Monkeypox
General
Prevention | Diagnosis
| Infection Control - General Precautions
| Infection Control - Outpatient Management
| Infection Control - Veterinarians
| Treatment | Reporting
| Submission of Specimens from Patients with Suspected Monkeypox
| Additional Information
General Prevention
- Recommend that people avoid contact with any prairie dogs or
Gambian giant rats that appear to be ill (e.g., are missing patches
of fur, have a visible rash on the skin, or have a discharge from
eyes or nose).
- Encourage careful handwashing after any contact with prairie dogs,
Gambian giant rats, or any ill animal.
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Diagnosis
- Physicians should consider monkeypox in persons with fever, cough,
headache, myalgias, rash, or lymph node enlargement within 3 weeks
after contact with prairie dogs or Gambian giant rats. Inform the
treating physician or other clinician of the animal exposure.
- Veterinarians examining sick exotic animal species, especially
prairie dogs and Gambian giant rats, should consider monkeypox.
Veterinarians should also be alert to the development of illness in
other animal species that may have been housed with ill prairie dogs
or Gambian giant rats.
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Infection Control: General Precautions
If a patient with suspect monkeypox infection is seen as an
outpatient or admitted to the hospital, infection control personnel
should be notified immediately. A combination of Standard, Contact, and
Airborne Precautions (http://www.cdc.gov/ncidod/hip/ISOLAT/Isolat.htm)
should be applied in all health care settings. These include:
- Hand hygiene after all contact with an infected patient and/or the
environment of care.
- Use of gown and gloves for any contact with the patient and/or the
environment of care.
- Eye protection (e.g., goggles or face shield) if splash or spray
of body fluids is likely.
- Respiratory protection including a NIOSH-certified N95 filtering
disposable respirator for entering the room or patient care area. If
N-95 respirators are not available for health-care personnel, then
surgical masks should be worn. (See
note)
- Airborne isolation room with negative pressure relative to the
surrounding area. If a negative pressure room is not available,
place the patient in a private room. Utilize a portable HEPA
unit in the room, if available. Keep door to patient room
closed.
- Contain and dispose of contaminated waste (e.g., dressings) in
accordance with facility-specific guidelines for infectious waste or
local regulations pertaining to household waste.
- Use care when handling soiled laundry (e.g., bedding, towels,
personal clothing) to avoid contact with lesion exudates. Soiled
laundry should not be shaken or otherwise handled in a manner that
may aerosolize infectious particles. Bag, transport, and reprocess
soiled laundry in accordance with current facility procedures for
handling contaminated linen and laundry.
- Handle used patient-care equipment in a manner that prevents
contamination of skin and clothing. Ensure that used equipment has
been cleaned and reprocessed appropriately. All reusable items
in patient room must be decontaminated before removing from room.
- Ensure that procedures are in place for cleaning and disinfecting
environmental surfaces in the patient care environment. Any
EPA-registered hospital detergent-disinfectant currently used by
healthcare facilities for environmental sanitation may be used.
Manufacturer’s recommendations for use-dilution (i.e.,
concentration), contact time, and care in handling should be
followed.
Respirators should be used in the
context of a complete respiratory protection program in accordance with
OSHA regulations. This includes training and fit testing to ensure a
proper seal between the respirator’s sealing surface and the wearer’s
face. Detailed information on respirator programs, including fit test
procedures, can be accessed at www.osha.gov/SLTC/etools/respiratory.
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Infection Control: Outpatient Management
Segregate the patient from others in the reception area as soon as
possible, preferably in a private room with negative pressure relative
to the surrounding area. Place a surgical mask over the patient’s nose
and mouth. Care should be taken to cover exposed skin lesions (sheet
and/or gown on patient) to prevent contact with infectious material.
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Infection Control: Veterinarians
Veterinarians should use personal protective equipment, including
gloves and gowns. When examining sick rodents, lagomorphs, and exotic
pets, especially prairie dogs and Gambian giant rats, a NIOSH-certified
N95 filtering disposable respirator should be used, if available;
otherwise, a surgical mask should be worn. Practice careful
hand hygiene after all contacts with sick animals and contaminated
surfaces. Wear eye protection (goggles or face shields) if
splashes or sprays of body fluids are likely. Clean contaminated
surfaces with an EPA registered hospital disinfectant. Laundry can
be washed in standard washers with warm water and detergent. Use
care when handling soiled laundry to avoid direct contact with the
contaminated material. Do not shake or otherwise handle laundry in
such a way that it might aerosolize potentially infectious
particles. When a suspect case is
identified, veterinarians should limit staff that come in contact with
the animal, and if the animal is admitted, it should be housed in a
manner that would isolate it from all other animals. Housing in a
negative air-flow room is highly recommended, if available.
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Treatment
No specific treatment recommendations are being made at this time.
Smallpox vaccine has been reported to reduce the risk of monkeypox among
previously vaccinated persons in Africa. CDC has recommended the limited
use of post-exposure smallpox vaccine. For Division of Public
Health guidelines on the use of smallpox vaccine in this outbreak, see
"Recommendations for
Smallpox Vaccine for Prevention of Monkeypox."
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Reporting
Health care providers, veterinarians, and public health personnel
should report cases of these illnesses in humans and animals to their local health departments, or
the Wisconsin Division of Public Health (at 1-608-267-9003) as soon as they are suspected.
Submission of Specimens from Patients with Suspected Monkeypox
Procedures recommended for collection of samples for diagnosis of
potential monkeypox disease are essentially the same as those for
diagnosis of the related orthopoxvirus diseases, vaccinia and smallpox.
For information regarding collection of serum specimens and lesions,
please refer to the smallpox laboratory testing guidelines at http://www.bt.cdc.gov/agent/smallpox/lab-testing/index.asp.
Consultation with the state epidemiologist (http://www.cste.org/members/state_and_territorial_epi.asp)
and state health laboratory (http://www.aphl.org/)
is necessary for submission instructions before sending specimens to CDC.
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Additional Information
For more information contact your state or local health department or
the CDC Emergency Operations Center 1-770-488-7100. Additional
information and recommendations will be released as they become
available. Updated information will be available at http://www.cdc.gov.
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Case
Definition | Emergency Order
Prevention / Diagnosis / Control /
Treatment / Reporting
Status Report | Links
/ Resources | Monkeypox Home
Last Revised: August 24, 2009 |
