By Michael Koziol and Mary Ward
The federal government is being urged to vaccinate vulnerable groups against monkeypox, as men who have sex with men fear the infection will spread in Australia following the northern summer.
There have been at least 38 confirmed and probable cases of the disease in Australia, the vast majority in recent international travellers. Twenty-two of the infections were reported in NSW, including two believed to have been caught locally.
A bucket with a suspected monkeypox sample at the microbiology laboratory of La Paz Hospital in Madrid, Spain, where there has been an outbreak.Credit: Getty
Sydney MP Alex Greenwich, whose electorate has a high number of men who have sex with men, wrote to federal Health Minister Mark Butler asking for “urgent action” to procure vaccines after constituents raised the alarm about travellers returning from holidays.
“The concern is that people are travelling to cities like Madrid, New York and London where there are outbreaks, and travellers from those cities are coming or will be coming to Sydney, and we have the ability to ensure we don’t have an outbreak by vaccinating at-risk groups,” he told the Herald.
More than 11,000 monkeypox cases have been reported this year across 55 countries, after the virus – endemic in central and western Africa – spread through travellers to Europe.
Health authorities have urged the public to be alert to symptoms, particularly after visiting large parties or sex-on-premises venues, with this variant of the virus most commonly spreading via sexual and close contact among men who have sex with men.
People stand in long lines to receive the monkeypox vaccine at San Francisco General Hospital on July 12, 2022.Credit: Jessica Christian/San Francisco Chronicle via AP
National vaccine advisory group ATAGI recommends the ACAM2000 vaccine, a second-generation smallpox vaccine in supply in Australia, for healthcare workers who will be seeing patients with or doing laboratory work with monkeypox.
The group says contacts of monkeypox cases “may be considered” for vaccination as post-exposure treatment, depending on their risk factors. One high-risk contact of a known monkeypox case has received a smallpox vaccine in NSW.
Greenwich asked Butler to work with the Therapeutic Goods Administration to urgently approve a third-generation smallpox vaccine, JYNNEOS, which is more effective against monkeypox and is used in the US. “We have a golden opportunity to stop the virus in its track ... but we have to act quick,” he said.
A spokesman for Butler said the TGA had not received an application to register the MVA-BN (JYNNEOS) vaccine in Australia, but the regulator “would prioritise its evaluation if an application was received, provided it had the required information”.
The government recognised community concern about the virus and was working on its response through relevant agencies, the spokesman said, including working with peak bodies to increase awareness among at-risk groups.
Brisbane MP Stephen Bates said it was crucial to prevent queer communities being stigmatised by the outbreak, and it should not be incumbent on the community to push the government to act.
“We’ve seen from COVID that early action is important – and every delay in developing an action plan just puts people’s lives at risk,” he said.
Writing in the Medical Journal of Australia on Monday, Kirby Institute researchers Professor Raina MacIntyre and Professor Andrew Grulich argued containment of monkeypox infections in Australia would be best achieved with available antiviral treatments and third-generation smallpox vaccines.
“We have the expertise, the resources, and the tools to mount a rapid and successful response,” they wrote, arguing vaccination of close contacts of cases should be the first step and noting Australia had used similar strategies to successfully nearly eliminate HIV.
“Given the concentration of cases in men who have sex with men, if cases increase we may also need to consider offering vaccine to men who have sex with men who report multiple partners.”
Targeted community vaccine programs are operating in cities in North America and Europe, but demand is extremely high as cases rise.
Last week, World Health Organisation director-general Tedros Adhanom Ghebreyesus said global vaccine supplies were “scarce” and the WHO was working with nations to secure supply while also encouraging public health messaging to reduce stigma around coming forward for treatment.
Just one in 10 Australians are believed to have received a smallpox vaccine in their lifetime, most commonly immigrants from countries where the vaccine for the eradicated disease was more widely administered.
NSW Health advises people with monkeypox symptoms to call ahead for an appointment at a GP or sexual health service, tell them the symptoms and wear a mask as a precaution.
“While the usual symptoms of monkeypox include fever, headache, body aches, and a lumpy rash, some of the cases reported in NSW so far are not presenting in this way,” a NSW Health spokesperson said.
“Instead, people may initially see what appears to be a couple of pimples in the genital area or buttocks so people, especially men who have sex with men, need to pay careful attention to any potential symptoms.”
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