Mpox (monkeypox): symptoms, testing & vaccine

Mpox (previously called monkeypox) tends to make the news in waves, which can make it hard to know how worried to be. For most people it’s a self-limiting illness that clears in a few weeks — but it can be painful, it can be more serious for some groups, and it spreads readily through close contact. Knowing how to recognise it, how it’s diagnosed and treated, and how vaccination works helps keep both you and the people around you safe.

What is mpox?

Mpox (previously called monkeypox) is an illness caused by the monkeypox virus, part of the same family of viruses as smallpox, though generally much milder. It causes a characteristic rash — often with fever and other flu-like symptoms — and most people recover fully within two to four weeks. It can, however, be painful, and it can be more serious in certain groups.

Mpox has been present in parts of Africa for many years, but from 2022 a global outbreak spread it to many countries, including Australia, mainly through close and sexual contact. It remains something worth understanding — knowing how to recognise it, how it spreads, and how vaccination can protect you helps keep both you and others safe.

Mpox symptoms and the rash

Mpox symptoms usually appear within about 3 to 21 days of exposure. They can come in a slightly different order from person to person, but typically include:

• A rash or skin lesions — the most recognisable feature (described below).
• Fever, chills and feeling generally unwell.
• Headache, muscle aches and backache.
• Swollen lymph nodes (glands), which is a fairly characteristic feature.
• Tiredness and exhaustion.
• Sore throat, or pain and bleeding around the anus or rectum if lesions are there.

In many recent cases, the rash has been the first thing noticed — sometimes with only a few lesions, often in the genital or anal area — rather than a big illness with fever first. Because of this, even a small number of new lesions in that area is worth taking seriously.

The mpox rash

The mpox rash is its hallmark. It typically goes through recognisable stages: it starts as flat spots, which become raised bumps, then fill with fluid to form blisters, then become pustules (filled with pus), before finally crusting over into scabs that fall off as the skin heals. The whole process usually takes two to four weeks.

The rash can appear anywhere, but is often seen on the genitals, around the anus, in or around the mouth, and on the hands, feet or face. The lesions can be painful — particularly around the anus or in the mouth — and are sometimes few in number rather than widespread. A person is generally considered infectious from when symptoms begin until all the scabs have fallen off and fresh skin has formed underneath.

How mpox spreads, and who is at higher risk

Mpox spreads mainly through close physical contact with someone who has it. This includes:

• Skin-to-skin contact, including during sex — the main route in recent outbreaks.
• Contact with mpox lesions, sores or scabs.
• Prolonged close face-to-face contact (via respiratory droplets).
• Contact with contaminated items such as bedding, towels or clothing.

In the recent global outbreak, most spread has been through sexual contact, which is why mpox is often discussed alongside sexual health — although it isn’t a classic sexually transmitted infection, and anyone in close contact with an infected person can catch it. Condoms don’t fully prevent it, because it spreads by skin contact, but avoiding contact with someone who has active lesions is the key.

Who is at higher risk

In Australia and similar countries, a high proportion of recent cases have been among gay, bisexual and other men who have sex with men, with spread largely through sexual contact — so this group is a focus for vaccination and awareness. Anyone can get mpox, though, through close contact.

Mpox clades and the current situation

The monkeypox virus comes in two main types, called clades. Clade I (including subtypes Ia and Ib) has historically been associated with more severe illness, and clade II (including IIb) with generally milder disease. The 2022 global outbreak — including the cases seen in Australia — was driven by clade IIb.

More recently, a large clade I (clade Ib) outbreak centred on the Democratic Republic of the Congo and neighbouring countries prompted the World Health Organization to declare a public health emergency. Clade Ib has since been detected in a number of countries outside Africa, almost all linked to travel — and Australia recorded its first clade Ib case, in a returned traveller, in 2025, with a low risk of onward spread. Current data suggest clade Ib is less severe than the older clade Ia and broadly similar in severity to clade IIb. The situation continues to evolve, so up-to-date advice — particularly before travel to affected regions — is worth checking.

How mpox is diagnosed and treated

Mpox is diagnosed by taking a swab from one of the lesions and testing it for the virus (a PCR test). If you have a new rash or lesions — especially in the genital or anal area, after close or sexual contact, or after travel to an affected region — it’s important to get assessed, ideally contacting the clinic ahead so they can arrange to see you safely. A clinician will take a swab and can also check for other sexually transmitted infections at the same time, since symptoms can overlap.

Mpox treatment

For most people, mpox treatment is supportive — the illness resolves on its own, and care focuses on relieving symptoms while the body clears the virus. This includes:

• Pain relief, which can be important, as lesions (especially around the anus or mouth) can be very painful.
• Good skin and wound care to keep lesions clean and help prevent secondary infection.
• Rest, fluids and managing fever.
• Treating complications if they arise, such as a secondary bacterial infection of the skin.

A specific antiviral is available and may be considered for people with severe disease or at high risk of it, under specialist guidance — though its benefit in speeding recovery has been uncertain in studies, so it isn’t used routinely. People at higher risk of severe illness should be assessed promptly, as they may need closer monitoring or hospital care.

The mpox vaccine and stopping the spread

A vaccine (JYNNEOS) protects against mpox. It’s given as two doses, at least 28 days apart, and full protection builds after the second dose — so completing both doses matters. The vaccine is used in two ways:

• Before exposure (pre-exposure): for people at higher risk, to prevent infection — and it can reduce the severity of illness even if you do catch mpox. Vaccination before travel to regions with clade I transmission is recommended for those who may have higher-risk contact there.
• After exposure (post-exposure): given ideally within 4 days of contact with someone with mpox (and potentially up to 14 days) to prevent or lessen illness.

The mpox vaccine is provided free for eligible people at higher risk under the national program. Because two doses give the best protection, it’s worth completing the course rather than relying on a single dose. Speak to a doctor about whether the vaccine is right for you and how to access it under the national program.

When to see a doctor

See a clinician if you develop a new rash or lesions — particularly in the genital or anal area — with or without fever, swollen glands or feeling unwell, especially after close or sexual contact with someone who may have had mpox, or after travel to an affected region. Phone ahead where you can, so you can be seen safely.

Frequently asked questions