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 in some parts of the world 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.

How mpox spreads

Mpox is a viral 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 one 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 the 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.

There is some evidence that mpox spreads through other bodily fluids such as semen.

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

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 one lesion instead of many.

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

Diagnosing mpox

If you think you may have been exposed to mpox or if you develop symptoms, you should stay home 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 should be prioritised to people who have mpox symptoms and at least one of the following apply. They:

  • 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

If you are tested for mpox, health staff may ask you to stay home or stay away from work while you wait for your results. This is more likely if you have mouth lesions, or lesions that you cannot easily cover, such as lesions on the face or hands. 

You should also take precautionary actions to prevent potential spread to others such as:

  • keeping all skin lesions covered where possible
  • avoiding sexual or intimate activities, including kissing, hugging and all skin-to-skin contact with other people
  • avoiding face-to-face contact with people at high risk of serious disease from mpox, including pregnant people, young children, people with severe eczema, and immunocompromised people.

If your health condition worsens while you are waiting for your test result, or you develop new skin lesions which are not able to be covered, you should contact the healthcare provider who took the test for you to seek further advice.

Even if you are not asked to stay at home while waiting for your test results, you should still follow the precautionary actions mentioned above until you hear from your healthcare provider. 

Before visiting a healthcare provider in person, you should call ahead of your visit so staff can take necessary precautions ahead of your arrival.

If you do have mpox

If your healthcare provider confirms you have mpox, you result will need to be reported and any close contacts will need to be contacted.

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 health staff can monitor your symptoms and consider if any additional precautionary measures are required to reduce spread to other people. Health staff will contact you to provide you with support and advise you on what you need to do. 

If you do not hear from them, call your healthcare provider or Healthline on 0800 611 116 for free advice.

You can also ask your healthcare provider for a medical certificate to show your employer if you need to stay home.

Identifying close contacts

If you have mpox, health staff will talk to you about who your close contacts might be. A close contact could include:

  • people you live with
  • people you have had intimate or sexual contact with.

Any identified close contacts will need to be contacted so they can get any necessary health advice and support. Health staff may contact these people, or you may be asked to provide information to your close contacts instead. 

Your privacy is protected

When communicating 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.

Actions to reduce spread

Isolation is not usually required for people with mpox, unless lesions are very widespread across the body. 

Health staff will undertake a risk assessment and will advise you of whether you should isolate, or follow any or all of the precautions listed below to prevent spread of mpox to others.

If recommended to take precautions, you should continue these 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. This usually takes 14 to 28 days. 

Health staff will keep in close contact with you and will advise when you can return to your normal activities. 

Returning to normal activities (internal link)

Precautionary actions include:

  • covering all scabs or lesions until they have fallen off and new skin has formed
  • avoiding sharing your bed with anyone else
  • opening windows to improve airflow
  • avoiding physical contact, particularly sexual contact (including kissing, intimate touching)
  • using a separate bathroom — or if you cannot, clean the bathroom after you use it
  • not sharing clothing, bedding, towels and unwashed crockery and cutlery 
  • avoiding any contact with household pets and animals — do not let pets into your room and onto your bed (they can get the virus and spread it). 
Open all

  • Clean your hands often with soap and water, and dry using a 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.

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:

  • avoid contact with your skin lesions
  • clean their hands regularly with soap and water and dry thoroughly using separate towel to yours or use an alcohol-based hand sanitiser.

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 a laundry service or local laundromat. 

  • 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.
  • 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 during the time you have symptoms (and are therefore infectious) 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.

Health staff will advise you if any additional actions are needed to prevent the spread of mpox. 

Cleaning after your recommended isolation

Once you are symptom-free and are safe to be around others again, 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 bags should be placed carefully into a plastic rubbish bag along with any single use cloths or wipes and then closed. Place the bag inside a collection rubbish bag. Wash your hands thoroughly or use alcohol-based hand sanitiser. 

Returning to normal activities

Health staff will monitor you regularly and advise you when you are no longer infectious and can return to your normal activities without any restrictions. 

Safe sexual activity 

For 3 months after symptoms have gone, 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)

Treatment for mpox

Treatment for most people with mpox focuses on relieving symptoms.

The following tips may help with symptoms:

  • Take paracetamol to help treat 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

You are at highest risk of getting mpox if you have close physical or sexual contact with someone who has mpox. 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.

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.

If you, or someone you may have had close physical or sexual contact with develops symptoms, having each others contact details means you can let each other know. 

Mpox vaccine

If you are travelling or on holiday in a country that has an mpox outbreak, you are not at high risk unless you are in close physical or sexual contact with someone who has mpox.

People who are at highest risk of mpox in Aotearoa New Zealand are eligible to receive the mpox vaccine. This includes people aged 18 and over who are:

  • at risk of mpox infection during an mpox outbreak
  • at risk of mpox infection because they are gay, bisexual and other men who have sex with men (GBMSM), transgender or non-binary people with certain high-risk indications
  • at risk of mpox infection because they are people living with HIV, if at risk of mpox exposure
  • sexual partners of those at increased risk of mpox infection
  • anticipating experiencing any of the above.

If you are under the age of 18 and at risk of getting mpox, you can receive the vaccine but you will need a prescription. Talk to your vaccinator about this.

About the mpox vaccine

The mpox vaccine works by triggering your immune system to produce antibodies that work against the mpox virus if you are exposed to it. The vaccine cannot give you mpox.

It is recommended you have 2 vaccine doses, a minimum 28 days apart — 1 dose gives good protection from severe disease. Protection starts from 2 weeks after your first vaccine dose. 

If you would like to discuss mpox immunisation, you can contact:

  • your nearest sexual health clinic
  • your doctor or healthcare provider
  • Healthline immunisation line, freephone 0800 28 29 26.

Sexual health clinics (internal link)

After your mpox vaccine

As with any vaccine, you may experience some reactions. Most reactions are mild, do not last long and happen in the first few days after getting the vaccine.

Common reactions may include:

  • local injection site reactions (pain, redness, swelling and hardening)
  • headache
  • feeling tired
  • nausea (feeling sick)
  • chills. 

The current evidence suggests there is no increased risk of serious reactions related to the mpox vaccine, including myocarditis or pericarditis. But you should seek immediate medical attention if you get any of these new symptoms after receiving a vaccine:

  • tightness, heaviness, discomfort or pain in your chest or neck 
  • difficulty breathing or catching your breath 
  • feeling faint, dizzy or light-headed 
  • a fluttering, racing or pounding heart, or feeling like it is ‘skipping beats’. 

If you are a close contact of someone with mpox

If you are a close contact of someone with mpox you 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 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 for free advice and care.

What you need to do

You should monitor for 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:

  • 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 should seek further medical advice.