Anyone, 6 months of age and older, is eligible to receive the COVID-19 vaccine. Find your nearest vaccination location at vaccines.gov.
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If you encounter a patient with symptoms consistent with Monkeypox or have had exposure to Monkeypox, standard precautions should be implemented for all patient care. All health care personnel including administrative staff should be masked as Infection Prevention and Control for COVID-19.
Any health care personnel that encounter a patient suspected of MPV infection should have the following personal protective equipment (PPE):
Pregnant or immune-compromised staff should avoid interacting with suspect patients.
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Immediately contact your LHD to discuss the best ways to:
If the rash is characteristic or the patient meets any of the exposure criteria above and has symptoms of monkeypox, contact your local health department prior to collecting diagnostic specimens.
In addition to isolating infectious patients and use of PPE when caring for patients, other standard precautions can limit the transmission of monkeypox virus.
Monkeypox is spread between people mainly through direct skin to skin contact with infectious sores, scabs, or body fluids. It can also spread by respiratory secretions during prolonged face-to-face contact. It can spread during intimate contact between people, including during sex, kissing, cuddling, or touching parts of the body with MPV lesions.
In one to three days, a rash with raised bumps develops. The rash will start out as flat, red bumps and then turn in to blisters which fill with pus. After several days, the blisters will crust and fall off.
The rash associated with monkeypox involves vesicles or pustules that are deep-seated, firm or hard, and well-circumscribed; the lesions may umbilicate or become confluent and progress over time to scabs.
As a health care provider, relaying prevention and control messages will help your patient to reduce their risk to further spread of MPV infection, be exposed and infected, and prevent re-infection.
Consultation with the local and state health departments and Centers for Disease Control and Prevention (CDC) should be performed prior to collecting specimens. Real-time PCR may be used on lesion material to diagnose a potential infection with monkeypox virus.
There is a growing list of laboratories that offer monkeypox/orthopoxvirus testing. Exact sample collection guidelines and supplies will vary based on your selected laboratory provider.
Personnel who collect specimens should use personal protective equipment (PPE) in accordance with recommendations for health care personnel. Specimens should be collected in the manner outlined below. When possible, use plastic rather than glass materials for specimen collection.
More than one lesion should be sampled, preferably from different locations on the body and/or from lesions with differing appearances. Refer to the Poxvirus Molecular Detection and Poxvirus Serology tests on the CDC Test Directory for specimen storage, packaging, and shipping instructions.
For more information, visit: https://www.cdc.gov/laboratory/specimen-submission/
Health care providers should report by telephone to their local health departments immediately.
Standard cleaning and disinfection procedures should be performed using and EPA-registered hospital-grade disinfectant with and emerging viral pathogen claim. Products with Emerging Viral Pathogens Claim can be found on EPA’s list Q. Be sure to follow manufacturer’s directions for concentration, contact time (dwell time, kill time), care and handling of product.
Wet cleaning methods are preferred. Avoid dusting, sweeping, or vacuuming.
Soiled laundry including but not limited to bedding, towels, clothing, should be handled in accordance with standard practices. Avoid contact with lesion material that may be present on the soiled laundry. Soiled laundry should be appropriately bagged and never shaken or handled that may disperse infectious material.
Health care workers who have cared for an MPV 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.
Health care workers who have unprotected exposures (i.e., not wearing PPE) to patients with MPV 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 health care worker should be interviewed regarding evidence of fever or rash.
Health care workers who have cared for or otherwise been in direct or indirect contact with MPV patients while adhering to recommended infection control precautions may undergo self-monitoring or active monitoring as determined by the health department.
Transmission of monkeypox requires prolonged close contact with a symptomatic individual. Brief interactions and those conducted using appropriate PPE in accordance with Standard Precautions are not high risk and generally do not warrant PEP. See the link below and/or contact your local or state health department for information.
Local health departments should request the monkeypox vaccine from the Strategic National Stockpile (SNS) through their emergency preparedness and response procedures.
In the United States, the supply of JYNNEOS is limited but is expected to grow in the coming weeks and months. So providers will need to determine which patients need JYNNEOS based on the following criteria, as ACAM2000 has limitations on who can receive that vaccine.
The immune response for JYNNEOS take 14 days after the second dose (of two doses) and 4 weeks after the ACAM2000 dose for maximal development. Please remind patients receiving these vaccines that they should continue to take steps to protect themselves from infection.
JYNNEOS is a two dose vaccine, with the second injection 28 days after the first. JYNNEOS is currently licensed by the FDA for use in people ages 18 and older. Use in younger populations currently requires requesting and obtaining a single patient emergency use authorization from FDA for each person under 18 years.
Adverse reactions after JYNNEOS include injection site reactions such as pain, swelling, and redness. Fatigue, headache, and muscle pain were the most common systemic reactions observed after JYNNEOS in a clinical trial.
While there are no data in people who are pregnant or breastfeeding, animal data to no show evidence of reproductive harm. Pregnancy and breastfeeding are not contraindications to receiving JYNNEOS.
When vaccinating with ACAM2000, a successful inoculation will lead to a lesion (known as a “take”) will develop at the site of the vaccination. This lesion may take up to 6 weeks or more to heal.
Adverse reactions after ACAM2000 include injection site pain, swelling, and redness; fever; rash; lymph node swelling; and complications from inadvertent inoculation. ACAM2000 may cause myocarditis and pericarditis. People with severe allergy to any component of the vaccine should not receive it. In addition, people with severely weakened immune systems should not receive this vaccine.
ACAM2000 should not be given to infants less than 12 months of age or to people with the following conditions:
Many people infected with monkeypox virus have a mild, self-limiting disease course in the absence of specific therapy. However, the prognosis for monkeypox depends on multiple factors, such as previous vaccination status, initial health status, concurrent illnesses, and comorbidities among others. Patients who should be considered for treatment following consultation with IDPH and the CDC might include:
For additional information on patients best qualifying for treatment and treatment options, visit the CDC page with Treatment Information for Health Care Professionals.