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Thursday, 5 June 2025
WHO releases new recommendations for Clinical management and infection prevention and control for mpox [https://www.who.int/publications/i/item/B09434]
WHO has released new recommendations for clinical management and infection prevention and control (IPC) for mpox. The guideline applies to patients with mpox infection cared for in the community, at home or in a health facility. If the person with mpox is an acute infection patient or is at risk of complications, they should be managed in a health facility setting and have more supportive care. Only mild, non-complicated cases of mpox should be managed with home-based care.
The guideline contains recommendations for public health specialists, health emergency responders, clinicians, health facility managers, health and care workers and IPC practitioners including but not limited to those working in primary care clinics, sexual health clinics, emergency departments, dental practices, infectious diseases clinics, genitourinary clinics, maternity services, paediatrics, obstetrics and gynaecology and acute care facilities that provide care for patients with suspected or confirmed mpox.
IPC recommendations in health care setting:
Health workers should use gloves, gowns, medical masks and eye protection based on risk assessment when providing care for mpox patients. Respirators are required when aerosol generating procedures are performed and to be considered if the room is poorly ventilated.
IPC recommendations for home care:
WHO suggests that persons with mild, uncomplicated mpox cared for at home are not required to isolate, provided their lesions are covered and they wear a well-fitting medical mask when in close proximity with others until all lesions are healed. Persons with mpox who are unable to comply with covering their lesions or wearing a medical mask should be isolated at home. IPC measures to reduce environmental contamination in the home should be implemented.
Clinical management recommendations:
The three new clinical recommendations below apply to all individuals with mpox infection, regardless of whether they are being cared for in the community, at home, or within a health facility.
WHO suggests that mothers with mpox continue breastfeeding whilst limiting direct contact with their non-infected infant.WHO suggests that mothers who recover from mpox infection and who had withheld breastfeeding and direct contact, to resume breastfeeding and direct contact with the infant as soon as lesions are healed.WHO recommends rapid initiation of antiretroviral therapy (ART) in people with mpox infection and HIV who are ART naïve or have had a prolonged interruption of ART.
WHO published an interim guidance for mpox in 2022: WHO published interim guidance for mpox in 2022. [https://www.who.int/publications/i/item/WHO-MPX-Clinical-and-IPC-2022.1] Since then the mpox virus, also known as the monkeypox virus (MPXV), has continued to evolve and the pattern of disease outbreaks has also changed. Prior to 2022, mpox was primarily reported in Central and West Africa. In 2022, a global outbreak of clade IIb was declared and continues to affect numerous countries. Subsequently, there have been outbreaks associated with clades Ia and Ib, primarily affecting the Democratic Republic of the Congo and neighbouring African countries. Since August 2024, increasing mpox infections in Africa and detection of clade Ib beyond the African continent, have led to a second declaration by the WHO Director General of a public health emergency of international concern related to the epidemic risk and widespread transmission of MPXV.
Related links:
Clinical management and infection prevention and control for mpox: living guideline, May 2025 [https://www.who.int/publications/i/item/B09434] Mpox outbreak [https://www.who.int/emergencies/situations/mpox-outbreak]
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