განხილვები პაციენტთან
Advise patients about signs and symptoms of complications that should prompt urgent care (e.g., lesions get worse or increase in quantity, worsening pain, persistent fever, decreased oral intake, visual symptoms, difficult breathing, dizziness, confusion). Also advise patients to monitor for any persistent, new, or changing symptoms, and to seek medical care if this occurs.[1]
Inform patients that once the skin rash has healed they will be fully recovered and no longer infectious.
The World Health Organization (WHO) recommends the following general principles for patients who are recovering at home:[1]
Infection prevention and control measures should be followed until all lesions are healed (e.g., frequent hand hygiene, having dedicated personal items, cleaning and disinfection of environment, appropriate handling of linens and laundry, waste management).
Patients are not required to isolate during home-based care provided their lesions are covered and they wear a well-fitting medical mask when in close proximity with others until all lesions are healed. Patients who are unable to comply with either of these recommendations should be isolated at home. Measures to reduce environmental contamination in the home should be implemented.
The WHO guidelines reflect a shift away from isolation during home-based care and provide infection prevention and control measures which can be implemented instead. However, recommendations for patients who are recovering at home differ between guidelines and you should follow guidance from your local public health authority. Unlike WHO, some agencies still recommend that all patients at home should self-isolate until they are no longer infectious.[322][384]
Detailed guidance for patients on infection prevention and control measures for home-based care is available:
WHO: clinical management and infection prevention and control for mpox Opens in new window
UKHSA: mpox-guidance for people who are isolating at home Opens in new window
CDC: isolation and infection control at home Opens in new window
Pets
The risk of a case infecting a pet is considered to be low. There has been one case report of possible human-to-dog transmission in the 2022 global clade II mpox outbreak; however, more evidence is needed.[385][386] Surveillance studies have found no cases in pets in the UK.[387]
Advise patients to avoid contact with their pets, domestic animals, or wildlife. Pets should be cared for by someone else in a separate household, if possible.[1][134]
Travel
The World Health Organization (WHO) does not currently recommend any measures that interfere with international traffic for incoming or outgoing travelers.[73]
Travel alerts may be applicable to some countries. Consult your local public health authority for more information.
Blood or tissue donation
Monkeypox virus DNA was not detected in blood donations in the UK during the 2022 global clade II mpox outbreak.[388] Although no cases of transfusion-associated transmission have been reported, the presence of viremia during symptomatic infections creates a theoretical risk to the blood supply. Deferral policies for blood donation may apply in some countries for patients with mpox, close contacts of mpox cases, or people who have received the vaccine. Questions to ascertain mpox exposure have been added to donor interviews in some countries.[389][390] Consult your local public health authority for more information.
The WHO recommends that asymptomatic contacts should not donate blood (or cells, tissue, organs, breast milk, or semen) while they are under symptom surveillance.[79]
The Food and Drug Administration (FDA) has stated that existing safeguards for blood safety are likely to identify people who are currently at the greatest risk for mpox, and does not currently recommend specific screening via questionnaires or laboratory diagnostic tests.[391]
The FDA and a European expert panel have warned that clinical use of fecal microbiota transplantation (FMT) has the potential to transmit monkeypox virus, and that additional precautions are required for stool donated on or after 15 March 2022 (e.g., an expanded donor questionnaire, screening donors for the presence of prodromal symptoms and new skin lesions).[392][393]
The following patient resources are available:
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