‘Window of opportunity’ for Australia to avoid big monkeypox outbreak


thorne harbour health colin batrouney monkeypox vaccine atagi vaccination rollout
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LGBTIQ+ health experts say there’s a “window of opportunity” to prevent a significant outbreak of monkeypox in Australia with targeted vaccination over the coming months.

Monkeypox cases have now climbed into the tens of thousands in the northern hemisphere. The rare virus doesn’t transmit easily, and most people can recover without treatment.

Symptoms can range from mild to very painful. But the virus can cause serious illness in some people.

As cases rise, countries overseas are vaccinating against monkeypox, but supply shortages have hampered rollouts.

Last week, the Australian Technical Advisory Group on Immunisation (ATAGI) updated its clinical guidance on monkeypox vaccination to include a crucial smallpox vaccine, Jynneos.

In the update, ATAGI recommends targeted vaccination for gay, bisexual and other men who have sex with men who are at highest risk, among other groups, though anyone can contract the virus.

‘Real window of opportunity to deal with monkeypox’

Colin Batrouney (pictured above) is director of health promotion at Thorne Harbour Health in Victoria. He told 3CR on Friday he welcomed ATAGI’s advice and stressed Australia needs to ramp up its monkeypox vaccine rollout as soon as possible.

Amid the global outbreak, Australia has seen 45 cases nationally. The majority are in returned travellers, and all Australian cases have been men who have sex with men, Batrouney said.

“There have been 16 cases in Victoria. Twelve of those cases have cleared the virus,” Batrouney said.

“At the moment there’s a real window of opportunity to deal with this. But that window will close very quickly if we see transmission in the community.

“Overseas, they are seeing a big upswing in the number of cases in Spain and in America. They’re seeing a levelling off of cases in London.

“The take-home message really is, we need a vaccine rollout to be able to deal with this.”

Colin Batrouney welcomed ATAGI’s advice on the Jynneos vaccine and told 3CR he thinks the federal government is “taking this seriously, as they should”.

The Jynneos vaccine is crucial as it is the suitable option for people who are immunocompromised. This includes Australians living with HIV.

“The third-generation smallpox vaccine Jynneos is the vaccine used internationally for pre and post-exposure prophylaxis for monkeypox,” he said.

Batrouney said despite global shortages, the Australian government has procured supplies of that vaccine, though “not in huge numbers”.

“It’s been difficult to get supplies of the vaccine globally. There’s a shortage,” he said.

“[So] it’s great that the states and territory governments have procured vaccines to roll out.

“The health department hasn’t given us a date, it all depends on when the vaccine gets into the country.

“But we need to ramp it up as soon as possible.”

Monkeypox symptoms can vary from person to person

Australia’s Chief Medical Officer Paul Kelly last week declared monkeypox (MPX) a “communicable disease incident of national significance” in Australia. This declaration allows a national response.

However Prof Kelly said it’s “important to note” monkeypox is “far less harmful than COVID-19″ and less transmissible.

“Although MPX is not usually considered a sexually transmissible infection, physical contact with an infected person during sexual intercourse carries a significant risk of transmission,” he said.

“Intimate physical contact such as hugging, kissing and sexual activities represent a risk of infection.

“Infectious skin sores [are] the likely mode of transmission.

“The rash usually occurs on the face before spreading to other parts of the body. This includes the palms of the hands and the soles of the feet.

“However, in this outbreak it is being seen especially on the genital and perianal regions of affected people.”

Dr Kelly said the rash can “vary from person to person and take on the appearance of pimples, blisters or sores.”

“The flu-like symptoms often include fever, chills, body aches, headaches, swollen lymph nodes and tiredness,” he said.

Australia’s National Medical Stockpile has monkeypox treatments, such as antivirals available.

Community ‘highly motivated’ to get vaccinated

Thorne Harbour Health’s Colin Batrouney said Australia should target vaccines to those at highest risk, starting with close contacts.

And men who have sex with men who have multiple sex partners should also be prioritised, including those who’ve travelled overseas.

“Given that kind of sexual activity, you’re more likely to be exposed to monkeypox in the community,” he explained.

Batrouney said as with other viral infections, there’s a “spectrum” of symptoms of monkeypox.

“Some people experience very mild symptoms that are not very serious at all. Other people require hospitalisation,” he said.

Federal Health Minister Mark Butler said Australia “actively pursued supplies of [the Jynneos vaccine] well before” the World Health Organisation declared the outbreak a public health emergency, “recognising there is limited supply and significant global demand”.

“This is in collaboration with the states and territories which are the distribution point for vaccinations and post-exposure treatment,” Butler said last Thursday.

Colin Batrouney said Thorne Harbour Health does not have vaccine stock yet. However the organisation has fielded lots of inquiries about the jabs.

“There’s a high level of interest and motivation within the community regarding vaccination for this preventable disease,” he said.

“We need the vaccine rollout implemented. Nobody wants monkeypox.

“Gay, bisexual and other men who have sex with men want to protect themselves and protect others.

“The clearest, easiest and most effective way is through vaccination.”

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