How to cope with suspected mpox patients in the outpatient clinic

Abstract

Background: This article outlines procedures for monitoring and handling mpox outbreaks in Korea based on the 5th edition of the guidelines for response to mpox and recent briefing material from the Korea Disease Prevention and Control Agency (KDCA). Covering epidemiology, pathogenesis, clinical characteristics, diagnosis, treatment, prognosis, and prevention, and focusing on domestic resources, it offers guidance for healthcare professionals on coping with suspected mpox cases.Current Concepts: Human mpox infections mainly occur through person-to-person transmission. Historically, sporadic outbreaks of mpox have taken place, primarily in Africa, but mpox has subsequently spread globally. In Korea, after the first case report in June 2022, 52 cases had been reported as of May 1, 2023. Fifty cases had sexual contact with high-risk persons with mpox infection. Furthermore, 46 cases had not travelled abroad within 3 weeks prior to symptoms/signs onset. Mpox lesions involve the skin, lymph node, and respiratory tract. Confirmation of diagnosis requires laboratory testing, including polymerase chain reaction (PCR). Treatment is mainly supportive, but antivirals, e.g., tecovirimat, show favorable efficacy. The prognosis is generally favorable, with a 0.13% case fatality rate (116/86,930) from January 1, 2021, to April 10, 2023, worldwide. Prevention involves avoiding contact with suspected cases, practicing good hygiene, and timely reporting.Discussion and Conclusion: Suspected mpox cases should receive accurate information and undergo PCR testing while maintaining privacy. Physicians should report suspected cases to the KDCA. Seeking medical attention and vaccination is crucial for preventing infection in higher-risk groups, including men who have sex with men.