Thursday 2 June 2022 06:25 AM Monkeypox outbreak spreads as NEW case is identified in Australia trends now

Health chiefs are racing to find the source of a new monkeypox outbreak after a third Australian was diagnosed with the potentially lethal disease.

The man in his 50s had recently returned to Sydney from Queensland but has had no contact with the previous cases identified in Melbourne and a second case in Sydney.

The disease - which can kill up to one in 10 people - was detected after the man became ill several days after arriving home and was confirmed by urgent testing. 

'The man is currently being cared for in hospital,' said NSW Health. He lives alone and investigations to date have identified no high-risk contacts in NSW.

'Several people who had other lower level contact with the case are being contacted to advise to monitor for symptoms.'

But health chiefs have yet to find the cause of the initial infection and are now working Queensland health to trace where it came from.

NSW chief health officer Dr Kerry Chant insisted there was no cause for concern, insisting it was 'a rare viral infection that does not spread easily between people'.

The case comes two weeks after Australia's party scene was put on high alert after the nation recorded two cases of monkeypox which were believed to be sex-related. 

The two men from Sydney and Melbourne both returned from Europe infected with the rare tropical disease.

The Victorian case was known to have been in the UK where there are currently 196 cases, which are mainly among men from the gay and bisexual community, with just two women infected.

Worldwide, WHO this week reported 377 confirmed or suspected cases in the unprecedented outbreak. 

Dr Chant last month warned gay men in particular to watch out for symptoms - which include unusual rashes - and seek immediate help if worried.

'We know it's transmitted by that close skin to skin contact - you can be infectious and that close droplet contact in a very sort of close prolonged way,' Dr Chant said.

'We're particularly urging men who are gay or bisexual, or men who have sex with men, to be aware of any unusual rashes or lesions and to contact by phone a sexual health clinic or GP without delay if they have any concerns.'

A Sydney man in his 40s developed a mild illness several days after arriving home and his GP found the tell-tale monkeypox symptoms of blisters and rashes.

Another case in Victoria has also now been reported in a man in his 30s who had been on a trip to the UK and developed symptoms after his return on May 16.

Urgent testing identified the Sydney man has been infected with a probable case of monkeypox and medics are now conducting follow up tests for final confirmation.

The Australian cases come after new cases were detected in Italy and Sweden, just days after nine cases were found in the UK.

The Italian patient tested positive at a hospital in Rome after returning from the Canary Islands and the Swede was diagnosed in Stockholm. 

The latest cases bring the number of countries outside of Africa with confirmed or suspected cases to eight.

Patients with confirmed monkeypox have now also been recorded in the UK, US, Spain and Portugal, while Canada is probing potential cases.

Experts fear the known cases are the tip of the iceberg, with the majority of patients not linked to each other, suggesting it is spreading more widely.

NSW health minister Brad Hazzard said the disease may currently be spreading like wildfire through Europe and the US as a result of the current warm weather party season.

'In Europe and North America, they've come out of COVID and there's a lot of partying going on.' he said.

'This virus is something which particular groups in the community are more likely to have and to convey as a result of the close associations that occur with people during this partying season in Europe.'

Dr Chant added: 'It is important to be particularly vigilant if you returned from overseas from large parties or sex on premises venues overseas.

'You can imagine that some settings, such as sex on premises venues or other events and gatherings may lead to sort of what we've seen as super spreading events.

'It is important that people who have recently returned from Europe who attended such parties be particularly alert given the worldwide case reports today.'

The outbreak has been described as 'unusual' by experts because person-to-person transmission of monkeypox was thought to be extremely rare.

One in ten of those infected can die from the rare African-originated disease which leaves victims pockmarked with painful, ugly blisters and rashes over their body.

It's highly infectious between people in close proximity but can only be spread through bodily fluids or very close face-to-face contact in droplets of breath.

In the UK and Spain, the virus outbreak appears to have been confined to gay or bisexual men - but none of the latest cases had a direct connection with Africa. 

Until now, it had never been found to be transmitted sexually.

But it was known that it could be passed on through close contact with the likes of body fluids, respiratory droplets and lesions — meaning it was theoretically possible to transmit through sex.

Dr Chant said NSW Health has taken steps to ensure it identifies and reacts to any potential cases, including alerting sexual health clinics.

'NSW Health has issued a clinician alert to GPs and hospitals across the state,' she said, 'We will be speaking with GPs about this issue again today.

'Cases are occasionally reported in non endemic countries in returning travellers or their close contacts, or in owners of imported pets. 

'The infection is usually a mild illness and most people recover within a few weeks.'

NSW Health said it will continue to work closely with colleagues throughout Australia to monitor for cases and ensure the best clinical response if any are identified.

There is no vaccine or treatment for monkeypox, but anti-viral drugs have shown some effectiveness and NSW Health said they were exploring those as a treatment.

The smallpox vaccine has been found to be 85 per cent effective against the disease, but it is in short supply across the world after the disease was eradicated globally 40 years ago and smallpox jabs were no longer required.

Pharmaceutical firm Bavarian Nordic plans to release a monkeypox version of a modified smallpox vaccine, but it will not be available before 2023.

The US has placed an initial $170 million order for the prospective long-life freeze-dried vaccine, with an option for another $255million order, for a total of 13 million doses, costing around $30 a dose.