Mpox (te koroputa maki) Mpox (monkeypox)

Mpox (formerly known as monkeypox) is a viral disease most commonly passed on through contact with the blisters or lesions of someone who has mpox. While mpox cases are increasing globally and localised outbreaks will likely continue, the risk of catching the virus in Aotearoa New Zealand is very low as it is not easily spread from person to person.

Symptoms of mpox

Symptoms of mpox usually show up between 1 and 3 weeks after exposure.

Most people with mpox develop a rash or other skin change. These are known as 'lesions'. Lesions are spots, bumps, blisters or sores.

Symptoms include:

  • skin lesions — including any around your face, hands, feet, mouth or throat, genitals or anus
  • pain, bleeding or discomfort in your anus.

Some people also experience flu-like symptoms early on, including:

  • swollen lymph nodes
  • fever
  • muscle aches
  • tiredness.

The sores of the rash usually change through stages — they appear flat, they become solid and raised or bumpy, they fill with fluid, crust over and eventually flake off.

The lesions are often painful and itchy and can take a few weeks to heal.

Sometimes you can have the rash without other symptoms, or you can only have 1 lesion instead of many.

Mpox symptoms usually go away on their own within 2 to 4 weeks.

Who to contact for medical advice

If you have symptoms that you are worried about:

  • contact your usual doctor or healthcare provider
  • call Healthline for free advice 0800 611 116
  • call 111 for an ambulance  if you feel very unwell, have severe shortness of breath, of have severe pain — wear a mask when the ambulance arrives.

How mpox spreads

Mpox is a rare infection. The risk of it spreading widely in Aotearoa New Zealand remains low.

You are able to give someone else mpox from when your symptoms start until your rash and scabs heal.

Mpox can pass from 1 person to another through:

  • close physical, intimate or sexual contact with someone who has mpox, by skin-to-skin contact
  • direct contact with mpox skin rashes, lesions or scabs
  • direct contact with bodily fluids like saliva of someone with mpox
  • touching the clothing, bedding or towels used by someone with an mpox rash.

There is also a low risk of getting mpox from breathing in air droplets exhaled by someone with the virus. There needs to be long and close contact for this to be possible.

It is not known yet whether mpox spreads through other bodily fluids such as semen.

Mpox has the potential to pass between animals and humans, although this is extremely rare.

Diagnosing mpox

If you think you may have been exposed to mpox or if you develop symptoms you should stay home, isolate and seek medical advice. This is especially important if you have a rash.

Testing for mpox

If your healthcare provider thinks you might have mpox they will ask you about your symptoms, exposure to people who might have mpox and about your recent travel.

Lab testing for mpox is usually limited to people who have mpox symptoms, and who:

  • are a priority group for testing
  • have been exposed to a confirmed or possible case in the 21 days before their symptoms started
  • have a history of travel to a country with mpox in the 21 days before their symptoms started.

Priority groups for testing currently include:

  • people with multiple or anonymous sexual partners in the 21 days before symptoms started
  • gay men, bisexual men, or men who have sex with men (MSM).

Waiting for results

All people being tested for mpox, whether they are asked to isolate or not, must:

  • avoid sexual or intimate activities, including kissing, hugging and all skin-to-skin contact with other people
  • inform any healthcare facility they need to visit that they are waiting for mpox results before visiting.

If you are waiting for the results of a test from mpox, you must let any healthcare facility you plan on visiting know before you visit.

Staying home

If you are being tested for mpox, you will be asked to isolate if any of the following apply to you:

  • your healthcare provider suspects you have mpox
  • you have mouth lesions
  • you have lesions that you cannot easily cover — such as lesions on the face or hands
  • you have cold or flu symptoms such as fever, body aches, vomiting or diarrhoea.

Some immunocompromised people may also need to isolate while waiting for their test results. Your healthcare provider or public health services will let you know what you need to do.

If you are not asked to isolate

If you are not asked to isolate while waiting for your resuts, you should still:

  • avoid face-to-face contact (such as work or school) with anyone at high risk of mpox — including pregnant people, young tamariki, people with severe atopic eczema, and immunocompromised people
  • isolate and contact your doctor if any symptoms start.

If you do have mpox

If your healthcare provider confirms you have mpox, or if it is 'probable' or likely that you have mpox, there are a few things you need to do, including isolate.

Reporting your result

If you test positive for mpox your healthcare provider will report your result to public health services to let them know.

This is so they can monitor symptoms and spread in the region. They will contact you to tell you what you need to do.

If you do not hear from them, call Healthline on 0800 611 116

You can also ask your healthcare provider for a medical certificate stating you need to stay home and cannot go in to work.

Telling close contacts

If you have mpox, you should tell your close contacts so they can keep an eye out for symptoms, and get tested if needed. 

A close contact includes:

  • people you live with
  • people you have had intimate or sexual contact with
  • your employer — if your colleagues have a risk of exposure.

Your privacy is protected

If we communicate with your close contacts, your personal details will be kept confidential. Your details will not be shared with anyone without this being discussed with you first.

  • As mpox is an infectious illness it is important you remain at home while you isolate.

    That means you should not:

    • go to work, recreation, or education facilities
    • have friends or relatives visit you
    • have close contact with others until your skin lesions have crusted over, the scabs have fallen off and a fresh layer of skin has formed underneath.

    It is also important that you:

    • do not share your bed with anyone else
    • isolate in a separate room from your household
    • do not let others enter the area you are isolating in
    • open windows to improve air flow through the area you are isolating in
    • do not engage in sexual activity
    • use a separate bathroom — or if you cannot, clean the bathroom after you use it
    • avoid making your own meals in shared areas and do not share food and drinks with others
    • avoid any contact with household pets and animals — do not let pets into your room or onto your bed (they can get the virus and spread it).
    • Clean your hands often with soap and water, and dry usinga dedicated towel, or use an alcohol-based hand sanitiser. Take care if you have open blisters or lesions on your hands.
    • Do not share toothbrushes, roll on deodorants, razors, skin creams or other personal items with others.
    • Cover your mouth and nose when sneezing and coughing either by coughing into your elbow using disposable tissues. Throw used tissues into a bag and clean your hands.
    • Use a folded sheet or towel to sit on items of furniture with fabric covers to protect the surface. Furniture is hard to clean and can get infected.
  • If you need to leave your room, wear a mask and cover skin lesions with a bandage, band aid or clothing such as long sleeve tops and trousers. If you have lesions on your feet wear socks. If you have lesions on your hands wear a pair of disposable gloves.

    If you need to leave your house, ask your healthcare provider what preventions and precautions you need to take, and if you will be able to leave.

  • If you need to put dressings or bandages on your skin lesions:

    • clean your hands either with alcohol-based hand sanitiser or wash with soap and water and dry thoroughly before and after changing any dressings or bandages, and
    • place used dressings and bandages into a rubbish bag and tie off before being disposed of as usual with your domestic waste.
  • To reduce the risk of passing on the virus, people you live with should:

    • clean their hands regularly with soap and water and dry thoroughly using separate towel to yours or use an alcohol-based hand sanitiser
    • keep their distance from you and avoid entering your room.

    If another person needs to enter your room:

    • you should wear a mask
    • cover your lesions with clothing or bandages
    • if possible, keep a distance of at least 1 m between each other — only 1 household member should enter the room and keep it as the same person throughout your isolation period
    • they should clean their hands with either soap and water or an alcohol-based hand sanitiser, before and after contact with you or areas you have used.

    Tell your healthcare provider if you cannot follow these recommendations.

  • Some items of your clothing may get dirty from your lesions leaking fluid.

    The virus can be passed on through laundry items — it is important you have your own linen, towels and bedding. Only you should handle them. Wash items separately from the rest of the household's.

    When changing bedding, carefully lift and roll bedding in on itself to prevent infectious particles from lesions and body fluids from travelling in the air. Do not shake bed linen, quilts or blankets.

    Place items for washing into a bag first before taking it to the washing machine. Clean your hands before you use the washing machine.

    Wash items with laundry detergent at the highest temperature stated on label. Avoid using an ‘eco’ or ‘quick wash’ cycle. Dry clothes you usually would.

    Clean all surfaces, for example the washing machine including the lid or handle, after you have finished and clean your hands.

    Do not use laundry service or local laundromat. 

  • Keep your own separate supply of plates, cups, knives and forks. These should be washed after use by you, either in a dishwasher using a full hot wash cycle or by hand with hot soapy water and left to air dry.

    If you have lesions or blisters on your hands, wear single use disposable gloves when washing up. Throw these away into a rubbish bag that only you put rubbish in.

    • Do not fill rubbish bags more than three quarters full.
    • Double- bag your rubbish.
    • Make sure it is tied securely.
    • Wear a medical mask and use disposable gloves
    • Regularly clean and disinfect household surfaces, toilets or floors, or any location where you have been or had contact with surfaces. Pay particular attention to frequently touched surfaces such as door handles, TV remote, light switches etc.
    • Use common household disinfectants including diluted household bleach products. To clean floors it is best to use a damp mop.
    • Avoid vacuuming or dry sweeping until you have finished your isolation period to prevent stirring up infected particles.
    • Remove and dispose of all items including cleaning cloths and personal protective equipment (for example, gloves) into rubbish bags after you finish cleaning and wash your hands.
    • Regularly clean your hands with alcohol-based hand sanitiser or soap and water and dry hands thoroughly.

    Cleaning after isolation

    Once you have finished isolating it is important to thoroughly clean all areas and spaces.

    If another person is carrying out this cleaning, they should wear a mask and gloves.

    • Start cleaning surfaces higher up and work your way to the floor. This will make sure that any particulates or debris fall to the floor which will be cleaned last.
    • Start by cleaning surfaces and objects that are cleaner and work your way to cleaning dirtier items, for example, toilets.
    • Avoid going from an area that has not been cleaned to an area that has been cleaned to make sure you are not cross-contaminating items or surfaces.
    • It is best to use a mask while you or anyone else is vacuuming. Used vacuum bag should be placed carefully into yellow rubbish bag along with any single use cloths used or wipes and bag tied off.

Finishing isolation

Eight days after your first lesion appears, healthcare providers will assess you to see whether:

  • you need to isolate for longer, or
  • you can leave isolation with ways to prevent spreading the virus to others.

If your lesions are able to be covered and you are otherwise well, you might be able to leave isolation.

Safety measures after isolation

Health staff will keep in contact with you after you leave isolation to support you through the next steps.

You will need to follow extra precautions such as:

  • covering all scabs or lesions until they have fallen off and new skin has formed
  • avoiding public transport
  • avoid high-risk places like childhood education, gyms or schools.

You can only return to work when public health services tells you it is safe.

You must continue with safety measures until you are no longer infectious. This is when your lesions have crusted, the scab has fallen off and a fresh layer of skin has formed underneath. Symptoms normally last 14 to 28 days.

You need a final check-up with a health professional before your symptoms and restrictions do not need to be managed by public health services anymore.

Treatment for mpox

There is no specific treatment approved for mpox. Treatment for most people with mpox focusses on relieving symptoms.

The following tips may help with symptoms:

  • Take paracetamol to help treat with pain and fever.
  • Take an antihistamine if the lesions are very itchy. You can get family or friends to bring it to you or order it for delivery.
  • Talk to your healthcare provider if you need stronger pain relief.
  • Keep any lesions clean by washing your skin with soap and warm water to reduce the chance of infection.
  • Talk to your healthcare provider if an area gets infected. It might be red and sore, swollen and hot or shiny. You may feel very unwell.

How to prevent mpox

While anyone can get mpox, you are at highest risk if you have close physical or sexual contact while travelling overseas, or with people who have recently been overseas. We advise you to be mindful of mpox symptoms.

Globally, mpox has mostly affected:

  • men who have sex with men (MSM)
  • people who have sex with MSM — this may include people of any gender or sexual identity, whether they are transgender or cisgender, and non-binary people.

There is higher risk for these people, particularly if they have multiple anonymous sexual partners.

To reduce the risk of catching mpox:

  • make sure you feel healthy and have no mpox symptoms before having close physical or sexual skin-to-skin contact with others
  • avoid close contact with someone who has mpox or mpox symptoms
  • avoid direct contact with the skin rashes, lesions or scabs, or bodily fluids of someone with mpox
  • avoid physical contact with the clothing, bedding or towels of a person with mpox
  • swap contact details with the people you have close physical or sexual contact with, so if either of you develop mpox symptoms you can let each other know
  • consider having fewer casual sexual partners for a while and space sexual contacts a bit more, to give time for symptoms to show before you have close contact with someone new.

Safe sexual activity

For 3 months after release from isolation, the virus may still be present in semen. Condom use during sexual activity is recommended where semen could come into contact with another person. For more information contact a sexual health clinic. 

New Zealand Sexual Health Clinics (external link)

If you are a close contact of someone with mpox

If you are a close contact of someone with mpox you do not need to isolate but need to monitor for symptoms.

Finding out if you are a close contact

If you had close physical contact with someone with mpox when they were infectious, you may be a a close contact. 

When someone tests positive for mpox, they should tell their healthcare provider of any possible close contacts. A health professional will contact you to let you know.

If you have been exposed to mpox and have not heard from a health professional:

  • call Healthline for free on 0800 611 116
  • contact your doctor or healthcare provider
  • contact your nearest sexual health clinic.

What you need to do

Close contacts of mpox do not need to isolate.

You will be asked to monitor your symptoms for 21 days from when you last had close contact with the person with mpox. Health staff will give you guidance on how to identify symptoms and anything else you need to do.

If you are at high risk of getting mpox

If you are assessed as having a high risk of developing mpox, you will also be asked to:

  • wear a mask when around others
  • let health staff know if you are leaving the country within the 21 days
  • avoid high-risk activities, including sexual activity, kissing and other skin-to-skin contact with others.

If you develop symptoms

If you develop any symptoms you must isolate and seek further medical advice.

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