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Monkeypox

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Discovered in 1958, monkeypox was found in colonies of monkeys kept for research. Monkeypox virus is part of the same family of viruses as variola virus, the virus that causes smallpox. Monkeypox is rarely fatal. As of August 3rd, we currently have 6, 617 cases in the United States.

State by state counts: https://www.cdc.gov/poxvirus/monkeypox/response/2022/us-map.html

Signs and Symptoms:

Fever, Headache, Muscle aches and backache, Swollen lymph nodes, Chills, Exhaustion, Respiratory symptoms (e.g. sore throat, nasal congestion, or cough)

A rash that may be located on or near the genitals (penis, testicles, labia, and vagina) or anus (butthole) but could also be on other areas like the hands, feet, chest, face, or mouth. The rash will go through several stages, including scabs, before healing. The rash can look like pimples or blisters and may be painful or itchy.

Monkeypox symptoms usually start within 3 weeks of exposure to the virus. If someone has flu-like symptoms, they will usually develop a rash 1-4 days later.

Monkeypox can be spread from the time symptoms start until the rash has healed, all scabs have fallen off, and a fresh layer of skin has formed. The illness typically lasts 2-4 weeks.

https://www.cdc.gov/poxvirus/monkeypox/symptoms.html

Transmission:
Disinfectant/PPE:

It’s recommended that healthcare professionals wear mask and gloves with all suspected patients. Due to the rising cases, I would recommend mask and gloves for all patient contact. Good handwashing and/or use of alcohol based hand cleaner is recommended as well.

Please review this information in the following link about cleaning surfaces and disposing of gloves, bandages, etc.

https://www.cdc.gov/poxvirus/monkeypox/specific-settings/home-disinfection.html

https://www.cdc.gov/poxvirus/monkeypox/clinicians/infection-control-healthcare.html#:~:text=Personal%20Protective%20Equipment%20(PPE),-PPE%20used%20by&text=room%20should%20include%3A-,Gown,with%20N95%20filters%20or%20higher

https://www.cdc.gov/handhygiene/training/interactiveEducation/

https://www.cdc.gov/handhygiene/patients/index.html

Monitoring after Exposure:

Any healthcare worker who has cared for a monkeypox patient should be alert to the development of symptoms that could suggest monkeypox infection, especially within the 21 day period after the last date of care, and should notify infection control, occupational health, and the health department to be guided about a medical evaluation.

Healthcare workers who have unprotected exposures (i.e., not wearing PPE) to patients with monkeypox do not need to be excluded from work duty, but should undergo active surveillance for symptoms, which includes measurement of temperature at least twice daily for 21 days following the exposure. Prior to reporting for work each day, the healthcare worker should be interviewed regarding evidence of fever or rash.

Healthcare workers who have cared for or otherwise been in direct or indirect contact with monkeypox patients while adhering to recommended infection control precautions may undergo self-monitoring or active monitoring as determined by the health department.

Please review the link and review the various degrees of exposure.

https://www.cdc.gov/poxvirus/monkeypox/clinicians/monitoring.html#:~:text=Healthcare%20workers%20who%20have%20unprotected,21%20days%20following%20the%20exposure.

What to do if patient is in clinic with suspected Monkeypox:

It varies depending on the state health department. I have the direct links below which will provide guidance via state. I prefer to use links instead of PDFs because the information may change:

Alabama: https://www.alabamapublichealth.gov/monkeypox/healthcare.html

Connecticut: https://portal.ct.gov/dph/epidemiology-and-emerging-infections/ct-monkeypox

Florida: https://www.floridahealth.gov/diseases-and-conditions/monkeypox/index.html

Georgia: https://dph.georgia.gov/monkeypox/information-providers

Massachusetts: https://www.mass.gov/monkeypox

Tennessee: https://www.tn.gov/health/cedep/reportable-diseases/monkeypox.html

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