Monkey Pox

Background

MPX (MPox) is notifiable a zoonotic viral disease caused by the enveloped double‐stranded DNA Monkeypox virus (MPXV)
Others in its Orthopoxvirus genus include Vaccinia, Cowpox and Variola viruses
The Central African (Congo Basin) strain is typically more infectious and associated with more sever disease
Transmission via direct contact
Some cases globally (2022) in gay or bisexual men. Most do not have a Hx of travel
Clinical presentation similar to smallpox

Fever (>38° ±rigors), headache(±severe), marked asthenia, adenopathy, myalgia
1-3 days post fever the rash appears (face→trunk→hands & feet and mucous membranes)
Macules→papules→vesicles→crusts/scabs
Lesions all appear at the same stage, distinguishing them from chicken pox (varicella chicken pox)
Most MPX patients have significant prodromal lymphadenopathy (varicella chicken pox usually don't)
Most MPX patients have a significant prodromal fever (most varicella don't)
For most, (not immunocompromised) MPX is a self-limiting disease lasting up to 4 weeks with full recovery
< 10%, (age extremes or immunocompromised), resp. distress, 2° bacterial infections and encephalitis may develop

Contact, droplet and airborne precautions
PPE with FFP2/3 mask, eye protection, disposable nitrile gloves, long-sleeved gown
Discuss with ID
The majority can be discharged and managed in the community
In the exceptional cases requiring admission, care is supportive
If very unwell/requiring admission, consider prevention / treatment of 2° bacterial infections
If admitted, I may consider empiric treatment of HSV or early syphilis while awaiting test results
Inform Public Health