Monkeypox virus (MPXV) causes MPOX. A ‘global outbreak’ of infections and disease became noticeable in 2022. The MPOX outbreak continues, and below is an update on the ongoing MPOX cases detected in Australia, driven by an uptick in local transmission.

This electron microscopic (EM) image depicts MPXV particles obtained from a clinical sample associated with the 2003 prairie dog outbreak. It was from a thin-section image of a human skin sample. On the left can be seen mature, oval-shaped virus particles, and on the right are the crescents and spherical particles of immature virions. From the CDC PHIL.[1]

MPOX symptoms mostly occur within a week but can sometimes appear up to 3 weeks after exposure. Symptoms can include rash, fever, sore throat, headache, muscle aches, back pain, low energy and swollen lymph nodes.[6] Some people may develop a lot of blisters; some may have very few. Blisters follow the rash and can appear anywhere, including the palms of hands, soles of feet, face, mouth, throat, groin and genital areas and the anus. Transmission occurs via contact with infectious lesions. Most people recover, but some can get very sick.

The latest Australian National Notifiable Diseases Surveillance System (NNDSS) fortnightly summary for selected diseases spans 8 July to 21 July 2024.[2] It was published 2 August.

I had a look at the MPOX numbers. I thought it might be useful for my international readers to see that the MPOX global outbreak certainly does roll on. And yes, global means lots of countries—even Australia.

The MPOX part reviewed the previous 12 months (22 July 2023 – 21 July 2024) and noted that 160 cases of MPOX had been notified to the NNDSS. Of those, 134 (84%) had occurred in the past 3 months.

Because I apparently can’t help myself, I’ve made my own version of the graph on the NNDSS page using their data (thanks for making these numbers public).

Monkeypox virus (MPXV) notifications to NNDSS, Australia, Australia. Data from NNDSS. VDU made the graph using Excel.

NNDSS adjusted for population size in each of the 8 Australian States and Territories. We can see that the Australian Capital Territory (ACT—where the Capital, Canberra, is located for out-of-towners), New South Wales (NSW; where Sydney is), and Victoria (VIC; where Melbourne is) have the highest rates of notification.

This distribution doesn’t follow the population size, which is NSW > VIC > QLD > SA > WA > TAS > NT > ACT.[4]

I’m not clear how proactive and effective each jurisdiction is at case finding. And I’m not sure how much testing they are each doing for MPXV. These can impact the number of cases missed.

Monkeypox virus (MPXV) notification rate per 100,000 population by State and Territory, Australia. Data from NNDSS. VDU made the graph using Excel.

Maybe the World Health Organization (WHO) closed out the MPOX Public Health Emergency of International Concern (PHEIC) [3] a bit prematurely.

However, a new PHEIC is being considered as the Democratic Republic of the Congo’s ongoing epidemic has been spiling over into other African nations. ALso, MPOX cases continue to be found in countries around the world.[5]

Perhaps the WHO just trusted too much in the world to make…

..sustained efforts in a transition towards a long-term strategy to manage the public health risks posed by mpox, rather than the emergency measures inherent to a public health emergency of international concern
Pan American Health Organization.[3]

References

Virology Down Under

Facts, data, info, expert opinion and a reasonable, occasionally grumpy, voice on viruses: what they are, how they tick and the illnesses they may cause.

Update on Monkeypox virus (MPXV) transmission in Australia

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