An infectious disease expert is calling on New Zealand to step up its response to monkeypox as pressure continues to mount on the Government to take action.
So far, New Zealand has three confirmed cases of monkeypox, with all of them being from travellers returning from overseas.
Dr Nick Chamberlain, National Director of Te Whatu Ora – Health New Zealand's National Public Health Service, said the first two cases have now fully recovered and there is no evidence of community transmission.
The latest stats from the University of Oxford showed more than 23,000 cases in 78 countries, while Brazil, India and India have so far reported deaths.
Infectious disease and sexual health physician Dr Massimo Giola told Newshub Live at 8pm on Thursday Aotearoa needs to step up its response.
"We do [need to step up our response] and not just in New Zealand, but worldwide because the outbreak is growing at a very fast pace ... so, yes, it's definitely an alarm bell ringing," Dr Giola told host Rebecca Wright.
Dr Giola said New Zealand needs to act now if we want to avoid seeing the virus spread around the country.
"Well, some also are saying we have already lost the race with the virus worldwide and this becoming an endemic amongst the communities most at risk," he said.
"I guess in New Zealand, we have a pretty unique opportunity to avoid monkeypox getting hold in our population, but we need to act fast if we want to avoid that."
Cases of monkeypox have been mostly identified among men who have sex with men but it can also spread from person to person through close contact with someone who has a monkeypox rash, including through face-to-face, skin-to-skin, mouth-to-mouth or mouth-to-skin contact, the World Health Organization said.
Dr Giola said the virus might be mutating.
"It can be [extremely unpleasant], and also, this outbreak is behaving in a different way from classical textbook monkeypox," he said.
"There are also some early signs the virus might be mutating, evolving and adapting more to human hosts, but also potentially causing different pathology than what it used to."
Dr Giola said from previous experience, the virus is likely to spread among the general population.
"So gay and bisexual men tend to be, as I say, the canary in the coal mine of STIs, and then you normally see a spill-over to the general population," he told Newshub at 8pm.
"So, for example, that's exactly what's happened with syphilis in New Zealand over the last decade.
"We saw in 2011 the cases go up among gay and bisexual men and only a couple of years later, we had cases in the general population, including in congenital syphilis cases. So, yes, that's definitely a worry and something that's probably going to happen."
It's not just Dr Giola who thinks monkeypox cases will spread around the country - Dr Chamberlain said New Zealand will likely see community transmission.
"The risk is low, but we will continue to see cases and these are likely to be from international travels as is currently the case, he said during an update on New Zealand's COVID-19 response on Thursday.
"At some stage, looking at the international experience, there will also be community transmission."
Chamberlain urged Kiwis travelling overseas to take caution, particularly in practising safe sex.
There is currently a global shortage in monkeypox vaccines as they are only supplied by one company.
New Zealand currently doesn't have any guaranteed supply of the vaccine, but the Ministry of Health said it is developing a plan.