expanding these pages, including a suite of disease-related information. In the meantime, information about diseases in Australia is available on the Department of Health and Aged Care’s website. 

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