The following pathway provides actions to be taken when a patient has been identified as requiring a clinical assessment to determine if they are a possible or probable case of mpox.
Download the community setting mpox pathway and checklist in PDF format (PDF 101KB)
Initial assessment
Initial assessment of patient to determine whether they are clinically stable or require immediate intervention, in community/outpatient settings (e.g. WIC and community pharmacies).
- Patients should be isolated/socially distanced and a virtual assessment should take place (eg by phone).
- Staff should not physically assess the patient without personal protective equipment (PPE).
Actions if clinically well
- Assessment indicates patient is clinically stable and can remain at home (or return home via their own transport) whilst maintaining isolation.
- Patient should be advised to return home, maintain isolation and contact 111.
- 111 pathway implemented.
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.
- Advise the patient to dial 999 if urgent, or contact regional ambulance service to arrange transfer, clearly stating the patient is a suspected mpox case.
- Emergency department pathway implemented.
Pathway checklist
Community based Clade I mpox pathway checklist – probable or possible cases:
- Where possible isolate/socially distance from the patient
- Have you assessed the patient’s ability to self-transfer (maintaining self-isolation)?
- Seek advice from local infection prevention and control as required (including cleaning).
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) 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.