Case definitions for mpox (monkeypox)

Case definitions for mpox
Suspected case	The patient has a new characteristic rash or Meets one of the epidemiologic criteria and there is a high clinical suspicion for mpox (eg, presentation is consistent with an illness confused with mpox, such as secondary syphilis, herpes simplex, and varicella)
Probable case	There is no suspicion of other recent orthopoxvirus exposure (eg, vaccinia virus in ACAM2000 vaccination) and: Orthopoxvirus DNA is detected by polymerase chain reaction testing of a clinical specimen or Orthopoxvirus is detected using immunohistochemical or electron microscopy testing methods or The patient has detectable levels of anti-orthopoxvirus IgM antibody during the period of 4 to 56 days after rash onset
Confirmed mpox case	Monkeypox virus DNA is detected by polymerase chain reaction testing or next-generation sequencing of a clinical specimen or monkeypox virus is isolated in a culture from a clinical specimen.
Data used to determine case definition
Characteristic rash	New rash (any of the following):* Macular Papular Vesicular Pustular Generalized or localized Discrete or confluent The characteristic rash associated with mpox lesions involves deep-seated and well-circumscribed lesions, often with central umbilication. Lesions progress through specific sequential stages: macules, papules, vesicles, pustules, and scabs.
Epidemiologic criteria	Within 21 days of illness onset (any of the following): Patient reports having had contact with a person or people who have a similar appearing rash or who received a diagnosis of confirmed or probable mpox Patient had close or intimate in-person contact with persons in a social network experiencing mpox^¶^Δ Patient traveled to a country with confirmed cases of mpox or traveled to a country where monkeypox virus is endemic Patient had contact with a dead or live wild animal or exotic pet that is an African endemic species or used a product derived from such animals (eg, game meat, creams, lotions, powders)^◊
Laboratory criteria	The following findings on laboratory testing are used to inform the case definition: Detection of orthopoxvirus DNA by polymerase chain reaction testing of a clinical specimen Detection of orthopoxvirus using immunohistochemical or electron microscopy testing methods Detection of monkeypox virus DNA by polymerase chain reaction testing or next-generation sequencing of a clinical specimen Isolation of monkeypox virus in culture from a clinical specimen Demonstration of detectable levels of anti-orthopoxvirus IgM antibody 4 to 56 days after rash onset
Exclusion criteria	A case may be excluded as a suspected, probable, or confirmed mpox case if any of the following criteria are met: An alternative diagnosis can fully explain the illness An individual has some symptoms consistent with mpox (eg, fevers, chills, adenopathy) but does not develop a rash within 5 days of illness onset High quality specimens do not demonstrate the presence of orthopoxvirus or monkeypox virus or the patient does not develop antibodies to orthopoxvirus

This table represents the case definitions and clinical and epidemiologic criteria for mpox put forth by the United States Centers for Disease Control and Prevention (CDC) in May 2022. Updated information can be found on the CDC website. Other case definitions may vary. Case definitions put forth by the World Health Organization (WHO) can be found on the WHO website.

In November 2022, the World Health Organization changed the name of the disease referred to as "monkeypox" to "mpox." The virus that causes mpox continues to be referred to as monkeypox virus.

LRN: Laboratory Response Network.

* The rash associated with mpox can be confused with other, more common infections (eg, secondary syphilis, herpes simplex virus, chancroid, and varicella zoster virus). Sporadic reports of patients co-infected with monkeypox virus and other infectious agents have been reported (eg, varicella zoster virus, Treponema pallidum).

¶ This includes men who have sex with men who meet partners through an online website, digital applications, or at a social event (eg, bar or party).

Δ Although the 2022 outbreak to date has been primarily reported in men who have sex with men, anyone who has been in close contact with someone who has mpox is at risk.

◊ Other types of animal exposures have also been reported. In 2003, an outbreak of mpox in the United States was associated with prairie dogs who acquired the virus from African rodents.

Adapted from: Centers for Disease Control and Prevention. Monkeypox Outbreak — Nine States, May 2022. Available at: https://www.cdc.gov/mmwr/volumes/71/wr/mm7123e1.htm?s_cid=mm7123e1_w (Accessed on June 7, 2022).

Graphic 138741 Version 5.0

خرید پکیج

Case definitions for mpox (monkeypox)