Since May 2022, Mpox has rapidly spread globally and been posing new challenges. There is no specific treatment drug for monkeypox (Mpox), and how to avoid cross infection has become the key to the prevention and control of the Mpox epidemic. However, current guidelines lack systematic recommendations for reducing Mpox transmission risk in medical institutions. Therefore, the National Medical Institution Infection Surveillance System of China, National Training Center of Hospital Infection in China, National Clinical Research Center of Geriatric Disorders organized 64 experts in the fields of healthcare-associated infection control, clinical medicine, disinfection, etc. nationwide to sort out relevant issues and urgently release the consensus of Chinese experts on mpox healthcare-associated infection prevention and control. The main content includes an overview of the Mpox epidemic, pathogenic characteristics, epidemiology, early identification and diagnosis, infection prevention and control strategies and measures in medical institutions, and occupational exposure assessment and treatment, aiming to strengthen healthcare-associated infection prevention and control of Mpox and reduce cross infection.
2022年5月起猴痘在全球范围内迅速传播，给世界带来了新的挑战。2023年6月以来我国多个省份先后报告多例猴痘病例，感染风险持续增加。目前尚无特效治疗猴痘药物，医疗机构如何避免猴痘病毒交叉感染已成为防控的关键，然而目前国内外相关指南对医疗机构内猴痘传播风险的防控缺乏系统的推荐性建议。因此，全国医疗机构感染监测网、全国医院感染监控管理培训基地、国家老年疾病临床医学研究中心组织全国64名医院感染防控、临床医疗、消毒等领域专家，梳理相关问题，发布猴痘医院感染防控专家共识。主要内容包括猴痘疫情概况、病原学特点、流行病学、早期识别与诊断、医疗机构感染防控策略及具体措施、职业暴露评估及处理等内容，旨在加强猴痘医院感染防控，避免交叉感染。.

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Monkeypox is a zoonotic disease. Since the first human monkeypox case was detected in 1970, it has been prevalent in some countries in central and western Africa. Since May 2022, monkeypox cases have been reported in more than 96 non-endemic countries and regions worldwide. As of September 14, 2022, there have been more than 58,200 human monkeypox cases, and there is community transmission. The cessation of smallpox vaccination in 1980, which had some cross-protection with monkeypox, resulted in a general lack of immunity to monkeypox, which caused global concern and vigilance. As of September 14, 2022, there are four monkeypox cases in China, including three in Taiwan province and one in Hong Kong city. Previous foreign studies have shown that children are vulnerable to monkeypox and are also at high risk for severe disease or complications. In order to improve pediatricians\' understanding of monkeypox and achieve early detection, early diagnosis, early treatment,  and early disposal, we have organized national authoritative experts in pediatric infection, respiratory, dermatology, critical care medicine, infectious diseases, and public health and others to formulate this expert consensus, on the basis of the latest \"Clinical management and infection prevention and control for monkeypox\" released by The World Health Organization, the \"guidelines for diagnosis and treatment of monkeypox (version 2022)\" issued by National Health Commission of the People\'s Republic of China and other relevant documents. During the development of this consensus, multidisciplinary experts have repeatedly demonstrated the etiology, epidemiology, transmission, clinical manifestations, laboratory examinations, diagnosis, differential diagnosis, treatment, discharge criteria, prevention, disposal process, and key points of prevention and control of suspected and confirmed cases.

While the coronavirus disease 2019 pandemic is ongoing, monkeypox has been rapidly spreading in non-endemic countries since May 2022. Accurate and rapid laboratory tests are essential for identifying and controlling monkeypox. Korean Society for Laboratory Medicine and the Korea Disease Prevention and Control Agency have proposed guidelines for diagnosing monkeypox in clinical laboratories in Korea. These guidelines cover the type of tests, selection of specimens, collection of specimens, diagnostic methods, interpretation of test results, and biosafety. Molecular tests are recommended as confirmatory tests. Skin lesion specimens are recommended for testing in the symptomatic stage, and the collection of both blood and oropharyngeal swabs is recommended in the presymptomatic or prodromal stage.

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Monkeypox (MPX) is an important human Orthopoxvirus infection. There has been an increase in MPX cases and outbreaks in endemic and non-endemic regions in recent decades. We appraised the availability, scope, quality and inclusivity of clinical management guidelines for MPX globally.
For this systematic review, we searched six databases from inception until 14 October 2021, augmented by a grey literature search until 17 May 2022. MPX guidelines providing treatment and supportive care recommendations were included, with no exclusions for language. Two reviewers assessed the guidelines. Quality was assessed using the Appraisal of Guidelines for Research and Evaluation II tool.
Of 2026 records screened, 14 guidelines were included. Overall, most guidelines were of low-quality with a median score of 2 out of 7 (range: 1-7), lacked detail and covered a narrow range of topics. Most guidelines focused on adults, five (36%) provided some advice for children, three (21%) for pregnant women and three (21%) for people living with HIV. Treatment guidance was mostly limited to advice on antivirals; seven guidelines advised cidofovir (four specified for severe MPX only); 29% (4/14) tecovirimat, and 7% (1/14) brincidofovir. Only one guideline provided recommendations on supportive care and treatment of complications. All guidelines recommended vaccination as post-exposure prophylaxis (PEP). Three guidelines advised on vaccinia immune globulin as PEP for severe cases in people with immunosuppression.
Our results highlight a lack of evidence-based clinical management guidelines for MPX globally. There is a clear and urgent need for research into treatment and prophylaxis including for different risk populations. The current outbreak provides an opportunity to accelerate this research through coordinated high-quality studies. New evidence should be incorporated into globally accessible guidelines, to benefit patient and epidemic outcomes. A \'living guideline\' framework is recommended.
CRD42020167361.

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