Infection Prevention Reminders Regarding Monkeypox
From the Wisconsin Department of Health Services (DHS)
As cases of monkeypox continue to be identified in Wisconsin and the U.S., health care systems and facilities should ensure their employee health policies and patient intake processes will continue to protect their health care personnel, patients, and visitors.
In addition to following standard infection prevention and control best practices, and specific infection control guidance on monkeypox from the Centers for Disease Control and Prevention (CDC), health care facilities should also consider the following points.
Protect Employee Health
- Review internal employee health policies and reinforce the message that all staff (clinical and non-clinical) should not report to work if they have new, unexplained rashes, flu-like symptoms, other symptoms related to monkeypox, or any other communicable disease. Follow CDC guidelines for quarantine and isolation duration.
- Train staff to identify potential exposure situations. Encourage staff to remain aware of potential exposure to monkeypox or any other communicable disease through their work, as well as their own community-based activities and those of other household members.
- Provide appropriate personal protective equipment (PPE) to all clinical and non-clinical staff (e.g., housekeeping and laundry services) who are at risk of exposure.
- Remain familiar with the latest CDC guidance for monitoring people, including health care workers, who have been exposed to monkeypox virus (MPV). Individuals needing to self-monitor may be provided with the Department of Health Services’ Monkeypox Symptom Monitoring handout, where they can record their daily health monitoring.
- Report all suspected or confirmed cases and exposure concerns to your local or Tribal health department (LTHD).
- Be aware that your LTHD will request the results of occupational exposure assessments, including individuals’ monkeypox risk assessment classification per CDC’s algorithm. At this early stage in the MPV response, CDC is requesting that public health entities document exposure assessments as well as subsequent monitoring and outcomes for health care workers determined to be at low, intermediate, or high exposure risk. This information is also needed as part of requests for post-exposure prophylaxis (PEP) for individuals determined to be at high exposure risk.
Prevent Exposures During Patient Intake
- Consider standardizing MPV screening questions as part of your triage process.
- Ensure that staff who are scheduling and rooming patients are aware of facility policies regarding monkeypox, especially for patients who present with rash, skin, or sexually transmitted infection (STI) concerns, and that the care team is notified of these concerns prior to entering the room.
- Ensure patients wear a mask and anyone with rashes or lesions that cannot be covered are roomed immediately with the door remaining closed.
- Encourage staff to proactively use PPE to prevent high-risk exposures. This includes using gowns, gloves, eye protection, and fit-tested N95 respirators with individuals suspected or confirmed to have monkeypox, as well as PPE as part of standard precautions.
Understanding the patient’s presentation concerns prior to room entry, encouraging communication between all layers of the care team, and proactively utilizing PPE are strategies to protect staff and avoid transmission to others.
Full infection prevention and control guidance for monkeypox in health care settings is available from CDC, and includes information related to:
- Precautions for preventing MPV transmission
- Patient placement
- PPE
- Waste management, including worker health and safety
- Environmental infection control, including appropriate disinfectants for emerging viral pathogens (EPA List Q)
- Duration of precautions, including information about management of health care personnel and patients with a monkeypox exposure, and visitation considerations
Note that on August 11, CDC updated infection control information related to monkeypox. Be sure to visit the CDC webpages on infection control often to be sure you are aware of current guidance.
Resources
Infection Control and Public Health Resources
- DHS: Monkeypox in Wisconsin
- CDC: Infection Prevention and Control of Monkeypox in Healthcare Settings
- CDC: Monkeypox Isolation and Infection Control for Home Settings
Clinical Resources: