NHS England (NHSE) has published a pathway for community pharmacies to follow if a patients presents with suspected mpox.

If a clinical assessment is required to determine if the patient is a possible or probable case, they should be assessed remotely – for instance, on the phone, NHSE said.

And staff should not physically assess the patient without wearing appropriate personal protective equipment (PPE), it added.

Symptoms of a probable or possible case include a fever over 38 degrees celcius, chills, headache, exhaustion, myalgia, arthralgia, lymphadenopathy, a new characteristic rash, unexplained lesions, or ulcers.

If the clinical assessment indicates a suspected mpox case but that the patient is clinically stable, they should be told to remain at or return home, maintain isolation, and contact 111.

But if the patient is clinically unwell, 999 should be called or regional ambulance services should be contacted to arrange a transfer to an emergency department. Ambulance services should clearly be told that the patient is a suspected mpox case, NHSE stressed.

Any patient thought to be potentially suffering from mpox should self-isolate and be socially distanced from others throughout the process, the guidance said.

And if a suspected mpox patient has attended a community pharmacy premises, staff should seek advice from local Infection Prevention and Control to determine if any cleaning is required.

Meanwhile, general practitioners have been told to isolate patients with suspected mpox in a single room with a phone and conduct a clinical assessment over the phone, or face-to-face if this can be done more than 1m away from the patient with appropriate PPE.

All potential cases should also be referred for further assessment and testing – including for other travel-related conditions such as malaria, National Director for NHS Resilience Dr Mike Prentice wrote in a letter to providers this week.

The guidance follows a warning from the UK Health Security Agency (UKHSA) for health professionals to be aware of a new more fatal variant of mpox, known as Clade 1.

UK health professionals should be aware of the risk of mpox exposure where there is a travel history to Democratic Republic of the Congo (DRC), Republic of the Congo, Central African Republic, Burundi, Rwanda, Uganda, Kenya, Cameroon, and Gabon, UKHSA said.

There may also be a risk associated with Angola, South Sudan, Tanzania and Zambia.