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August 20, 2024

Everything Kiwis Need to Know About Mpox

everything kiwis need to know about mpox

The World Health Organization (WHO) has declared the mpox, also known as monkeypox virus, a public health emergency of international concern because of the recent mpox outbreak in the Democratic Republic of the Congo. The epidemic has rapidly extended to neighbouring countries, marking the second time in two years that the WHO has issued such a declaration for this virus.

The announcement was issued based on the recommendations and research of an International Health Regulations Emergency Committee, which consists of independent experts who gathered earlier to evaluate information from the WHO and impacted countries.

Dr. Michael Baker, an epidemiologist from the University of Otago, emphasised the importance of supporting Africa during this crisis, while suggesting that residents of New Zealand should not be overly alarmed. He noted that while a previous mpox outbreak was effectively managed, the current situation is dire for Africa, which faces medicine shortages and resource limitations.

The current pandemic is linked to a variant of the virus, known as clade 1, which poses a higher fatality risk compared to the milder clade 2 strain responsible for the earlier mpox outbreak.

The WHO’s response was prompted by reports of outbreaks in 16 African nations, with Sweden being the first country outside Africa to confirm a case.

The Pakistan Ministry of National Health Services announced on Friday that it has confirmed its first case of the virus, noting that the individual had recently travelled from Saudi Arabia.

Meanwhile, the Philippines has also reported a new mpox case, but in this instance, an individual with no history of foreign travel contracted the virus.

“The mpox virus is among us. This is a warning to everybody,” Philippine Health Secretary Teddy Herbosa said.

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Source: Centers for Disease Control and Prevention/Cynthia S. Goldsmith, Russell Regnery, Hannah Bullock

Understanding Mpox and Its Symptoms

Mpox is a viral infection that spreads through close personal contact and can occasionally be fatal. It typically presents with flu-like symptoms, followed by the appearance of pus-filled lesions on the skin. Symptoms usually manifest within one to three weeks after exposure, with most individuals developing a rash characterised by spots, bumps, blisters, or sores.

Common symptoms include:

  • Skin lesions, particularly around the face, hands, feet, mouth, throat, genitals, or anus
  • Pain, bleeding, or discomfort in the anal region
  • Early flu-like symptoms such as swollen lymph nodes, fever, muscle aches, and fatigue

The progression of the rash involves several stages: starting flat, then becoming raised and bumpy, filling with fluid, crusting over, and eventually flaking off. Lesions can be painful and itchy, often taking several weeks to heal. In some cases, individuals may only have a single lesion or the rash without other symptoms, with recovery typically occurring within two to four weeks.

Transmission of Mpox

Mpox is primarily spread through close physical or intimate contact with an infected person, including skin-to-skin contact and exposure to bodily fluids. It can also be transmitted through:

  • Direct contact with skin rashes, lesions, or scabs
  • Touching contaminated clothing, bedding, or towels
  • Inhaling respiratory droplets from someone with the virus, although this requires prolonged close contact

There is some evidence suggesting that mpox can spread through other bodily fluids, such as semen, and while it can potentially pass between animals and humans, this is rare.

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Source: Kateryna Kon/Science Photo Library

Diagnosing and Testing for Mpox

If you suspect exposure to mpox or are experiencing symptoms, particularly a rash, it is crucial to stay home and seek medical advice. Healthcare providers will assess your symptoms, exposure history, and recent travel to determine if mpox testing is necessary.

Lab testing for mpox should be prioritised for individuals who meet the following criteria:

  • Have mpox symptoms and belong to a priority testing group
  • Have been exposed to a confirmed or possible case within 21 days before symptom onset
  • Have travelled to a country with mpox activity within 21 days before symptom onset

Priority testing groups currently include:

  • People with multiple or anonymous sexual partners in the 21 days before symptom onset
  • Gay, bisexual, or men who have sex with men (MSM)

While waiting for test results, individuals may be asked to stay home or avoid work, especially if they have lesions on the mouth, face, or hands that cannot be easily covered by a mask or any personal protective equipment. Precautionary measures should be taken to prevent potential spread, such as:

  • Covering all skin lesions
  • Avoiding sexual, intimate, or skin-to-skin contact with others
  • Staying away from people at high risk of serious mpox disease

If the condition worsens or new lesions appear, contact the healthcare provider who ordered the test for further guidance. Even if not asked to stay home, follow the precautionary actions until receiving the test results.

Reducing Spread

If the test is positive, the result will be reported to Public Health Services. Health staff will monitor symptoms, provide support, and advise on necessary precautions to limit transmission. If you do not receive any form of communication from them, contact your healthcare provider or Healthline at 0800 611 116 for free advice. Moreover, a medical certificate may be obtained for the employer if needed.

Close contacts, such as household members and intimate partners, will be identified and contacted for health advice and support. Isolation is not always required unless lesions are widespread.

Precautionary actions to reduce spread should continue until lesions have crusted, scabs have fallen off, and new skin has formed, typically 14 to 28 days. These actions include:

  • Covering lesions until healed
  • Avoiding shared bedding and improving airflow
  • Refraining from physical and sexual contact
  • Using a separate bathroom or cleaning after use
  • Not sharing personal items and unwashed items
  • Avoiding contact with household pets and animals

Health staff will maintain close communication and advise when normal activities can be resumed.

Risk Assessment for New Zealand

Since 2022, New Zealand has reported 53 cases of the milder clade 2 variant of mpox. While anyone can contract the virus, the majority of cases outside Africa have occurred among individuals with multiple or anonymous sexual partners, particularly men who have sex with men.

Currently, the risk of widespread mpox transmission in New Zealand is considered low. Te Whatu Ora is monitoring the situation and awaiting further guidance from the WHO before altering public health recommendations.

“The old variant was still transmitting at low levels around the world,” Baker said, and it was possible the new variant “will eventually spread to New Zealand”.

“It hasn’t so far,” he added. “The good news is basic public health measures can still stop this virus. That is, identifying cases, isolating them, following up their contacts—and we also have a vaccine that can be used.”