Public health management of mpox
Version 2.0

• Name changed to ‘Public health management of mpox’
• Derogation of mpox clade I as a HCID on 19 March 2025 led to changes throughout the guidance and removal of the HCID naming of mpox. Updates of various links to the latest UKHSA guidance, including updated contact tracing matrix. The majority of guidance for clade 1 and clade 2 combined.
• PHS enhanced incident reduced to standard incident in March 2025. Arrangements for management changed, for example, the incident mailbox has been replaced with the relevant topic team mailboxes and the topic team mailbox for BHEI updated to ZEBR.
• Move from Roman numerals to standard (Arabic) numerals to improve the accessibility of the guidance.
• Addition of updated HAIRS guidance on rodents (March 2025).
• First use of possible, probable and confirmed public health case definitions.

• Updated vaccination advice for clade II mpox to reflect changes in the UKHSA contact tracing matrix.

• HCID mpox case definition updated to add that transit through an affected country without leaving the airport does not count as travel to that country
• Links to UKHSA guidance on reducing risk of transmission at vaccination clinics added
• Links to cleaning guidance for non-healthcare settings added
• Links to case isolation sheet added

• Testing section updated to add SVC to the list of laboratories offering HCID mpox testing

• Case definition links updated based on changes to case definition and lay-out of country list by UKHSA

• Change of name from monkeypox to mpox throughout when referring to the disease only
• Updated guidance to include differential public health management of HCID and non-HCID clades in response to outbreak of clade I (HCID) mpox in DRC and neighbouring countries.
• References to 2022 outbreak updated throughout.
• Case definitions updated based on changes by UKHSA.

• Updated the management of suspected HCID cases section.

• Updated clinical features section with link to Tecovirimat clinical policy.
• Updated notification requirement section with HCID clade lineage information.

• Updated symptom list in case definition.
• Updated actions for probable and possible cases.
• Updated household pets advice.
• Aligned with Green Book chapter update.
• Added blood, tissue, organ donation section.
• Revised clade nomenclature to align with WHO.

• Updated case definition.
• Information in transmission routes section updated.
• Added advice to notify cases their details may be shared during flight and international contact tracing for specific purposes.
• Addition of CMO letter link to the pre and post-exposure vaccination section.

• Remove links to  primary and community care guidance (archived).
• Align with UKHSA changes:
  • HCID status (derogation) and waste re-categorisation.
  • Updated Principles consensus statement.
  • Change to condom usage advice (12 weeks instead of 8) (new guidance).
  • Updated case def symptomology (proctitis added).
  • Updated contact tracing.
  • Updated PHS labs information note.
  • Updates case/contact information sheets.
  • Clarify wording on de-isolation.
  • Add links to new UKHSA guidance (events and mass gatherings).
  • Add link to Autopsy HSE guidance.
  • Isolation support.

• Move to passive surveillance of all contacts – active surveillance no longer required.
• Disposal of home testing waste clarified.
• APHA guidance on pet ownership added.

First publication.