The Aga Khan University Hospital, Karachi

Department of Infection Prevention and Hospital Epidemiology (DIPHE)

Emerging Infection Alert: Mpox (Monkeypox)

26th April 2023
For internal Use Only
Name of organism: Monkeypox virus

Current areas with outbreak: Multiple countries around the world.

Transmission:
• Human-to-human transmission occurs by:
o Face-to-face exposure (including health care workers without appropriate PPE).
o Direct physical contact.
o Contact with contaminated materials such as clothing or bedding.

Presenting complaints:
• Initially fever, headache, muscle pain, sore throat, and enlarged lymph nodes
• After 1 to 2 days rash starting from mouth to face then trunk and arms
o Rash starts as a flat sore that turns into a blister that is liquid-filled and may itch or hurt.
o All the lesions evolve at the same time (unlike chickenpox) and last 2 to 4 weeks
• Rash may also start before or at the same time as other symptoms or may not progress over the body.
• Rash may first develop in or around the mouth, groin, or anus.

Incubation period: 1 to 21 days

Contagious period: From the start of symptoms till all the crusts fall off

Screening at point of entry:

• Vesicular rash with fever or lymphadenopathy especially if history of travel
• Screening activities should be conducted maintaining a distance of at least 1 m from patients wearing a
mask.

Infection Control Measures:

• Initiate Airborne and contact precautions till chickenpox is ruled out.
• Once chickenpox is ruled out, shift the patient to droplet with contact precautions.
o A single room with a dedicated bathroom and staff is recommended.
o Cohorting is allowed if enough single rooms are not available.
o Recommended personal protective equipment (PPE) includes gloves, gown, N95 mask, and eye
protection.
o For Aerosol Generating Procedures shift to AIIR
o Cover lesions with a dressing, sheet, or clothing to reduce potential contact.
o PPE should be disposed of prior to leaving the isolation area where the patient is admitted.
o Ensure cleaning and disinfection of the equipment in between patients.
o Care must be taken when dealing with linen which may be infectious. Use red bags to transport.

In case of a suspected case, inform Infectious Diseases and DIPHE immediately.

Reference:
https://www.who.int/publications/i/item/WHO-MPX-Clinical-and-IPC-2022.1 (last accessed on: 26th April 2023)