Identification and notification of MPX cases Advice for Clinicians View online here: MPX (monkeypox) information for clinicians | Ministry of Health NZ Clinicians are asked to look out for signs and symptoms consistent with MPX. This is particularly important when seeing patients from groups disproportionately impacted by the current global MPX outbreak, which includes: • men who have sex with men (MSM), • people who have sex with MSM including transgender, cisgender, and non-binary people, • anyone with two or more sexual partners or any anonymous sexual partners. Information about all recent travel, sexual history (anonymous or multiple in the last 21 days) and smallpox and MPX immunisation history should be collected where MPX is suspected. Ensure that appropriate infection prevention controls such as Standard Precautions, Contact and Droplet Precautions are adhered to for physical examination. A P2/N95 mask is suggested for oropharyngeal samples. MPX signs and symptoms • Viral prodrome • Rash (or single lesion) – especially if localised to ano-genital skin, oropharynx or rectal mucosa (proctitis) If MPX is suspected If MPX is suspected, prior to the collection of any test samples, clinicians must escalate to their local Medical Officer of Health and/or Clinical Microbiologist according to the HealthPathway in their region. Cases under investigation should be advised to isolate and avoid close contact (including kissing or sexual contact) with others while waiting for test results. Probable cases are required to isolate until test results confirm a diagnosis and confirmed cases are required to isolate for a minimum of seven days from onset of symptoms. Just noting this may change imminently. Read more about people with MPX and isolation guidance. Clinical oversight of cases Once notified, the local Public Health Unit will follow up with the case to provide isolation advice and conduct source and contact tracing. Clinical oversight of the case (including clinical review, prescriptions, etc) will need to be provided by the case’s GP (within hours) or in liaison with the on call Acute General Medical Physician at either Bay of Plenty or Lakes hospitals (after hours). There may be capacity for clinical review by the local Sexual Health service if a GP review isn’t possible. This would need to be in discussion with the local sexual health staff at the time. Key links for the most up to date information: • •
Ministry of Health MPX (Monkeypox) information page Monkeypox Communicable Disease Control Manual chapter
This advice about the identification and notification of MPX cases has been developed for Bay of Plenty and Lakes districts clinicians by Toi Te Ora Public Health.
Toi Te Ora Public Health - Version 1.1 – 22/11/2022
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