痘痘

什么是流行性感冒？

Mpox (previously known as monkeypox) is a viral zoonosis (an infection spread from animals to humans). It is caused by a virus that belongs to the 正痘病毒 genus (which also causes the variola virus responsible for smallpox disease). Since the eradication of smallpox in 1980, mpox has become the most important orthopoxvirus affecting humans.

流感症状

The incubation period of mpox is usually 7-14 days, but can be as short as 5 days or as long as 21 days. The initial symptoms include fever, headache, muscle aches, fatigue and lymphadenopathy. Lymphadenopathy in this early phase is a key feature of mpox.

1-3 days following the beginning of fever, a rash may develop, often beginning on the mouth and face, and then spreading to other areas of the body. The face is involved in 95% infections, followed by the palms of the hands and soles of the feet (75%). Oral mucous membranes are involved in 70% of cases, and involvement of the genitalia is also common (30%).

The rash is initially characterised as being erythematous (reddened) and macular (flat), which then develops papular features (raised areas) and turns into well-demarcated pustules and vesicles (blisters). These then dry into crusts and fall off. The number of lesions is highly variable, ranging from a couple to over a thousand.

The infection is usually self-limiting with symptoms lasting from 2-4 weeks. Complications can include secondary infection such as cellulitis, sepsis, infection of the cornea (which can threaten vision), bronchopneumonia and encephalitis. The case fatality ratio is between 3-6%. More severe illness can occur in immunocompromised people.

结核病是如何传播的？

Mpox 通过动物传人（人畜共患病）或人传人传播。

Zoonotic transmission involves direct contact with the bodily fluids, blood, or lesions (cutaneous or mucosal) of infected animals (often through bites or scratches). This is most common for people living near or within forest areas with exposure to infected animals.

Human-to-human transmission involves close contact with respiratory secretions (through activities such as kissing), the skin lesions of an infected person (by touching or sexual contact), or through contact with contaminated objects such as linen or clothing. Droplet particle transmission requires prolonged face-to-face exposure, placing household contacts at highest risk. This can be minimised by isolating away from other members of the household. Infections during pregnancy can be transmitted to the baby.

照顾 mpox 患者的医护人员必须采取感染控制预防措施，实验室标本的处理应由经过适当培训的人员进行。

流行病学

Mpox 在西非和中非非常常见，通常在热带雨林地区。然而，目前全球许多其他国家也爆发了疫情，包括澳大利亚、欧洲部分地区和英国。

疫苗

There are two types of vaccines available for use in Australia for the prevention of mpox:

• ACAM2000 – 2nd generation, live-attenuated vaccine
• JYNNEOS (MVA-BN) – 3rd generation, non-replicating vaccine.

Both vaccines are formulated using the vaccinia virus, a poxvirus related to smallpox and mpox.

JYNNEOS (MVA-BN) can be administered either subcutaneously (preferred) or intradermally. ACAM2000 must be administered via a percutaneous route which can only be performed by a provider who is trained in this complex technique. ATAGI preferentially recommends JYNNEOS (MVA-BN) vaccine due to the ease of administration and decreased likelihood of side effects.

建议

Vaccines can be administered as either primary preventative vaccination (PPV) or post-exposure preventative vaccination (PEPV). For PEPV, vaccination within 4 days is recommended to provide optimal protection against the development of mpox infection. Vaccination between 4-14 days following exposure may lessen the severity of disease.

目前建议以下人群接种疫苗：

• sexually active gay, bisexual or other men who have sex with men (GBMSM), including transgender and gender diverse people
• sex workers
• people living with HIV or other immune suppressive conditions if at risk of mpox exposure
• laboratory personnel working with orthopoxviruses
• high-risk contacts of a confirmed case of mpox.

Vaccination may also be considered for:

• healthcare workers at risk of exposure to patients with mpox
• regular sexual partners of GBMSM, sex workers and people living with HIV.

禁忌症

任何有以下病史的人 过敏反应 to a previous dose of the vaccine to be administered or anaphylaxis to a component of the vaccine to be administered should not be vaccinated.  Due to the risk of vaccine associated disease, ACAM2000 is contraindicated for those with 免疫妥协 或者那些是 孕.

Individuals with active eczema, atopic dermatitis or other exfoliative skin conditions should not receive ACAM2000 due to the risk of developing eczema vaccinatum (a reaction to smallpox vaccination experienced by people with eczema/atopic dermatitis resulting in a severe rash and systemic illness).

防范措施

Subcutaneous vaccination is preferred over intradermal in individuals with a history of keloid scarring.

Individuals receiving ACAM2000 as PPV should consider an interval of 4 weeks between vaccination and administration of COVID-19 vaccines due to the rare risk of 心肌炎/心包炎.

Table 1: Vaccine brands, dose and route 

* subcutaneous and intradermal routes are considered interchangeable to complete a primary course; when vaccinating post-exposure (PEPV) using a subcutaneous route is preferred for the first dose
^ only immunisation providers with appropriate training and experience should administer vaccines via an intradermal route
# percutaneous administration involves using a bifurcated needle and scarification technique which requires specialised training and accreditation
Ω for full aftercare instructions, refer the 产品信息

资源

维多利亚时代的节目信息

• 维多利亚州卫生部：Mpox [包括有关在哪里获得疫苗的信息]

其他资源

• 澳大利亚政府卫生和老年护理部：Mpox 资源
• Mpox 病毒感染：CDNA 国家公共卫生单位指南
• 更好的健康频道：Mpox