Emergency Department, Outpatient Specialty Care, and Primary Care
Clinical Pathway for the Evaluation and Management of Mpox (Monkeypox)

  • Exposure Screen
    • Close contact (sexual, household) with person with suspected or confirmed case in preceding 21 days
    • and
    • Rash, fever/rash
Triage/Clinician Intake
Expedite to room, close door as able
Standard Precautions
  • Suspected case: exposure + rash
    or new onset characteristic rash
    • Exposure, Epidemiologic Criteria
      • Sexual contact (e.g., oral, anal, vaginal) in the preceding 21 days
      • Household, sexual, or close physical contact w/suspected or confirmed case
    • Rash  
      • Solely anogenital or may appear on other areas like the hands, feet, chest, face, or mouth
      • Appears as pustules, papules,
        or vesicles
      • Evolves into scabs
      • May be painful or pruritic
    • Prodrome
      • Fever, chills, headache, malaise, myalgia, lymphadenopathy
    • CDC – Signs and Symptoms  
Exposure, Asymptomatic with
Normal Physical Exam

Standard Precautions
Exposure + Prodrome without Rash
Standard Precautions
Rash Present (+/- Prodrome)
Expanded Precautions
Posted: August 2022
Revised: June 2023 Editors: Clinical Pathways Team
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