8/7/22

Monkeypox is now in the news, and the number of cases in the US is increasing. Here is some information from the CDC; we will provide updated information as more becomes available.

What is monkeypox?
Monkeypox is a rare disease caused by infection with the monkeypox virus. Monkeypox virus is part of the same family of viruses as variola virus, the virus that causes smallpox. Monkeypox symptoms are similar to smallpox symptoms, but milder. Monkeypox is rarely fatal; however, people with a weakened immune systems, children under 8 years old, people with a history of eczema, and people who are pregnant or breastfeeding may be more likely to get seriously ill.

What are the symptoms of monkeypox?

Symptoms of monkeypox usually start within 3 weeks of exposure to the virus.  Symptoms can include:

• Fever
• Headache
• Muscle aches and backache
• Swollen lymph nodes
• Chills
• Respiratory symptoms (e.g. sore throat, nasal congestion, or cough)
• A rash that can look like pimples or blisters that appears on the face, inside the mouth, and on other parts of the body, like the hands, feet, chest, genitals, or anus.
• The rash goes through different stages before healing completely. The illness typically lasts 2-4 weeks.
  Sometimes, people get a rash first, followed by other symptoms. Others only experience a rash.

How is monkeypox spread from one person to another?

• Monkeypox can spread to anyone through close, personal, often skin-to-skin contact, including:
  Direct contact with monkeypox rash, scabs, or body fluids from a person with monkeypox.
  Touching objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with monkeypox.
  Contact with respiratory secretions.
  
  
• This direct contact can happen during intimate contact, including:
  Oral, anal, and vaginal sex or touching the genitals (penis, testicles, labia, and vagina) or anus (butthole) of a person with monkeypox.
  Hugging, massage, and kissing.
  Prolonged face-to-face contact.
  Touching fabrics and objects during sex that were used by a person with monkeypox and that have not been disinfected, such as bedding, towels, fetish gear, and sex toys.
  
  
• A pregnant person can spread the virus to their fetus through the placenta.
  
  
• A person with monkeypox can spread it to others from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. The illness typically lasts 2-4 weeks.

Scientists are still researching:

• If the virus can be spread when someone has no symptoms
• How often monkeypox is spread through respiratory secretions, or when a person with monkeypox symptoms might be more likely to spread the virus through respiratory secretions.
• Whether monkeypox can be spread through semen, vaginal fluids, urine, or feces.
• Contact with respiratory secretions through prolonged face-to-face interactions (the type that mainly happen when living with someone or caring for someone who has monkeypox).

If you have symptoms

• See a healthcare provider if you notice a new or unexplained rash or other monkeypox symptoms.
• Remind the healthcare provider that monkeypox is present in the United States.
• Avoid close contact (including intimate physical contact) with others until you see a healthcare provider.
• Avoid close contact with pets or other animals until you see a healthcare provider.
• If you’re waiting for test results, follow the same precautions.
• If your test result is positive, stay isolated and observe other prevention practices until your rash has healed, all scabs have fallen off, and a fresh layer of intact skin has formed.
• Remain isolated if you have a fever, sore throat, nasal congestion, or cough. Only go out to see a healthcare provider or for an emergency. Avoid public transportation.
• If you must leave isolation, cover the rash and wear a well-fitting mask

Prevention
Take the following steps to prevent getting monkeypox:

• Avoid close, skin-to-skin contact with people who have a rash that looks like monkeypox.
• Do not touch the rash or scabs of a person with monkeypox.
• Do not kiss, hug, cuddle or have sex with someone with monkeypox.
• Avoid contact with objects and materials that a person with monkeypox has used.
• Do not share eating utensils or cups with a person with monkeypox.
• Do not handle or touch the bedding, towels, or clothing of a person with monkeypox.
• Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially before eating or touching your face and after you use the bathroom.
• CDC recommends vaccination for people who have been exposed to monkeypox and people who are at higher risk of being exposed to monkeypox.

CDC has issued guidance for people working in congregate settings.

Congregate living settings can include correctional and detention facilities, homeless shelters, group homes, dormitories at institutes of higher education, seasonal worker housing, residential substance use treatment facilities, and other similar settings. These settings may provide personal care services but are not traditional healthcare settings (e.g. hospitals).

Basics of the guidance if a case has been identified:

1. Communicate with staff, volunteers, and residents
2. Respond to cases
3. Identify people who might have been exposed to monkeypox
4. Ensure access to handwashing
5. Clean and disinfect the areas where people with monkeypox spent time
6. Provide appropriate personal protective equipment (PPE) for staff, volunteers, and residents

The full guidance can be found at Congregate Living Settings | Monkeypox | Poxvirus | CDC
If healthcare services are provided on site, they are usually provided in specific healthcare areas or by outside healthcare personnel (e.g., home health care workers). In these circumstances, healthcare personnel should follow recommendations in Infection Control: Healthcare Settings | Monkeypox | Poxvirus | CDC.

More information on monkeypox
US Centers for Disease Control (CDC): Monkeypox | Poxvirus | CDC
NYC Department of Health  https://www1.nyc.gov/site/doh/health/health-topics/monkeypox.page

NYS Department of Health  https://www.health.ny.gov/diseases/communicable/zoonoses/monkeypox