Mpox
Mpox Playbook – Updated August 16, 2024
To help infection preventionists quickly activate mpox prevention efforts, APIC’s Emerging Infectious Diseases Task Force has created an Mpox Playbook that IPs can download and customize for use in their facilities. The Playbook is a concise workflow document that is designed to be user-friendly and operational for busy IPs. Access the Playbook here.
About Mpox
- Mpox was historically known as monkeypox, but in 2022, the World Health Organization officially adopted the term mpox
- Mpox is a viral zoonotic disease caused by the mpox virus, part of the Orthopoxvirus genus (related to smallpox)
- There are two main genetic clades: Clade I is more virulent and historically associated with higher hospitalization and mortality rates. Clade II is less severe but is responsible for the global 2022-2023 outbreak
- Direct skin-to-skin contact with lesions or body fluids
- Respiratory droplets during prolonged face-to-face contact
- Fomite exposure, particularly via contaminated linens, bedding, or clothing
- Vertical transmission from pregnant individuals to the fetus
- Occasional animal-to-human transmission via contact with infected wildlife or exotic pets
- Incubation Period: 7 to 14 days (up to 21 days)
- Rash development may occur
- Lesions may be localized or generalized
- Antiviral and JYNNEOS vaccination can be used for treatment or post-exposure prophylaxis when indicated
- Prior to 2022, mpox cases were primarily linked to travel from endemic regions in Africa
- In 2022, mpox spread across dozens of countries without direct animal exposure, marking the first documented community transmission in non-endemic regions
Current Situation
- The United States reported tens of thousands of cases during the 2022 outbreak, with ongoing low-level community spread
- The first U.S. case of Clade I mpox was detected in November 2024, signaling the need for heightened clinical awareness. This resulted in the CDC issuing a HAN advisory (CDC, 2024).
- CDC continues to classify the overall risk to the United States public as low, but increased vigilance is recommended among healthcare providers
Mpox is a re-emerging infectious disease with outbreak potential that healthcare facilities must be prepared for, which includes a plan for:
- Screen individuals presenting with unexplained rash and lymphadenopathy, especially with recent travel or known close physicial contact
- Implement Standard and Contact Precautions with droplet or airborne precuations, depending on symptoms and procedures
- Ensure environmental cleaning and proper handling of contaminated laundry and formites
- Verify vaccination eligbility for staff and expossed patients
- Coordinate with public health authorities for testing and case report
APIC Resources and Tools
Click here to download the APIC Mpox Playbook
- Developed by the APIC Emerging Infectious Diseases Task Force to help infection preventionists rapidly activate Mpox prevention efforts
- The playbook is a concise workflow document that is designed to be user-friendly and operational for busy IPs.
Click here for a copy of the APIC and SHEA Mpox Webinar Slides
- In 2022, APIC and SHEA co-hosted a webinar on mpox, providing infection preventionists and healthcare epidemiologists with up-to-date guidance covering transmission, isolation, and vaccination guidance
Additional External Resources
