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Mpox (previously known as Monkeypox)

Please click the frequently asked questions below for further information and IPC precautions required:

  • What is Mpox?

    Mpox is considered a High Consequence Infectious Disease (HCID) and therefore the IPC team should be urgently contacted for advice for all potential cases.

    Mpox (previously known as monkeypox) is a rare disease caused by infection with the mpox virus. Mpox virus is part of the same family of viruses as variola virus, the virus that causes smallpox. Mpox symptoms are similar to smallpox symptoms, but milder, and mpox is rarely fatal. Mpox is not related to chickenpox.

    In June 2022, the Advisory Committee on Dangerous Pathogens (ACDP) considered the HCID criteria in the context of the UK outbreak (2022). Consensus has been reached between Public Health Agencies of the Four Nations that the specific outbreak clade of mpox in the UK should no longer be designated, and therefore managed, as a HCID.

    See HCID status of mpox (monkeypox) – GOV.UK ( for more information on the de-classification of the current outbreak clade of mpox.

  • How does it spread?

    Mpox can spread to anyone through close, personal, often skin-to-skin contact, including:

    • Direct contact with mpox rash and scabs from a person with mpox, as well as contact with their saliva, upper respiratory secretions, and areas around the anus, rectum, or vagina

    This direct contact can happen during intimate contact, including:

    • Oral, anal, or vaginal sex, or touching the genitals (penis, testicles, labia, and vagina) or anus of a person with mpox
    • Hugging, massage, and kissing
    • Prolonged face-to-face contact
    • The risk is considered low for getting mpox by touching objects, fabrics, and surfaces that have been used by someone with mpox and not disinfected, such as clothing, bedding, towels, fetish gear, or sex toys.

    A person with mpox can spread it to others from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. As of February 2023, new data show that some people can spread mpox to others from one to four days before their symptoms appear.

  • What are the symptoms of Mpox?

    People with mpox often get a rash that may be located on hands, feet, chest, face, or mouth or near the genitals, including penis, testicles, labia, and vagina, and anus.  The incubation period is 3-17 days. During this time, a person does not have symptoms and may feel fine.

    • The rash will go through several stages, including scabs, before healing.
    • The rash can initially look like pimples or blisters and may be painful or itchy.

    Other symptoms of mpox can include:

    • Fever
    • Chills
    • Swollen lymph nodes
    • Exhaustion
    • Muscle aches and backache
    • Headache
    • Respiratory symptoms (e.g., sore throat, nasal congestion, or cough)

    You may experience all or only a few symptoms

    • Sometimes, people have flu-like symptoms before the rash.
    • Some people get a rash first, followed by other symptoms.
    • Others only experience a rash.

  • Why is this important?

    If NIAS staff are aware that the patient has a suspected or confirmed Mpox this should be communicated to EAC / NEAC and the receiving unit when transferring the patient to ensure effective patient care and management.

    This should also be communicated to the IPC team.

  • IPC Precautions

    For imported case:

    • This should be treated as a HCID.
    • The HART team should be involved in risk assessment and transfer of all suspected and confirmed cases.
    • As this is a HCID there are specific guidelines surrounding the use of PPE. Guidance should be sought for the appropriate method of donning and doffing of PPE.
    • A fit tested FFP3 mask will be used.
    • Ensure use of a buddy system for donning and doffing PPE.

    The NIAS guidance for VHF should be used and the IPC team contacted immediately for further advice.

    For case associated with UK outbreak:

    • Fit-tested FFP3 respirator
    • Eye protection
    • Long sleeved, fluid repellent, disposable gown
    • Gloves
  • What cleaning is required?
    • All equipment and the ambulance should have a deep clean with a hypochlorite solution with a strength of 10,000 PPM (Same dilution as blood and body fluids).
    • Appropriate PPE should be worn when decontaminating the vehicle and the equipment.
    • Any single use equipment should be disposed of.
    • Waste should be treated as Category 4 waste and disposed of in line with the trust waste.

    Individual cases can be discussed with the IPC team.

  • Do staff need prophylaxis or follow up?

    A list of staff will be recorded of all staff who have had interaction with the suspected/confirmed case.

    All staff in contact with a case of Mpox will be individually risk assessed by the multi-agency team.

  • Links to guidance