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.
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.
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 below. This PGD template is for adaptation by local health boards.
- Modified Vaccinia Ankara Bavarian Nordic (MVA-BN) vaccine (Jynneos) suspension for injection for active immunisation against mpox
Patient Specific Direction (PSD)
The national mpox vaccination PSD template is available below. This PSD template is for adaptation by local health boards.
- Modified Vaccinia Ankara (MVA-BN) vaccine suspension for injection for active immunisation against mpox
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.
- Tecovirimat 200 mg capsiwlau caled (TPOXX®) – gwybodaeth i’r defnyddiwr
- Tecovirimat 200 mg hard capsules (TPOXX®) – information for the user
- Mpox: guidance from UKHSA
- Monkeypox – Information for health professionals from Public Health Wales
- Considerations for mpox (monkeypox) vaccination from Specialist Pharmacy Service (SPS)
- Monkeypox resources from the British Association for Sexual Health and HIV (BASHH)
- Smallpox and monkeypox immunisation, chapter 29 in Immunisation against infectious disease (the Green Book)
- Monkeypox vaccination information from Public Health Wales
- Monkeypox information on NHS Health A to Z
- Report any adverse reactions following MVA-BN vaccination to the MHRA using the online Yellow Card reporting site or via the Yellow Card app
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