Public Health England (PHE) has issued guidance on monkeypox infection for healthcare professionals in primary care. The guidance comes after the first imported case of monkeypox reported in England on 8 September 2018. A second case was reported on 11 September 2018.
Monkeypox does not spread easily and transmission occurs only when there is close contact with an animal reservoir, human, or materials contaminated with the virus. The routes of entry for the virus are broken skin, respiratory tract, or the mucous membranes. Human-to-human transmission may happen via contact with clothing or linens of an infected individual, direct contact with lesions or scabs, and coughing or sneezing of an infected individual with a rash.
The infection is mild and self-limiting, and the majority of individuals recover within several weeks; however, some individuals may experience severe illness. The initial symptoms include fever, headache, muscle aches, backache, swollen lymph nodes, chills, and exhaustion. This is followed by a rash progressing to scabs. Clinical diagnosis is often challenging and requires clinical assessment and specific lab testing. The Rare and Imported Pathogens Laboratory is the designated testing site in the United Kingdom. Treatment is primarily supportive due to its self-limiting nature.
Suspected and confirmed cases require respiratory isolation. Clinical laboratories should be informed beforehand to take necessary steps for infection control.