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    Anonymous
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    A possible case is defined as anyone who fits one or more of the following criteria:

    a febrile prodrome† compatible with monkeypox infection where there is known prior contact with a confirmed case in the 21 days before symptom onset
    an illness where the clinician has a suspicion of monkeypox – this could include unexplained genital, ano-genital or oral lesion(s) (for example, ulcers, nodules) or proctitis (for example anorectal pain, bleeding)octitis (for example anorectal pain, bleeding)
    †Febrile prodrome consists of fever ? 38°C, chills, headache, exhaustion, muscle aches (myalgia), joint pain (arthralgia), backache, and swollen lymph nodes (lymphadenopathy).

    Probable case
    A probable case is defined as anyone with an unexplained rash or lesion(s) on any part of their body (including genital/perianal, oral), or proctitis (for example anorectal pain, bleeding) and who:

    has an epidemiological link to a confirmed, probable or highly probable case of monkeypox in the 21 days before symptom onset
    or

    identifies as a gay, bisexual or other man who has sex with men (GBMSM)
    or

    has had one or more new sexual partners in the 21 days before symptom onset
    or

    reports a travel history to West or Central Africa in the 21 days before symptom onset
    Actions on a possible or probable case
    Test for monkeypox (using designated testing pathway).

    Undertake additional contemporaneous tests to rule out alternative diagnoses if clinically appropriate and if not done already.

    If admission of patient required for clinical reasons, admit to single room isolation at negative or neutral pressure at local hospital site with RPE PPE (with appropriate IPC arrangements).

    Or, if patient not requiring admission for clinical reasons: self-isolation at home (based on assessment by the clinician and following UKHSA guidance).

    Or, if patient not requiring admission for clinical reasons but self-isolation at home is not possible for social or medical reasons following clinician assessment: isolation in single room at negative or neutral pressure at local hospital site with RPE PPE pending test result (prioritise probable cases).

    Highly probable case
    A highly probable case is defined as a person with an orthopox virus positive result since 15 March 2022 and where monkeypox remains the most likely diagnosis.

    Confirmed case
    A confirmed case is defined as a person with a laboratory confirmed monkeypox infection (monkeypox PCR positive).

    UK Guidance July 2022

    G Mohan

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