Information for GPs and clinicians in NSW – please distribute to all staff
Mpox is increasing across NSW
• 236 notifications of mpox in NSW since mid-June
• All cases are male, almost all are MSM
• All cases in NSW are consistent with clade IIb
• Transmission in both Sydney and regional NSW
• 13 people hospitalised
• Risk of mpox spreading to other population
groups in NSW and of importation of the
potentially more serious clade Ib strain from Africa
Mpox can mimic other conditions (e.g. herpes,
syphilis, tonsilitis, haemorrhoids)
• Presentations vary and include: 1-2 lesions, disseminated lesions, proctitis without visible lesions
• When present, lesions are usually on the anogenital area or mouth, but can occur anywhere
• Only some cases have a prodrome (fever, malaise, myalgia, and/or lymphadenopathy). Ask people
with only the prodrome to return for testing if they develop further mpox symptoms
Test all sexually active people with symptoms
• Test if symptomatic, regardless of vaccination status, sexual orientation or travel history
• Most at risk are: MSM (or undisclosed MSM exposures), sex workers and partners of these groups
• If testing for herpes simplex virus (HSV), test for mpox. It is preferable to collect a separate
swab for mpox testing and store in a dry transport tube.
• Wear PPE, including gown, gloves, surgical mask, and eye protection
• For further testing advice: https://sti.guidelines.org.au/sexually-transmissible-infections/monkeypox/
• Advise patients to cover all lesions and abstain from sex while awaiting the result
• If positive, the public health unit (PHU) will contact the person with further advice. Please advise patients

of this when testing.
Check MSM have had both doses of vaccine and encourage vaccination for those at risk
• Vaccination is recommended and available at no cost to all gay, bisexual men and sex workers, and
their sexual partners. Find a vaccine clinic: health.nsw.gov.au/mpox-clinics
• People who are not fully vaccinated and report sexual or other close contact with someone with
mpox should be offered post-exposure preventive vaccination (PEPV). health.nsw.gov.au/mpox-pep
• There have been no hospitalisations in people who have received two vaccinations
Clade Ib circulating in Africa, Public Health Emergency International Concern (PHEIC) declared
• If mpox is suspected in a returned traveller or someone who has had contact with a returned
traveller from Africa, call the PHU immediately on 1300 066 055
• See countries with clade Ib: https://worldhealthorg.shinyapps.io/mpx_global/#32_Recent_trends
• Mpox is not recommended as a travel vaccine, unless already in an eligible group in NSW as
described here: https://www.health.nsw.gov.au/Infectious/factsheets/Pages/mpox-travel.aspx
Further advice
• A GP webinar is scheduled for 30th September. https://www.racgp.org.au/racgp-digital-eventscalendar/online-event-items/webinars/stay-ahead-in-sexual-health-navigating-mpox-and-do
• Additional information: health.nsw.gov.au/mpox
• Your local sexual health clinic (health.nsw.gov.au/sexual-health-clinics) or Sexual Health Info Link
on 1800 451 624, Monday to Friday 9am - 7pm; select option 1 for health professionals.
Dr Jeremy McAnulty, Exec Director, Health Protection NSW