The following pathway provides actions for when patients are rereferred to emergency departments (ED) for clinical assessment and testing after being identified as a possible case of mpox.
Download the referred to ED mpox pathway and checklist in PDF format (PDF 102KB)
Patient has been identified as a possible or probable case of mpox by a health care professional (HCP)
HCP should contact ED to agree arrangements for transfer (eg likely time of arrival, arrival point, what to do on arrival, including phone number to notify of arrival).
Actions if clinically unwell
Assessment indicates patient is clinically unwell and should be transported by ambulance, or is unable to self-transfer whilst maintaining isolation.
HCP to contact regional ambulance service to arrange transfer, clearly stating the patient is a suspected mpox case.
Patient to be managed as per local pathways and in line with suspected Clade I mpox virus pathway for patients self-presenting at emergency departments (link).
Actions if clinically stable
Assessment indicates patient is clinically stable and can transport themselves to attend ED via their own transport, whilst maintaining isolation.
Confirm with patient arrangements for transfer:
- maintain isolation
- where to present
- who to contact upon arrival
Patient to be managed as per local pathways and in line with suspected Clade I mpox virus pathway for patients self-presenting at emergency departments (link).
Pathway checklist
Patients referred to ED Clade I mpox pathway checklist – probable or possible cases:
- Have you isolated the patient?
- Have you assessed the patient’s ability to self-transfer?
- Have you confirmed transfer/arrival arrangements with the receiving department?
- Have you confirmed arrangements with the patient, including a phone number to contact upon arrival?
Links and guidance
- UKHSA public health messaging for NHS service providers
- Operational mpox (Clade I) case definition – including countries of risk
- Mpox case definition
- National infection prevention and control manual (NIPCM)
- Addendum on high consequence infectious disease (HCID) personal protective equipment (PPE)
Preparedness actions
- Providers to ensure that all clinical services are aware of the public health messaging and that a differential diagnosis of Clade I mpox should be considered in any patient that meets the operational case definition.
- Providers should review current infection prevention and control (IPC) plans, PPE availability, waste management and staff training to ensure that arrangements are in place to safely assess and treat patients presenting with suspected mpox – this should include identifying a suitable room and access and egress arrangements.
- Providers should review existing plans and clinical pathways ensuring that staff are aware of the arrangements for isolation, clinical management, specialist infection advice, PPE and associated infection control measures.