Mpox, How Monkeypox Is Managed at Home or in the Hospital

While a case of Mpox, formerly monkeypox , has been confirmed in Italy, in Umbria, in a young man in good health for whom the origin of the contagion is not yet clear, the World Health Organization has published in recent days new recommendations for the clinical management, prevention and control of Mpox infections . The new WHO guidelines apply to infected patients cared for in the community, at home or in a health facility , and update the provisional indications released by the Geneva agency in 2022.

Since then - WHO recalls - the Mpox virus (Mpxv) has continued to evolve and the pattern of epidemics supported by this pathogen has also changed. Before 2022, Mpox was reported mainly in Central and West Africa, while in 2022 - a watershed year - a global epidemic of the viral clade IIb was declared and continues to affect numerous countries. Subsequently, epidemics associated with clades Ia and Ib occurred, mainly affecting the Democratic Republic of the Congo and neighboring African countries. Since August 2024, the increase in Mpox infections in Africa and the detection of clade Ib outside the African continent led the Director-General of WHO, Tedros Adhanom Ghebreyesus, to declare Mpox a Public Health Emergency of International Concern (PHEIC) for the second time. The fourth meeting of the dedicated Emergency Committee was held on June 5 to decide whether or not to confirm the status of Pheic for Mpox.

"If the person with Mpox is a patient with acute infection or is at risk of complications - is the first recommendation of the WHO - he or she should be managed in a health facility and receive supportive care. Only mild and uncomplicated cases of Mpox should be managed at home".

If the person infected with the Mpox virus has a mild infection and is not at risk of complications , and can therefore be cared for at home , the WHO specifies that the patient is not required to isolate themselves, provided that the lesions are covered and that the infected person wears a well-fitting mask when in close proximity to other people, until all the lesions have healed. If it is impossible to cover the lesions or keep the mask on, the patient must be isolated at home. In the home, it is still necessary to implement measures to reduce environmental contamination.

If the infected person's condition warrants hospitalization , the operators who assist him must use gloves, gowns, masks and eye protection based on the risk assessment, the WHO prescribes. Respirators are mandatory when performing procedures that release aerosols and must be considered if the room is poorly ventilated.

The UN health agency also provides 3 new general clinical recommendations , addressed to all people with Mpox infection regardless of the context in which they are cared for. WHO advises infected mothers to continue breastfeeding, but to limit direct contact with the uninfected newborn. It also advises mothers who have recovered from Mpox, who had stopped breastfeeding and direct contact with the newborn, to resume them as soon as the lesions have resolved. Finally, WHO recommends rapidly initiating antiretroviral therapy in people with Mpxv and HIV infection who have never received treatment or who have stopped it.