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# Mpox - Whole blood and components

Also known as: monkeypox, previously

### Scenarios

Affected individual

Obligatory

  Must not donate.

Discretionary

  If the donor has recovered from confirmed or suspected mpox infection, and

  - It is at least 28 days since the diagnosis of mpox was made, and
  - It is at least 14 days since recovery, and the donor remains well, and
  - It is at least 14 days since all skin lesions have healed, and
  - It is more than 7 days since completing any antiviral or antibiotic therapy, and
  - The donor has been discharged from all follow-up (including public health surveillance),

  accept.

Contact with an affected individual

Includes
  Individuals who have been identified by public health teams as a close contact of an individual with mpox.
Obligatory

  Must not donate.

Discretionary

  If it is more than 21 days since last contact, and

  - The donor has no symptoms of mpox, and
  - The donor has completed any isolation period, and
  - The donor has been discharged from all follow-up (including surveillance by public health), and
  - The donor fulfils the criteria in the Immunisation for contact or risk section below regarding vaccination, if applicable,

  accept.

Immunisation for contact or risk

Excludes
  Individuals who have received vaccination because they work in a health care setting – see ‘Immunisation - no known contact’ below.
Obligatory

  Must not donate.

Discretionary

  If the donor fulfils the criteria in Contact with an affected individual above, and

  - It is more than 4 weeks since the most recent dose of a non-live or attenuated smallpox vaccination (e.g. Imvanex®), and
  - the course of vaccination (if more than 1 dose) is complete,

  accept.

Immunisation - no known contact

Includes
  Individuals who have received vaccination because they work in a health care setting.
Discretionary

  An individual who has received routine vaccination with Imvanex® or another third-generation smallpox vaccination in an occupational setting, can be accepted provided that they are not deemed to be at risk due to an exposure episode.

See if relevant
  - Immunisation

## Supporting information

Additional information

  Mpox was previously known as Monkeypox. In November 2022, the World Health Organization (WHO) recommended mpox as the new name for Monkeypox disease. Mpox is endemic in some African countries. During 2022, a multi-country outbreak was identified with cases in the UK, Europe, North America and other regions.

  The incubation period of mpox is up to 21 days. The initial symptom are fever, myalgia, fatigue and headache. These symptoms are followed by a rash starting from the site of the primary infection, this rash develops into vesicles and pustule followed by scabs. Infectivity may start during initial symptoms and lasts until the rash clears and all scabs have dropped off.

  Staff should be alert for donors who report rashes and illnesses consistent with mpox, regardless of sexual behaviour, travel history or other risk factors.

  Mpox does not spread easily between people. Human-to-human transmission occurs through contact with:

  - infectious material from skin lesions
  - respiratory droplets in prolonged face-to-face contact
  - virus-contaminated objects such as bedding or clothing

  During the 2022 multi-country outbreak, the predominance of cases among men who have sex with men (MSM) and the distribution of the mpox skin rash at presentation, suggests mpox transmission is associated with direct contact during sex.

  Contacts may have received vaccination, to reduce the risk of serious illness. Usually vaccination will be with Imvanex® or other third generation vaccine against smallpox. Contacts are eligible to donate once they satisfy the requirements of the Contact with an affected individual and Immunisation for contact or risk sections above.

  Healthcare workers may also have received vaccination to protect against mpox in the event of possible exposure to mpox during their work. They will be working in accordance with Infection Prevention and Control policies and with suitable personal protective equipment which, if not breached, means they are eligible to donate.

  Other recipients of vaccination for mpox must be assessed according to the Immunisation for contact or risk section above.

  Imvanex® is a live attenuated non-replicating third generation smallpox vaccination. For donor selection purposes, this can be assessed as a non-live vaccine but primarily donors must be assessed according to their individual risk of exposure to mpox. The deferral of some donors for 4 weeks from the date of a non-live vaccination allows symptoms of mpox from prior exposure to become evident (incubation period up to 21 days) and encompasses the time for maximum efficacy of the immunisation (up to 4 weeks). Donors should be deferred until completion of a course of vaccination.

Reason for change:
  Inclusion of sections for donors who have received vaccination either because they are or could be a contact or because they work in a health care setting. Additional Information applicable for the whole entry contained within one section.
Version details:

  WB-DSG Edition 203 Release 67 (31 January 2021)

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