Mpox

Mpox, previously called monkeypox, is an infection cause by the mpox virus.

Mpox usually causes a rash or skin lesions. These may look like spots, bumps, blisters, ulcers or sores. They can appear anywhere on the body, including the face, mouth, hands, genitals, anus or around the anus.

For most people, mpox is mild and settles on its own within 2 to 4 weeks. Some people can become more unwell, especially people who are pregnant, immunocompromised, or have severe pain, eye symptoms, or infected skin lesions.

More information can be found on the Burnett Foundation website.

Mpox does not spread easily. It usually passes on through close physical contact with someone who has mpox, especially direct skin-to-skin contact with mpox lesions or scabs.

This can happen through:

• Sex or intimate contact
• Touching mpox lesions, scabs, or bodily fluids
• Kissing or close face-to-face contact
• Sharing sex toys
• Contact with clothing, towels, bedding, or other items used by someone with mpox lesions.

Mpox can affect anyone. In Aotearoa New Zealand, mpox has mostly affected gay, bisexual, takatāpui and other men who have sex with men, and people who have sex with people in these groups. People with multiple sexual partners may have a higher risk.

Symptoms usually start 1 to 3 weeks after exposure.

Symptoms may include:

• Fever
• Swollen glands
• Headache
• Muscle aches
• Chills or tiredness
• A rash, spots, blisters, ulcerse or sores
• Pain, bleeding or discharge from the anus
• Pain when passing urine
• Swelling of the foreskin.

Some people have flu-like symptoms before the rash. Others may only notice one or a few lesions, including on the genitals, anus or in the mouth.

For most people, mpox is mild and settles on its own within 2 to 4 weeks.

However, mpox can be painful, and some people can become more unwell or develop complications. This is more likely for people who are immunocompromised, pregnant, very young, or who have severe symptoms.

Seek medical advice urgently if you have:

• Severe pain
• Eye pain, eye redness or changes in vision
• Difficulty passing urine or opening your bowels
• Lesions that are becoming more red, hot, swollen or painful
• Symptoms that are getting worse
• Fever or feeling very unwell
• Concerns about pregnancy or a weakened immune system.

Even when mpox is mild, it is important to get advice because it can spread through close contact while you are infectious.

If you think you may have mpox, stay home and contact a sexual health clinic, GP, hauora provider, or Healthline on 0800 611 116 for advice.

Call before attending in person so the clinic can advise you what to do and reduce the risk of passing mpox on to others.

Testing usually involves taking a swab from a lesion or from an area where you have symptoms. Other swabs may be taken depending on your symptoms.

In New Zealand, mpox is a notifiable disease. This means public health services may contact you if you test positive, to provide advice and help identify anyone else who may have been exposed.

Most people do not need specific antiviral treatment. Treatment usually focuses on managing symptoms while the infection clears.

This may include:

• Pain relief such as paracetamol or ibuprofen
• Fluids and rest
• Keeping lesions clean and covered
• Medication for itch if needed
• Warm baths or saltwater rinses if lesions are painful
• Stool softeners if passing bowel motions is painful.

Seek urgent medical advice if symptoms are getting worse, pain is difficult to manage, lesions become red, hot, swollen or increasingly sore, or you feel very unwell.

Some people with more severe illness or higher risk of complications may need specialist care or hospital treatment.

The best way to reduce the risk of mpox is to avoid close physical or sexual contact with someone who has mpox symptoms.

If you have mpox, avoid sexual contact, intimate touching and sharing sex toys until all lesions have healed completely. This means the scabs have fallen off and afresh layer of skin has formed underneath.

You should also:

• Cover lesions when around others
• Wash your hands often
• Avoid sharing towels, bedding, clothing or sex toys
• Clean shared surfaces
• Avoid close contact with people at higher risk of severe illness, including pregnant people, young children and people who are immunocompromised.

The mpox vaccine is available for eligible people in Aotearoa New Zealand. Vaccination reduces the risk of mpox and can reduce complications if infection occurs, but it does not remove the risk completely.

Because mpox virus may remain in semen for a time after symptoms have settled, condoms are recommended during sex for 12 weeks after symptoms have resolved.

If you are diagnosed with mpox, public health or sexual health services will talk with you about who may need to be contacted. This can include people you have had sexual, intimate, or close physical contact with, and people you live with.

Your privacy will be protected. Public health staff can help you decide the best way to let contacts know, and your personal details will not be shared without discussion.