'Sex bubbles': Why Victorians should keep a list of their sex partners

19 Jul 2024

The state’s chief health officer is urging Victorians to create “sex bubbles” and maintain contact details of all their sexual partners to curb an outbreak of mpox.

Mpox - Figure 1
Photo The Age

Victoria is in the grip of its largest mpox outbreak, one in which 76 cases have been detected over the past three months, compared with just eight cases for all of 2023.

Mpox is a serious infectious disease.Credit: AP

“One of our key messages to communities is to maintain contact details of sexual partners because that helps us facilitate contact tracing,” Chief Health Officer Dr Clare Looker said.

Looker said creating a “sex bubble” – an idea that emerged during the COVID pandemic and involves limiting the number of sexual partners to a small group – was another effective strategy alongside vaccination.

“Whether it’s a sexual bubble, or perhaps just lying low a little bit in the colder months, [we support] whatever way works.”

Unlike the previous mpox outbreak in 2022, which peaked at 70 cases and was mainly linked to returned travellers, the current outbreak has been predominantly fuelled by local transmission.

The disease spreads through close physical contact, and in Victoria, it has mostly affected men who have sex with other men. But Looker said it had also been detected in small numbers of people outside this group.

Victorian Chief Health Officer Dr Clare Looker.Credit:

Mpox, caused by the monkeypox virus, is related to smallpox and often characterised by a painful rash, enlarged lymph nodes and fever.

Mpox - Figure 2
Photo The Age

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In May, Australia recorded the fourth-highest number of mpox cases in the world, behind the more densely populated Democratic Republic of Congo, United States and Spain, according to the World Health Organisation.

State health authorities anticipate Australia will maintain its position, or potentially rise in the global tally, when the WHO updates its data in coming weeks.

Victoria is fuelling the rise in mpox cases in Australia, with 60 per cent of cases detected in the southern state. There have been 27 cases detected in NSW and 17 in Queensland this year.

A Sydney man in his 20s, who spoke to this masthead on condition of anonymity, contracted the disease in late June after travelling to Melbourne for a sex party.

His symptoms included stomach cramps, frequent trips to the toilet, muscle aches, headache and excruciating pain in his anus, which he later discovered was caused by lesions.

Doctors at a local sexual health clinic initially did not suspect mpox because the man did not have the virus’s signature rash. He only had one small pimple on his bottom.

He was instead given medication for gonorrhea, chlamydia and herpes – infections he did not have.

But the pain was so intense he went to a local emergency department and had a CT scan. Emergency doctors referred him to a gastroenterologist for a colonoscopy.

Mpox - Figure 3
Photo The Age

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It wasn’t until he landed an appointment with another doctor a few days later that he was finally diagnosed.

“The doctor said, ‘I’m 90 per cent sure it’s monkeypox and swabbed me’,” he recalled. “It came back positive the next day, so I contacted all my sexual partners and let them know.”

While the man had received his first dose of the mpox vaccine before he became infected, he had not yet had his second dose, which is required for the best protection.

“It was bloody awful,” he said of his two-week infection.

While most people recover from mpox, some will need to be hospitalised. Others can be left with permanent scarring. Four Victorians have been hospitalised with the disease this year, while 10 have turned up at emergency departments for treatment.

Monash Health’s director of public health and infection prevention, Professor Rhonda Stuart, said anyone could contract mpox.

Monash Health’s director of public health and infection prevention, Professor Rhonda Stuart.Credit:

“Anybody who has contact with that rash, no matter where it is on their body, has the potential to be infected,” she said.

She said Monash Hospital treated a couple of people infected with mpox during the 2022 outbreak, providing them with pain relief to manage their symptoms.

Thorne Harbour Health, which provides health services for LGBTQ communities, has vaccinated 700 people against mpox in the past eight weeks through its pop-up clinics.

Peter Locke, the organisation’s director of HIV, clinical and community support, said the vaccine offered people the best protection against mpox. “If you do catch mpox and you’re double vaccinated, you’ll have a lot less severe symptoms,” he said.

In Victoria, the vaccine is free for eligible groups through GPs, sexual health clinics and some councils. These groups include high-risk contacts of mpox cases, attendees of sex on-premises venues where there has been transmission, men who have sex with other men, and sex workers.

Locke said people who suspect they have mpox should see their GP and demand a test. If they test positive, they should notify all their close contacts and isolate until lesions have healed.

For more information visitbetterhealth.vic.gov.au/mpox

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