Is Australia ready for monkeypox?

Disease control efforts can draw on lessons from the past and prevent the epidemic from becoming established in Australia

Monkeypox belongs to the genus Orthopoxvirus and is related to variola, the virus that causes smallpox. As such, smallpox vaccines also prevent monkeypox. It has an incubation period of 5–21 days and transmits while symptomatic. It remains infectious until the skin lesions have scabbed and healed (2–3 weeks). It is a zoonotic infection with occasional human to human transmission in close contacts.1 In West Africa, most cases have been in children. Before this outbreak, the clinical presentation has been described as including fever, malaise, and lymph adenopathy, with the rash appearing first inside the mouth. A rash on the face and lymphadenopathy occur in most cases, followed by a rash on the palms and soles, and body and genital rash in 30% of cases. Monkeypox is usually a self‐limited disease with the symptoms lasting from 2 to 4 weeks. However, complications can occur — particularly in children and in immunodeficient individuals — including eye infection, blindness, skin infection, sepsis, encephalitis and pneumonia. In Africa, the West African clade has a case fatality rate of 3.6% compared with 10.6% for the Congo basin clade.2