Surveillance, case investigation and contact tracing for mpox (monkeypox): Interim guidance, 20 March 2024
Interim guidance
Overview
This is an updated version of the interim guidance for surveillance, case investigation and contact-tracing for mpox published on 22 December 2022. It applies to all countries.
The document has been revised to align with the recommended reporting procedures following the issuance of the WHO Standing recommendations for mpox and includes the most recent information available on mpox. The document contains a new chapter on mpox reinfection and provides case definitions for suspected, probable and confirmed reinfection. It has also been adapted to include more considerations relevant to endemic contexts in the African region.
The overall goal of surveillance, case investigation and contact tracing for mpox is to detect new outbreaks and stop transmission, protect people at risk in endemic and new settings, and make progress towards elimination of human-to-human transmission of mpox.
The key objectives of surveillance and case investigation for mpox are to rapidly identify cases and clusters of infections as well as the sources of infection as soon as possible in order to:
- provide optimal clinical care;
- isolate cases to prevent further transmission;
- identify, manage and follow-up contacts to recognize early signs of infection;
- identify risk groups for infection and for severe disease;
- protect frontline health workers; and
- tailor effective control and prevention measures.
Clinicians should report suspected cases immediately to relevant public health authorities. Probable and confirmed cases of mpox should be reported to WHO through IHR national focal points (NFPs) as early as possible, at least once monthly, including a minimum dataset of epidemiologically relevant information, in line with Article 6 of the International Health Regulations (IHR 2005) and the mpox standing recommendations issued by the WHO Director-General (August 2023).
In areas where mpox is endemic, presumed or suspected cases that meet the national case definition (i.e., cases that are clinically compatible) should also be reported to WHO.
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, questioning the patient about possible sources of infection, and safe collection and dispatch of specimens for monkeypox 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.
