Surveillance, case investigation and contact tracing for mpox (monkeypox): interim guidance, 22 December 2022

Overview

This is an updated version of the previous guidance published on 25 August 2022. It applies to all countries with potential mpox (monkeypox) cases, including countries that have historically documented mpox transmission and those that have not.

The document has been updated to consistently replace the name of the disease monkeypox with mpox, following the most recent WHO recommendations on this regard. It also includes a more detailed description of the investigation of a possible animal exposure, as well as the potential use of wastewater surveillance for detection of mpox transmission in communities. The advice on known contacts of probable and confirmed cases has been updated.

The overall goal of surveillance, case investigation and contact tracing in this context is to detect new outbreaks and stop human-to-human transmission to control the outbreak and minimize zoonotic transmission. The key objectives of surveillance and case investigation are to rapidly identify cases and clusters in order to provide optimal clinical care; to isolate cases to prevent further transmission; to identify, manage and follow up contacts to recognize early signs of infection; to protect frontline health workers; to identify risk groups; and to tailor effective control and prevention measures.

Clinicians should report suspected cases immediately to local and national public health authorities. Probable and confirmed cases of mpox should be reported as early as possible, including a minimum dataset of epidemiologically relevant information, to WHO through IHR national focal points (NFPs).

If mpox is suspected, case investigation should consist of clinical examination of the patient in a well-ventilated room while using appropriate personal protective equipment (PPE), questioning the patient about possible sources of infection, and safe collection and dispatch of specimens for mpox virus laboratory examination.

As soon as a suspected case is identified, contact identification and forward contact tracing should be initiated. Contacts of probable and confirmed cases should be monitored, or should self-monitor, daily for any sign or symptom for a period of 21 days from last contact. Quarantine or exclusion from work are not necessary as long as no symptoms develop, but known contacts should avoid sexual contact with others during the 21 days monitoring period, regardless of their symptoms.