Don’t panic, it’s just a CDINS requiring a smallpox vaccine…

An Australian expert has added his voice to the call that despite rising numbers, the outbreak of the orthopoxvirus Monkeypox (MPX) is far less harmful than COVID and the general population should not be unduly concerned by its upgraded status.

Associate Professor of Medicine at UQ, Director of Infectious Diseases at Mater Health Services, and Medical Director and Principal Investigator at Q-Pharm, Paul Griffin, has welcomed the recent declaration that MPX is a Communicable Disease Incident of National Significance (CDINS).

He hopes the July 28th announcement by Australia’s Chief Medical Officer, Professor Paul Kelly, will be the catalyst for a more effective response, adding there are several very reassuring considerations when it comes to MPX – including a new vaccine.

“I don’t think we should encourage anyone to be worried necessarily, what we need here is a perception of risk that’s sufficient that appropriate awareness is widespread,” Professor Griffin said.

“Hopefully the recent declarations should highlight the significance of this event and lead to enhanced communication and awareness, both of the public and clinicians, so our ability to find cases early and then isolate them is improved.

“It should also make sure we have coordinated policies and procedures to ensure our control is optimised,” he explained, pointing out that the National Incident Centre will provide enhanced coordination to help states and territories effectively manage the outbreaks within their jurisdictions.

“We already have safe and effective vaccines as well as therapies, so our tools to combat this infection are far more advanced than they were for COVID for example, at the beginning of the pandemic.”

Just two days before Professor Kelly’s declaration, ATAGI updated its clinical guidance for MPX vaccination to include the use of JYNNEOS (or MVA-BN), in preparation for supplies of the third-generation vaccine becoming more widely available in Australia.

Federal Health Minister Mark Butler announced yesterday (August 4th) that 450,000 doses have just been secured by the government, and the National Medical Stockpile has also made several MPX treatments, such as antivirals, available for states and territories to access upon request.

The original and other available shot, a second-generation smallpox vaccine called ACAM2000, is live-attenuated and replication-competent, requiring special training to administer via percutaneous scarification to prevent ‘self-inoculation from the vaccination site’ – one of its associated ‘rare but serious adverse events.’

By contrast, the guideline states that JYNNEOS is administered in a 2-dose schedule by subcutaneous injection, has fewer ‘adverse events’ and can be used in children – though to date, most cases of MPX in Australia have been found in GBMSM aged 21 to 40 years.

“Whilst the situation now is truly extraordinary with over 20 000 cases globally… fortunately, this virus is harder to transmit than COVID, requiring direct contact with infected blood or body fluid,” Professor Griffin said.

“It also most often leads to an illness that’s visible as the rash is quite prominent, so infected individuals are relatively less likely to go about their normal lives whilst infectious, particularly if they understand the significance of this infection and receive the right advice to isolate.”

According to the WHO, MPX’s incubation period is between 5 – 21 days, and although it is not usually considered an STI, physical contact with an infected person during sex carries a significant risk of transmission, as does intimate contact such as hugging, kissing and other sexual activities.

More information on monkeypox is available from the Department of Health and Aged Care’s website