Health advocates are urging the federal government to approve and secure supply of a second vaccine for monkeypox amid fears of rising cases in Australia.
Over the weekend, the World Health Organization declared the monkeypox outbreak a public health emergency of international concern — the United Nations' highest level of alert.
There are more than 16,000 cases in 75 countries, including more than 40 in Australia.
There are two types of smallpox vaccines that can be used for monkeypox, but only one of them — ACAM2000 — is available in Australia and it can be risky for patients who are immunocompromised, like those with HIV, for example.
It's currently only recommended for healthcare workers or anyone at high risk of exposure and considered for close contacts of positive cases.
Heath advocates are calling for the federal government to approve and secure a supply of the other vaccine, the MVA vaccine known as Jynneos/Imvanex/Invamune, which is widely being used in the United States and Europe.
The Australian Federation of AIDS Organisations' Heath Paynter says its rollout also needs to be targeted.
"What we're asking for is for a supply of the vaccine, and then for ATAGI to recommend access to the vaccine for all gay and bisexual men who are at risk of monkeypox," he said.
So far, more than 98 per cent of cases have been in men who have sex with men.
Mr Paynter says gay and bisexual men are particularly vigilant about their health and the health of their communities, given the right information.
"What they want to do is to be able to have access to the tools and strategies to protect their own health and to protect the health of their communities," he told 7.30.
"And I think it's the concern about having those tools available which is driving fears and concerns here in Australia."
With Sydney set to host World Pride in February, there are concerns that without adequate vaccine supply it could become a superspreader event.
"We need to have rapid access to the vaccine, and we need to be able to scale vaccine coverage to all gay and bisexual men," Mr Paynter said.
"We need to have these measures in place before summer, and particularly before next February and March when Sydney hosts World Pride."
In a statement, a spokesperson for Health Minister Mark Butler said that securing supply and the relevant approvals for new vaccines for monkeypox was a priority.
They said the TGA was yet to receive an application for the second vaccine option but would prioritise its evaluation as soon as it did.
'I was crying going to the bathroom'
Like COVID before it, New York City has been the epicentre for the monkeypox outbreak in the United States.
Mark Hall spent more than three weeks in isolation with the virus after contracting it at New York's Pride event in June.
"It looked like an ingrown hair. I really didn't think anything of it," he told 7.30.
"Couple of days later there were two more in that same area. And I looked at them and I was like, wow, this is a little bit strange. I think that this might be monkeypox."
Those initial spots quickly spread and were joined by a headache and fever.
"I developed some lesions in my urethra, which were really, really painful. I just felt it was incredibly painful.
"I know that I have to urinate and I'm anticipating that and I'm crying on the way to the bathroom."
Even after noticing the symptoms, Mr Hall struggled to get tested due to a local supply shortage.
"When I got tested a few weeks ago the city of New York was able to run about 10 people per day and it would take several days for my results to come back," he told 7.30.
"And one of the big problems with that is that there's a four-day window of exposure to vaccination, where you can prevent people from getting monkeypox once they've been exposed.
"But that whole window had already closed for everybody that I had had contact with."
Mr Hall hopes Australia can learn from and avoid what has happened in the United States, which has also seen long queues for vaccines.
"If there's education, if there's testing, if there's vaccines that are available, then I think it's not going to be a problem. I think we can get control of this quickly," he said.
"We still are able I think to do that, but if not, it's going to be a big issue."
Hopes for eradication but 'it may take time'
Associate Professor Fasseli Coulibaly is the laboratory head at Monash University's Biomedicine Discovery Institute.
He said while people should monitor for symptoms, there was no cause for alarm.
"These viruses have been around for a very long time. We know of human diseases caused by monkeypox since the 1970s," he told 7.30.
"It is spreading more than we have anticipated, more than we've seen before, so the virus seems to be behaving differently from previous outbreaks.
"But [there is] hope from what we know of smallpox that we can have strategies to eradicate it. We have eradicated smallpox, which is caused by the variola virus.
"The tools are still there, vaccines, a couple of drugs, and so there are approaches [but] it may take time."
So far, there have been fewer than 10 deaths in the current outbreak and Dr Coulibaly says most people will have relatively mild symptoms.
"Monkeypox has had a case fatality ratio of 1 per cent. What we're seeing here, and that's good news, is that it's much lower than this currently," he told 7.30.
"The disease seems to be quite mild and doesn't cause deaths in the vast majority of cases, but the symptoms can be quite painful.
"So it's really important to get diagnosed, it's really important to act. You shouldn't let it fester if you might have been contaminated.
"But there's not the same level of concern as previous outbreaks of monkeypox or even smallpox. It's nowhere near these levels."
Paid leave for monkeypox sufferers
Advocates are also urging the federal government to consider a paid leave scheme for those who need to isolate due to monkeypox.
The current advice is that people with probable or confirmed monkeypox should isolate until all lesions have cleared up to prevent further spread of the disease, which can take weeks.
Heath Paynter says isolation will be an important part of the response to the outbreak.
"People will need to be supported to take the multiple weeks of leave they will need to properly recover from monkeypox," he told 7.30.
"And this will need support from government for people who are in casual employment.
"But it also needs employers to be flexible with people who do have sick leave to ensure that they can take the leave, they need to fully recover from monkeypox."
The ABC has contacted Emergency Management Minister Murray Watt for comment.
Watch this story on 7.30 on ABC TV and ABC iview.
