Mpox (monkeypox)


Mpox (monkeypox) – information for healthcare professionals

Mpox is caused by the mpox virus, and is a member of the Orthopoxvirus genus in the family Poxviridae. It is a viral zoonotic disease that occurs primarily in tropical rainforest areas of central and west Africa. There has been a recent increase in cases in the UK. This page provides information to support healthcare professionals in NHS Wales.


Key facts

The following information has been taken from the WHO fact sheet on mpox:

  • Mpox is usually a self-limited disease with the symptoms lasting from 2 to 4 weeks. Severe cases can occur. In recent times, the case fatality ratio has been around 3–6%.
  • Mpox is transmitted to humans through close contact with an infected person or animal, or with material contaminated with the virus.
  • Mpox virus is transmitted from one person to another by close contact with lesions, body fluids, respiratory droplets and contaminated materials such as bedding.
  • The clinical presentation of mpox resembles that of smallpox, a related orthopoxvirus infection which was declared eradicated worldwide in 1980. Mpox is less contagious than smallpox and causes less severe illness.
  • Mpox typically presents clinically with fever, rash and swollen lymph nodes and may lead to a range of medical complications.

Antiviral treatment options

The Chief Medical Officers of Wales, England, Scotland and Northern Ireland have issued a Therapeutic Alert on the use of tecovirimat as a treatment for patients hospitalised due to mpox infection. An UK-wide interim clinical commissioning policy statement has also been published.

There are three potential antiviral treatment options for human mpox infection. The Welsh Medicines Advice Service have compiled the following table to help healthcare professionals consider the risks and benefits of each of the treatment options.

Monkeypox vaccination

No stock of UK-licensed product is currently available. The US Jynneos® brand and the EU version of Imvanex® are currently being imported into the UK.

For further details on the current licence status of available products and the legal mechanisms for administration, see the considerations for mpox vaccination page from the Specialist Pharmacy Service.

Patient Group Direction (PGD)

The national mpox vaccination PGD template is available in the immunisation section of the PGD page.

Patient Specific Direction (PSD)

The national mpox vaccination PSD template is available below. This PSD template is for adaptation by local health boards.

Public information resources

NHS 111 Wales have information on mpox

Public Health Wales have produced leaflets on protecting from mpox

The Welsh Medicines Advice Service has produced information leaflets on tecovirimat, an antiviral used to treat orthopoxvirus diseases, such as mpox, in adults and children weighing 13 kg or more.

Useful information

Change history

16 Aug 23

National PGD template for mpox vaccination moved to PGD page.

25 Jan 23

Amended terminology to reflect WHO preferred mpox as a synonym for monkeypox. Updated national PGD template added.

25 Oct 22

Tecovirimat PILs added.

25 Sep 22

Statement on tecovirimat treatment for hospitalised patients added.

08 Sep 22

National PSD template and licence status information updated.

09 Aug 22

National PGD template and NHS 111 Wales A-Z link added.

21 Jul 22

Yellow card reporting site link added.

15 Jul 22

BASHH link added.

30 Jun 22

Public Health Wales leaflets and page added.

28 Jun 22

National PSD template added. Link to NHS Health A to Z page added.

22 Jun 22

Link to Green Book chapter added.

14 Jun 22