Surveillance, case investigation and contact tracing for Monkeypox: Interim guidance - ISS-G20 Laboratorium Repository

This is an updated version of the previous guidance published on 22 May 2022. It applies to all countries with potential monkeypox cases, including countries that have historically documented monkeypox transmission and those that have not.

The confirmed case definition has been updated to include polymerase chain reaction (PCR) positive cases, regardless of associated symptoms or their absence, in order to more fully characterize pre-symptomatic, pauci-symptomatic or asymptomatic infections. The contact definition has been amended to include more examples of potential exposures, as well as the contact risk levels established by the monkeypox immunization guidance.

The overall goal of surveillance, case investigation and contact tracing in this context is to stop human-to-human transmission to control the outbreak. 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 monkeypox should be reported as early as possible, including a minimum dataset of epidemiologically relevant information, to WHO through IHR national focal points (NFPs).

If monkeypox is suspected, case investigation should consist of clinical examination of the patient while using appropriate personal protective equipment (PPE), 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.

Entire content available on: https://www.who.int/publications/i/item/WHO-MPX-Surveillance-2022.2