Today, The Ministry of Health have announced that New Zealand’s Monkeypox cases have risen to 33, due to further community transmission.
Matt Hannant, Te Whatu Ora’s Interim Director of Outbreak Response fronts up to express for a in-depth discussion on patient isolation, financial support and NZ’s vaccine rollout strategy.
How many people in NZ have accessed a free monkeypox test through their doctor?
167 people have been tested for MPX in New Zealand during the current outbreak. (As at 0915 on 27 October.
In total there have been 401 tests conducted. (As at 0915 on 27 October.)
What is the percentage of tests showing a positive result?
28 individuals have tested positive for MPX during the current outbreak. (As at 0915 on 27 October.)
In terms of individual patients 16.7% have tested positive for MPX. (28 out of 167)
People who test positive need to isolate for a two to four week period (until legions are fully healed), but are offered no financial support in this time – why is this?
Te Whatu Ora is working with those affected by MPX, including those who are required to isolate, on a case by case basis to ensure they have the support they need.
Those who may require financial assistance can apply to MSD for any of the normal products and services they have relating to health support. MSD is best placed to comment on what financial support is available.
Why is isolation necessary if Monkeypox is only contracted through intimate contact?
We complete an assessment for each new case and advise cases about how to safely isolate and for how long. This can vary depending on timeframes since the onset of symptoms and they type of symptoms.
Public health clinicians may refer people with MPX to Care in the Community hubs for additional support, such as for alternative accommodation to self-isolate if they haven’t a safe place to isolate, but this will be dependent on individual circumstances.
Testing for MPX is free and patients will not be charged any consultation fee at their GP, primary health provider or sexual health clinic.
Most people who get MPX can recover at home and this takes two to four weeks. Anti virals are also now available for MPX patients who require additional treatment, our Care in the Community clinicians will continue to support those affected by MPX until they are symptom free.
Has Te Whatu Ora considered the implications for people who aren’t out?
Case privacy is at the forefront of our MPX public health management approach.
Any contacts that need to be notified are not informed of who the case is, and the case is involved and informed ahead of any notification of their contacts.
Since reports of MPX emerged internationally, we have worked closely with our community partners to ensure at risk communities have the information and resources they need to mitigate the risk of contracting MPX and remove any barriers that will prevent people coming forward to be tested.
We have also provided advice to public health units, primary health organisations and sexual health clinics on how to respect the privacy of those affected by MPX.
If they don’t want to tell their employers or the people they live with that they have Monkeypox aren’t they likely to not test?
This is carefully managed in consultation with the case, and public health risk is carefully balanced against the need to protect the privacy of individuals with MPX.
In the vast majority of instances cases are not required to tell their employer they have MPX, as there will have been a very low risk of transmission to others at their workplace.
If the case requires a medical letter to stay home from work they are provided with a certificate that states they must isolate, but this does not disclose their diagnosis.
In the rare instances where an employer does need to be informed of the diagnosis, where there was a high risk of transmission to colleagues, this would be managed with the case. They would be involved in the process and informed ahead of any notification of their contacts before it happens. Only high risk contacts would be notified.
Have you seen any clusters of transmission? If so, where have these been linked to?
To protect the privacy of cases we are not commenting on how and where MPX transmission has occurred to date.
Has contact tracing been implemented? And how successful has this been?
Contact tracing and source investigation is a key part of the public health response to MPX, as is standard for most communicable diseases. This has helped public health to identify some at risk contacts, ensure they know how to monitor for symptoms and get tested if any develop. Through this, we have limited transmission.
Te Whatu Ora staff follow established procedures for contact tracing including interviewing the case, and then contacting identified contacts.
In a MPX outbreak, this is always done in consultation with the individual involved, without identifiable information being shared about the case. This helps protect the privacy of individuals. When appropriate, cases have also notified their contacts themselves directly.
As recommended by the Burnett Foundation, people within the MSM community who have multiple or anonymous sexual partners are encouraged to swap some kind of contact detail following close physical or sexual contact. You do not need to exchange real names, but having some way of reaching out to someone if you or they develop MPX symptoms will help us slow the spread of the disease.
How many of the 504 units of Tecomvirat treatment that the Ministry of Health purchased have been utilised?
No units of tecomvirat have been prescribed as at 31 October 2022.
Why has none of it been used?
Since tecomvirat became available in late October no MPX cases have been assessed as requiring anti-viral treatment.
Overseas, 40% of cases were amongst people living with HIV – what is the situation in NZ?
Given the limited number of MPX cases in New Zealand to-date, we are not willing to comment on other health conditions cases have had. This is to protect case privacy.
In the US and Australia some clinics ran out of Monkeypox vaccine supplies within a day. When will the vaccine be arriving in NZ? What is the rollout strategy and how can the same be avoided in NZ?
Te Whatu Ora – Health New Zealand is working with Pharmac to secure a national supply of a smallpox vaccine known as Imvanex or Jynneos. Vaccines designed for smallpox are also considered effective against Monkeypox because the two viruses are similar.
While there are global supply constraints with the vaccine, the supplier has indicated that doses are anticipated to be available for New Zealand in December. These timeframes are subject to contractual discussions with the supplier and Pharmac.
Targeted vaccinations will form part of New Zealand’s response to monkeypox, alongside contact tracing and health promotion. Information about how the vaccine will be made available will be confirmed in due course.
[ Editor’s Note: answers emailed Tuesday 1 November; further comment supplied Wednesday 2 November.]
For further information visit: https://www.burnettfoundation.org.nz/articles/news/3-things-we-can-all-do-to-slow-the-spread-of-monkeypox/
