NSW-specific management of suspected, confirmed and probable cases and contacts.
Public Health Unit (PHU) should begin follow-up investigation (Figure 1) following notification of a suspected case of mpox. PHU should ensure that action has been taken to:
If required and on a case-by-case basis, the Communicable Diseases Branch (CDB) can convene an urgent Expert Panel meeting to discuss the clinical, epidemiological and laboratory information for the management of the suspected case. The Expert Panel may comprise of:
If the initial test result is negative for orthopoxvirus or mpox virus, the PHU should work with the treating clinician to contact the suspected case to inform them of the result and, if they are a contact of a confirmed case, advise them to continue to monitor for any clinically compatible symptoms for 21 days after their last exposure. If they develop any symptoms, they should be advised to call ahead before presenting to their GP for assessment and testing.
The PHU should arrange for the cases to be medically monitored from home by clinicians in the local health district, either:
If a patient in the community requires a medical review (for example, surgical, ophthalmological, medical) with concerns that they have complications, this should be escalated to the Westmead Hospital Infectious Diseases/Clinical Microbiologist physician on call so that they can arrange telehealth consult or facilitate transfer and assessment.
The decision to arrange transport of a patient who requires admission to NSW Biocontainment Centre by NSW Ambulance/Patient Transport Services should be dictated by severity of illness. This should be a shared decision between the treating physician and PHU. For patients with mild illness, patients can be transported by a family member or carer, or by public transport, provided lesions are covered and the patient is instructed to wear a mask and be diligent with hand hygiene.
PHUs are advised to follow the below procedure for any confirmed, probable or suspected mpox cases:
Contacts of probable and confirmed cases of mpox virus infection should be instructed to monitor their temperature and watch for signs and symptoms daily for 21 days after their last exposure.
Low-risk contacts can be followed up at PHU discretion and supplied with the
low-risk contact fact sheet.
There are three contact fact sheets available:
Guidance on infection prevention and control in community, hospital, and institutional settings including sexual health clinics, primary care, and laboratories is available from
Clinical Excelence Commission: Infection Prevention and Control Information for clinicians - Monkeypox.
Guidance on how to clean and disinfect a private residence for mpox cases who are isolating at home is available from
The Clinical Excellence Commission: Household Cleaning and Disinfection Information – Monkeypox.
Guidance on recommendations from an infection prevention and control perspective for infectious cleans as may be requested by NSW Health Protection:
Clinical Excellence Commission cleaning and disinfection information - Hotels.