Australia has declared monkeypox a “communicable disease incident of national significance” and has updated guidelines for who should get immunised ahead of newer vaccines being made available.
On Thursday the chief medical officer, Paul Kelly, revealed that there have been 44 cases of the disease in Australia, mostly in returned international travellers, people aged 21 to 40 years and men who have sex with men.
Following a declaration by the World Health Organisation earlier in July labelling monkeypox a public health emergency of international concern, Australia declared it a communicable disease incident of “national significance”.
The declaration means the response to monkeypox will have national coordination, in order to assist states and territories with outbreaks.
The Australian Technical Advisory Group on Immunisation [Atagi] also updated its clinical guidance on vaccination against monkeypox to include the use of a MVA-BN vaccine named Jynneos to prepare for supplies arriving in Australia.
“Limited supplies of … [MVA-BN Jynneos] have been secured by the commonwealth and some states and territories,” it said. It is unclear if these supplies have arrived in Australia, with demand high globally.
The health minister, Mark Butler, told Guardian Australia earlier this week that the federal government had “been actively pursuing supplies of the third-generation vaccine MVA-BN well before the WHO declaration was made, recognising there is limited supply and significant global demand”.
Health stakeholders believe an announcement of a supply deal for the newer vaccination is imminent.
Monkeypox can also be prevented with a smallpox vaccine, ACAM2000, which is registered for use in Australia and contained in the national medical stockpile, but that vaccine uses a weakened live pox virus called vaccinia, making it unsuitable for the immunocompromised. Jynneos has been recommended as the preferred vaccine, saying it can be administered to the immunocompromised, pregnant women, children and those with skin conditions.
Heath Paynter, the deputy chief executive officer of the Australian Federation of Aids Organisations, said the government needs to “implement policies to arrest the virus and to prevent it becom[ing] endemic”.
“Fundamental to this is to obtain a supply of vaccines for gay and bisexual men at risk of monkeypox,” he told Guardian Australia.
“It is our expectation the government will acquire and supply MVA-BN, which is the only vaccine that is safe and effective.”
“It is the only acceptable option,” he said, labelling ACAM2000 “inferior”.
“Australia has a golden opportunity to step in and stop monkeypox in its tracks, but it could quickly evaporate, and once it does – it’s lost, as we’ve seen in Montreal, London, New York and Madrid, cities with hundreds of cases of community transmission.”
Atagi advice states that “For healthy non-pregnant adults, where Jynneos is not suitable or not available, ACAM2000 has an established profile and may be considered” for those exposed to the virus or at high risk of exposure.
In his update, Kelly said according to the US Centers for Disease Control and Prevention, from 1 January to 28 July there had been 20,311 monkeypox cases in 71 countries that have not historically reported it, including Australia.
The fact most cases have been in returned travellers indicates community transmission in Australia has been limited.
Despite the declaration on Thursday, Kelly said it was important to note monkeypox “is far less harmful than Covid-19 and there have been no deaths reported during the current outbreak outside of countries where the virus is endemic”. Monkeypox is “far less transmissible” than Covid-19, he said.
Monkeypox results in rashes and flu-like symptoms which Kelly said are “relatively mild, and in most cases, resolve themselves within two to four weeks without the need for specific treatments”.
“Although monkeypox is not usually considered a sexually transmissible infection, physical contact with an infected person during sexual intercourse carries a significant risk of transmission and intimate physical contact such as hugging, kissing and sexual activities represent a risk of infection, with infectious skin sores being the likely mode of transmission,” he said.
“The rash usually occurs on the face before spreading to other parts of the body, including the palms of the hands and the soles of the feet. However, in this outbreak it is being seen especially on the genital and perianal regions of affected people.”
Kelly said since May the Department of Health had worked with at-risk communities, states and territories to ensure “our response to MPX [monkeypox] has been swift and coordinated”.
The national medical stockpile has available stock of monkeypox treatments, such as antivirals, for states and territories to access on request, he said.
