The Monash University professor suspects this reflects different acquisition routes for the virus in Australia, where it is fuelled by intimate and sexual contact, compared with places such as Africa, where monkeypox is considered endemic and transmission has been reported via more fleeting contact.
While the vast majority of cases in Australia’s outbreak are in men who have sex with men, monkeypox can affect anyone who comes into close contact with a case.
Chen said some patients had needed heavy painkillers, such as opioids, while others required hospital treatment for a secondary bacterial skin infection, known as cellulitis, and were admitted for intravenous antibiotics.
Chen had also overseen several severe cases where the powerful antiviral Tecovirimat – which requires a sign-off from the chief health officer – has been required. This treatment has been provided to five Victorian patients.
“Fortunately, all of these cases we’ve referred to hospital have got better,” Chen said.
But worryingly, he said, many patients were unaware they had been exposed to monkeypox. Because the virus so often resembled sexually transmitted infections (STIs), staff at his clinic were now testing for monkeypox in any person who showed signs of common sexually transmitted diseases.
It is a ramp-up in testing that he wants all GPs and clinicians nationally to mirror.
“We learnt very quickly to not only test for herpes and syphilis but also monkeypox in that same swab,” Chen said. “We have been surprised to find in several cases the swab has come back as monkeypox when we thought it was a different STI.”
Chen said the clinic had administrated more than 500 vaccines to those at highest risk of contracting the virus. “The vaccines were used up very, very quickly. Demand is huge.”
There are 16 active cases in Victoria and eight people across the state have been hospitalised. A Victorian Health Department spokesman said the numbers of infections had stabilised in the past week.
According to the state government’s most recent infectious disease surveillance report, all Victorian cases of monkeypox to date have been in males aged 20 or older.
Those eligible for a monkeypox vaccine in Australia include close contacts of people infected with the virus, such as intimate partners and people who live in the same household. National health authorities continue to evaluate how to ration scarce vaccine supplies amid a global shortage.
Typically, monkeypox causes fever, chills, rash and lesions on the face or genitals. Most people recover within several weeks without requiring hospitalisation.
Those diagnosed should isolate at home for three weeks and ensure all lesions have cleared up before they have sex, and use condoms for eight weeks after infection.
Australia has acquired 450,000 doses of the new third-generation monkeypox vaccine, including 78,000 due to arrive in the last quarter of this year and 350,000 next year.
Victoria is expected to receive thousands of new doses in October.
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