2022–2023 monkeypox outbreak in Australia
# 2022–2023 monkeypox outbreak in Australia

The 2022 monkeypox outbreak in Australia is a part of the outbreak of human monkeypox caused by the West African clade of the monkeypox virus. The outbreak reached Australia on 20 May 2022. By 28 October 2022 there were over 140 confirmed cases. The Chief Medical Officer of Australia stood down the country's Communicable Disease Incident of National Significance declaration on 25 November 2022.

## Background

Mpox (formerly known as monkeypox) is an infectious viral disease that can occur in humans and some other animals. Symptoms include fever, swollen lymph nodes, and a rash that forms blisters and then crusts over. The time from exposure to onset of symptoms ranges from five to twenty-one days. The duration of symptoms is typically two to four weeks. There may be mild symptoms, and it may occur without any symptoms being apparent. The classic presentation of fever and muscle pains, followed by swollen glands, with lesions all at the same stage, has not been found to be common to all outbreaks. Cases may be severe, especially in children, pregnant women or people with suppressed immune systems.

The disease is caused by the monkeypox virus, a zoonotic virus in the genus Orthopoxvirus. The variola virus, the causative agent of smallpox, is also in this genus. Of the two types in humans, clade II (formerly West African clade) causes a less severe disease than the Central African (Congo basin) type. It may spread from infected animals by handling infected meat or via bites or scratches. Human-to-human transmission can occur through exposure to infected body fluids or contaminated objects, by small droplets, and possibly through the airborne route. People can spread the virus from the onset of symptoms until all the lesions have scabbed and fallen off; with some evidence of spread for more than a week after lesions have crusted. Diagnosis can be confirmed by testing a lesion for the virus's DNA.

An ongoing outbreak of mpox, a viral disease, was confirmed in May 2022. The initial cluster of cases was found in the United Kingdom, where the first case was detected in London on 6 May 2022 in a patient with a recent travel history from Nigeria (where the disease is endemic). On 16 May, the UK Health Security Agency (UKHSA) confirmed four new cases with no link to travel to a country where mpox is endemic. All four cases appeared to have been infected in London. From 18 May onwards, cases were reported from an increasing number of countries and regions, predominantly in Europe and in the Americas but also in Asia, in Africa, and in Oceania. The outbreak marks the first time monkeypox has spread widely outside Central and West Africa.

## Transmission

A large portion of those infected were believed to have not recently traveled to areas of Africa where monkeypox is normally found, such as Nigeria, the Democratic Republic of the Congo as well as central and western Africa. It is believed to be transmitted by close contact with sick people, with extra caution for those individuals with lesions on their skin or genitals, along with their bedding and clothing. The CDC has also stated that individuals should avoid contact and consumption of dead animals such as rats, squirrels, monkeys and apes along with wild game or lotions derived from animals in Africa.

In addition to more common symptoms, such as fever, headache, swollen lymph nodes, and rashes or lesions, some patients have also experienced proctitis, an inflammation of the rectum lining. CDC has also warned clinicians to not rule out monkeypox in patients with sexually transmitted infections since there have been reports of co-infections with syphilis, gonorrhea, chlamydia, and herpes.

## History

The first case was detected on 20 May 2022 by a General Practitioner in Sydney. The patient, a male in his 40s, had recently returned from travelling in Europe and had developed symptoms. The man was placed in isolation while testing was carried out. Shortly afterward another male, in is 30s, who had recently returned from the United Kingdom to Victoria was diagnosed with the disease.

By 26 June 2022 there were six cases in New South Wales and four in Victoria.

By 30 June 2022 the first case of the virus was reported in South Australia, the man tested positive after returning from overseas and was placed in isolation.

Queensland reported the first case on 11 July 2022 with one person testing positive and being placed in isolation and under virtual monitoring in Brisbane.

On 24 July 2022 Australia had recorded a total of 44 cases, by 2 August the number of cases had increased to 53.

The first case was detected in Western Australia on 4 August 2022 in a person who had travelled from overseas. The person was placed in isolation in Perth, Western Australia.

On 5 August 2022 there had been 34 cases of monkeypox recorded in New South Wales and 57 cases had been recorded nationally.

By 11 August there were 70 confirmed and probable cases in Australia with 33 in New South Wales, 30 in Victoria, 2 in Queensland, 2 in Western Australia, 2 in the Australian Capital Territory and 1 in South Australia.

By 18 August there were 89 confirmed cases in Australia with 40 cases in Victoria, 39 in New South Wales, 3 in Queensland, 3 in Western Australia, 2 in both South Australia and the Australian Capital Territory.

There were 106 confirmed cases of monkeypox in Australia on the 25th of August with 52 recorded cases in Victoria, 43 cases in New South Wales, 4 in Western Australia, 3 in Queensland, 2 in South Australia and the Australian Capital Territory.

The Chief Medical Officer of Australia stood down the country's Communicable Disease Incident of National Significance declaration on 25 November 2022. At least 140 cases had been reported between May and late October 2022.

