Information for GPs
1. Local transmission of mpox has been reported in Victoria and Queensland
2. Encourage men who have sex with men (MSM) to have two doses of mpox vaccine to
ensure they are fully vaccinated
3. Test for mpox in MSM with a compatible illness, even if fully vaccinated

Current situation
• Mpox clusters, including local transmission, have been reported in MSM in Victoria and Queensland
• Two doses of mpox vaccine (JYNNEOS) are required for optimal protection. Approximately 24% of
people vaccinated for mpox in NSW have only received one dose
Vaccination
• Mpox vaccine (JYNNEOS) is recommended for:
o All gay and bisexual men (cis and trans) and their sexual partners
o Sex workers
o People living with HIV or immunocompromised, if at risk of mpox exposure
• Encourage people who have only received one dose to present for their second dose as soon as
possible, regardless of how long ago their first dose was (provided at least 28 days have passed)
• Vaccination is free. Find a vaccine clinic at health.nsw.gov.au/mpox-clinics
Clinical presentation
• Vesicular rash at the site of infection – often in the genital area but can be any part of the body
• Prodrome with fever, malaise, myalgia, lymphadenopathy – prodrome may not occur
• Painful proctitis can occur without visible lesions
• People who have been vaccinated or previously infected may present with an attenuated illness
Testing
• Test MSM with compatible signs or symptoms, regardless of vaccination status and travel history
• Test heterosexual people with anogenital lesions where other causes have been excluded
• Wear a surgical mask, gown, and gloves while examining and taking swabs
• Collect lesion fluid from a deroofed pustule or vesicle using a dry swab; consider swab lesions with separate swabs. If no fluid-filled vesicles/pustules are present send lesion tissue or
crusts in a dry container. A dry anorectal swab can be sent for patients with anal symptoms. Request
PCR testing for mpox, herpes simplex virus (HSV) and lymphogranuloma venerum (LGV)
• Perform a full HIV and STI screen (separate swabs required) as coinfection is common
• For further testing advice: https://sti.guidelines.org.au/sexually-transmissible-infections/monkeypox/
Advice to provide at the time of testing:
• If mpox is strongly suspected; provide the mpox fact sheet: health.nsw.gov.au/mpox-cases
• Avoid sexual activity and do not share bedding, towels, clothing, unwashed crockery and cutlery
until test results available and cover all lesions with a dressing or clothing
Further information
• For further information, see health.nsw.gov.au/mpox
• Contact your local sexual health clinic or call Sexual Health Information Link (SHIL) (1800 451 624
- Monday to Friday 9am - 7pm) and select option 1 to be prioritised for health professional support