Epidemiology of mpox outbreaks in Australia and insights from epidemic response and surveillance data: a mixed-methods study.

OBJECTIVES

Following a sharp rise in mpox cases in Australia in 2024-particularly clade IIb, this study aimed to characterise the epidemiology, identify surveillance gaps, and inform more effective and inclusive response strategies.

METHODS

This study combined quantitative epidemiological data analysis of the national mpox surveillance data with a narrative review of literature from 13 May 2022 to 10 November 2025 on risk perceptions, health-seeking behaviours, and social, ecological and health system factors affecting response efforts.

RESULTS

A total of 1,793 people were diagnosed with mpox, including four clade Ib and 1789 clade IIb infections. Annual notifications were 144 in 2022, 26 in 2023, 1409 in 2024, and 214 in 2025 (as of 10 Nov), representing an 878 % increase from 2022 to 2024. Overall, 99 % were male, 58 % aged 30-44 years. In 2024, New South Wales (NSW) accounted for 52 % of national cases and experienced a 12-fold increase from 2022. 89 % of NSW cases were locally acquired, and 39 % had received two-doses of vaccine. Surveillance primarily relies on symptomatic individuals presenting to clinics, followed by testing, interviews and contact tracing. Stigma, discrimination and the self-limiting nature of mpox may reduce health seeking behaviour and subsequent notifications.

CONCLUSION

There was a sharp increase in the number of people with mpox in Australia between 2022 and 2024 and sporadic infections were also reported in 6 states until November 2025. While the 2024 NSW outbreak was triggered by interstate importation, most infections were locally acquired. Strengthening surveillance requires addressing healthcare-seeking barriers and improving clinical recognition.