Monkeypox
Somerset Approved Pathway for Monkeypox - 24 June 2022
Monkeypox update 26.5.22
This email sets out the current process for managing all monkeypox enquires from clinicians. Establishing the case definition that your patient fulfils is key to ensuring the appropriate response.
1. Please check if your patient meets the case definition for a possible or probable case
Please continue to refer to the live link when assessing any patients as case definitions are subject to regular change by the UKHSA as the National Incident Team respond to the evolving situation.
2. For patients meeting the possible and probable case definition in the community:
- Check on the current location of the patient, and advise that they self-isolate at home until testing and clinical assessment can be arranged
- Speak to the infectious diseases/microbiology/virology consultant at your local trust for advice on clinical assessment and testing. Please refer to the Central Alerting System (CAS) notification of 16 May 2022. Full url here: CAS-View Alert (mhra.gov.uk) and note its attachment
If appropriate, the infectious diseases/microbiology/virology consultant will link with the UKHSA Imported Fever Service (IFS) for further advice – they will have the number for the Imported Fevers Service (FS) details also in the CAS alert.
The Imported Fever Service will work with the with Rare and Imported Pathogens Laboratory to coordinate diagnostic testing. They will advise on what testing needs to take place and where , if can’t be done safely in your setting then IFS will advise how testing can be safely accessed elsewhere, including communications to the receiving setting;
If the patient needs to attend a healthcare setting for assessment and testing, please ask them to avoid public transport or taxis, and walk or go by private car if at all possible as well as notifying the healthcare facility of their expected arrival. Please discourage people from turning up to health care facilities without an appointment.
3. Please inform your local HPT of the outcome of your assessment (possible or probable case) and any of the following, if you have available:
- Whether the patient being treated as probable or possible case of monkeypox, or if no further action has been recommended.
- Confirm date, time and location of clinical assessment
- Confirm date and site of testing
- Any known epidemiological links to existing cases or foreign travel
by emailing swhpt@phe.gov.uk with the HPZ reference number supplied in this email. This step is crucial to ensure rapid public health action in the event of a positive swab result.
You should not need to send any PII (since we are using an HPZ reference number) but if you do, please ensure you send this information encrypted (e.g. by Egress)
Should you have urgent updates, please call 0300 303 8162 stating urgent Monkeypox update. We respond to calls in and out of hours.
4. Clinicians assessing probable cases in the community:
- Please ensure that the correct PPE is worn for your situation by discussing this with the IFS.
If your patient does not meet the case definition as outlined in the link above, please assess them in the usual way, taking the appropriate infection, prevention and control precautions for anyone presenting with a rash illness.
Further information
A rolling news story on Monkeypox has pictures that may be of use in clinical assessment.
UKHSA have developed social assets in various formats for use on social channels for general awareness of monkeypox and what people should do if they have symptoms.
#Monkeypox Anyone with unusual rashes or lesions on any part of their body should contact NHS 111 or call a sexual health service.
Finally, please note a non-clinical general enquiry line is in operation for individuals impacted by Monkeypox (for example Category 1 – low risk contacts) by calling 0333 2423 672; 8am-6pm Mon-Fri and 9am-1pm Sat-Sun.
With much appreciation of your assistance in managing these cases and maintaining communication with UKHSA
Please find a link CEM_CMO_2022_008.pdf to the CAS alert issued last week following confirmation of a number of monkeypox cases. To date, there has been a total number of 20 confirmed cases since 06 May.
The CAS alert provides current clinical advice and guidance but as this is an emerging situation will be updated accordingly.
The actions are:
- Providers to ensure that they have appropriate PPE for the assessment and treatment of patients presenting with possible monkeypox virus.
- Services should consider a differential diagnosis of monkeypox virus in any patient who meets the possible case definition in the attachment.
- Inform local IPC teams and infectious disease/microbiology/virology consultants if a diagnosis of monkeypox virus is being considered so that appropriate testing and infection control measures can be implemented.
See also:
UK Health Security Agency briefing note on Monkeypox cases (16.05.22)
Monkeypox cases confirmed in England - latest updates from Gov.uk
