Information for clinicians treating patients with mpox who require hospitalisation

​​​​​​​​​​​​​​​When do patients with mpox require further assessment, hospital admission or treatment?

Most patients can be managed at home with a telehealth review through their GP, sexual health clinic or Public Health Unit. In most cases, mpox does not require treatment.

Clinical situations that may require further review or treatment include:

• eye problems as keratitis with mpox can impact on people’s eyesight
• secondary bacterial infection, sepsis or abscesses
• disseminated disease, particularly in those who are immunosuppressed
• severe pain not managed by simple analgesia.

Initial treatment should be discussed with local infectious diseases or sexual health physicians. Escalation for antiviral treatment or hospital admission should be discussed with an infectious diseases physician at the NSW Biocontainment Centre at Westmead Hospital.

Referral to the NSW Biocontainment Centre at Westmead Hospital

For patients requiring further assessment, treatment, or hospital admission for any of the conditions outlined above, the treating sexual health physician or infectious diseases physician are to contact the infectious diseases physician on-call at Westmead Hospital via the switchboard on (02) 8890 5555.

Eye reviews will initially be with ophthalmologists at Westmead Hospital via telehealth or in-person at the NSW Biocontainment Centre, if necessary. The ophthalmology staff have extensive experience assessing and managing this condition.

The infection prevention and control measures outlined in the NSW Health Mpox Control Guideline and CEC mpox​ Infection Prevention and Control Information for clinicians guidelines are recommended for patients and most settings. Patients requiring hospital admission, particularly in the setting of disseminated disease and immunosuppression, may have an increased risk for transmission of disease. The NSW Biocontainment Centre provides purpose-built quarantine facilities that incorporate enhanced infection prevention and control strategies to manage these patients.

Transporting patients to NSW Biocontainment Centre

The decision to arrange transport of a patient who requires admission to the NSW Biocontainment Centre by NSW Ambulance should be dictated by severity of illness. This decision should be made in consultation with the local Public Health Unit.

For a mild illness, patients can be transported by a family member or carer, or by public transport provided their lesions are covered, the patient wears a mask, and the patient is diligent with hand hygiene.​