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Here are some of the most commonly asked questions we get about monkeypox (mpox).

Updated: December 6 2022

Should I be concerned about mpox?

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We understand that many people in our communities are concerned right now. While mpox is a self-limiting illness and most people recover in a few weeks, it can be quite uncomfortable and currently requires an isolation period to prevent transmission.

Symptoms can be more severe in immunocompromised people.

A reminder: most people living with HIV and receiving treatment in Aotearoa are not considered immunocompromised.

Are people living with HIV at more risk from mpox?

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Initial reports show a high proportion of mpox patients are living with HIV, the reasons for this are unclear. So far, it appears that in the current outbreak, people living with HIV who are on effective HIV treatment are typically experiencing infection in a very similar way to their HIV-negative counterparts, which means it is most often mild and self-limiting.  However, those who are not on treatment or have low CD4 cell counts may be more vulnerable to more severe mpox disease.

The JYNNEOS vaccine is safe for people living with HIV. It has been tested among people living with HIV with CD4 counts >100. It can be used in people with lower CD4 counts, but we are not yet sure if it will be as effective.

What can I do to protect myself?

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Right now, the best thing you can do is to keep an eye out for symptoms.  Look out for any skin changes, new lesions/spots/scabs or any new pain and discomfort in the genital, anal or rectal areas (in and around your butt).

Other symptoms include fever, swollen lymph nodes, fatigue, muscle ache, headache and flu like symptoms (keep in mind that these do not appear in all MPX cases and can often be symptoms of other illnesses).

If you are concerned, stay home and get in touch with your local sexual health clinic, your GP or Healthline and follow their instructions.

Being alert and getting tested if you experience symptoms will be the easiest way to know what you might be dealing with.

 

Condoms

Condoms can prevent you getting mpox lesions where it might be the most painful.

Mpox lesions are likely to first appear on parts of your body where skin-to-skin contact has happened. Because this outbreak is primarily occurring through sexual contact, lesions are commonly starting on genitals or in and around the butt, before possibly spreading to other parts of the body. Unfortunately, these are also very sensitive parts of the body and therefore likely to have very painful lesions.

Some people may require hospitalisation to manage severe pain (particularly in and around the butt) and infections. We support the various ways we each practice safe sex, however while we wait for the mpox vaccine, condoms are a great way to reduce the risk of more painful lesions.

Click here and we’ll send you a box of free condoms.

 

 

What makes gay, bisexual, and other men who have sex with men more at risk?

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Mpox is primarily transmitted through skin-to-skin contact and direct contact with skin rashes, lesions or scabs, and may be transmitted through bodily fluids. In this global outbreak, the most common and efficient way mpox is spreading is through sexual contact.

Gay, bisexual, and other men who have sex with men make up a small portion of the population. So, when we’re meeting another guy for sex, the pool of people we are choosing from is much smaller. That makes us quite closely connected sexually, which can allow mpox to spread more quickly among us.

Will it be obvious if I get mpox?

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Not necessarily. Symptoms can start with just some spots/lesions (usually around the face, arms or legs). In this global outbreak, we are seeing more rashes/lesions on the mouth, genitals and anus where they may not be as easily noticed. Because of this, it’s important that if you are at risk and you notice any new symptoms, that you get them checked out early. For example, there have been reports of people experiencing proctitis (rectal pain, discharge or constipation) as the only symptom of mpox, so make sure to see your doctor if you have pain in or around your anus (butt) and genitals.

Is mpox contagious?

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Mpox is contagious if you have close or skin-to-skin contact with an infected person. But, by following public health advice, you can avoid passing it on to other people. In the current outbreak, the vast majority of cases are thought to have occurred through sexual activity. Mpox is not spread the same as illnesses like COVID-19, although mpox can be passed on through breathing in droplets exhaled by someone who has the virus (this is very rare). This route of transmission requires prolonged contact and for people to be very close together, therefore the risk of the virus spreading in this way is very low.

What might the risk be to my whānau if I get mpox?

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The risk to whānau if you get mpox is low, if you make sure to do the following:

  • Avoid physical contact with others, cover any lesions, and regularly clean common spaces.
  • While symptoms persist, use your own towels and sheets.
  • Avoid contact with pets.
  • Sleep in a separate room.
  • Use a separate bathroom where possible, otherwise clean the bathroom in between different people using it (ordinary disinfectant and cleaning products will work fine!).
  • If any of your whānau are identified as close contacts, they should also follow instructions from Public Health officials. They will not be required to isolate unless they start showing symptoms.
  • You will also be provided with specific guidance and advice from Public Health about how to keep others safe.

Why don’t we have vaccines in NZ right now?

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We understand that these issues are related to low stocks of the vaccine globally. There is only one manufacturer of the vaccine for mpox and lots of other countries are trying to source the same vaccine at the same time. Places with more severe outbreaks are currently being prioritised. We continue to support efforts to get access to the vaccine in New Zealand and will keep communities updated about when it becomes available.

Should I get vaccinated?

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The vaccine, when available, will be safe for most people. If you have questions or concerns, you should discuss these with your healthcare provider. When the vaccine becomes available, we encourage all eligible people at risk of mpox  to get vaccinated to help protect each other and themselves. The vaccine can be given before you have been exposed to mpox or after you have been exposed to mpox. Eligibility criteria for the vaccine in Aotearoa are still to be confirmed.

Will I have to give ID if I get vaccinated?

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Probably not. We are still awaiting information about how the vaccination rollout might occur, but we expect you should be able to access the vaccine in a way that offers you as much privacy as possible. We would recommend for it to be documented in your medical or vaccine record though, as it is a two-dose schedule that’s spaced apart, and this will help you and your provider make sure this is done correctly.

Are we fear-mongering?

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Our communities have a right to know about issues that could affect our health and wellbeing. 

Talking about a global public health issue that could realistically lead to a local epidemic in coming months, is not what we would call fear mongering. We are raising awareness, encouraging government to protect those most at risk, and giving people information they need to be safe and make informed choices about their own health. Prevention is the best medicine – the more people who know what to look out for, what to do and where to get help, the less likely it is we’ll see a larger outbreak disrupting people’s lives and the health system here.

Is mpox an STI?

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This is complicated. It is not classified as a sexually transmitted infection (STI), BUT, in this global outbreak, it is primarily spreading through sexual contact (the vast majority of cases have been associated with sexual contact!). This is because of the role that close contact has in transmission. Evidence on this is continuing to evolve, and we will update this answer as we find out more.

Why should I use a condom if it won’t stop me getting mpox?

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Using condoms is important as we are seeing that the first mpox lesions may often appear where the person has had contact with infected lesions or skin to skin contact. If this is while having oral sex, you could get lesions in your mouth. If this is while having penetrative sex, you can develop lesions on the penis, scrotum or in the vagina or front hole, or anus and rectum (inside your butt or around your butthole – ouch!), which are more sensitive than other areas. This can be very painful or can cause complications.

Essentially, while unlikely to eliminate the risk of mpox transmission, using condoms can prevent you getting mpox where it might be more painful or sensitive.

Plus, (and this applies to everyone, even if you are using PrEP or relying on U=U as HIV prevention), condoms are effective at reducing the risk of other sexually transmitted infections which can appear similar to mpox and can also be associated with unpleasant symptoms.

Do I have to tell anyone if I get monkeypox?

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Some people will need to know so that they can protect themselves or support you, but you won’t have to tell anyone who doesn’t need to know. 

  • Close contacts (including sexual partners)

    Yes, people who have had close contact with you while you have been infectious do need to know. Public Health will work with you to inform your contacts. Unless you tell them yourself, public health will not tell your contacts that you have mpox, just that they have been in contact with someone who has mpox.

  • Whānau

    The people you live with may need to know so that you can protect each other. You don’t need to tell anyone else in your whānau or anyone else you don’t want to know. Having mpox is nothing to be ashamed of, so if you need any help, consider reaching out to those around you for support

  • Employers

    Public Health will work with you to do this. Your healthcare provider can supply you with a medical certificate to give to your employer as evidence that you are required to isolate and cannot attend your place of work. This certificate will not include clarification of an mpox diagnosis unless you have asked for it to. Instead, it will just give a general explanation that you cannot attend work due to medical reasons. Your employer would only be told of your mpox diagnosis if Public Health needed to manage potential exposure to mpox in your workplace, but this is unlikely.

Do I have to isolate if I get mpox?

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Yes, current rules mean you do have to isolate until you have recovered. The length of isolation depends on your lesions healing process, which in turn indicates whether you may be infectious to others. This is likely to be for a 2-4 week timeframe and Public Health will assist with ensuring you are safe to leave isolation as soon as possible.

How can I avoid getting mpox?

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Currently, the best thing you can do is to look out for symptoms. If you do have any new symptoms or are a close contact, stay home until you have been tested or are all clear from having mpox (you should do this whether you have been travelling overseas or not). We do know that the risk of mpox is even greater if you have travelled to areas of increasing mpox infection and had sexual activity while you were there. Once vaccines are available, getting vaccinated will also offer protection.

Can only gay and bisexual men get mpox?

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Technically, yes, anyone can get mpox. However, in the current outbreak, gay and bisexual men are disproportionately affected. This means that for the general population, the risk of mpox is low. Sexually active gay and bisexual men should watch out for any skin changes or lesions/spots and get tested if mpox symptoms develop.

For Q&A's related to Cases and Close Contacts visit this page.

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