Mpox

• A Poxvirus infection with similar clinical syndrome to smallpox
• 2 distinct clades
  • Clade 1: epidemic virus in Central and East Africa; transmission both respiratory and sexual; characteristic vesicular rash
  • Clade 2: epidemic mainly in GBMSM globally; sexual acquisition; rash typically orogenital, perineal

If I think someone might have Mpox what do I do?

1. Isolate the case in a side room; can be seen in ED/GUM and take a history
2. Wear PPE: Droplet/ contact PPE: Gown, gloves, surgical mask, visor, similar to COVID-19 precautions
3. Viral swabs (x2) from skin lesions and throat should be taken by clinical staff in appropriate droplet/ contact PPE

Remember: Ask about travel history of the case AND the contacts

• Travel history: cases of clade 1 will either have travel to countries affected by clade 1, list here [Check here:] or will be contacts of someone who has travelled to an affected country
• Likely mechanism of acquisition: cases of clade 2 will usually be MSM (man having sex with men) or a contact of someone who is MSM. Cases of clade 1 are usually families (inc children) with travel to affected areas
• Clinical symptoms: clade 2 symptoms are often fairly mild, and rash present in the perineal/ genital area or oral cavity; clade 1 may be more unwell and rash can cover more of the body
• See also Table 2

Table 2: Distinguishing Mpox from other infections (micro/ID only)

Clinical diagnosis of Mpox can be difficult, and it is often confused with other infections such as chickenpox.

·         https://www.gov.uk/guidance/monkeypox

·         https://www.gov.uk/government/news/monkeypox-cases-confirmed-in-england-latest-updates