Establish monkeypox infection control team, monitor community outbreaks

Monkeypox is spreading across the United States, with all but six states reporting confirmed cases, according to the CDC.

The World Health Organization declared the contagion a global health emergency July 23 and HHS Secretary Xavier Becerra said the declaration “is a call to action for the global health community,” and that his agency and others will be accelerating plans to make “to make vaccines, testing, and treatments available to people in need.”

Meanwhile, the CDC continues to urge hospitals and other healthcare providers to use standard infection control precautions, “for all patient care, including for patients with suspected monkeypox.  If a patient seeking care is suspected to have monkeypox, infection prevention and control personnel should be notified immediately.”

The agency also notes that, among other steps, “activities that could resuspend dried material from lesions, e.g., use of portable fans, dry dusting, sweeping, or vacuuming should be avoided.”

Hospitals are already in the midst of a pandemic response, notes Steven A. MacArthur, a senior consultant with Chartis Clinical Quality Solutions (formerly known as The Greeley Company) in Danvers, Mass.

Next actions can be straightforward, he says:

• Establish a formal emerging infectious disease team. It “doesn’t have to be a committee, per se, but at this point, it should be pretty clear who needs to be at the table.”
• Closely monitor CDC communications for updated information and guidance
• Work with local health officials to determine the likely risks of outbreak in the community
• “Start game-planning what supplies might be needed,” including what would be required to establish monkeypox treatment locations.
• Review the gaps that presented themselves at the start of COVID and identify ways of avoiding a recurrence—“a kind of a ‘fool me once, shame on you; fool me twice, shame on me’ ” review, he says. “Not every lesson from COVID will be applicable, but there may be some elements that will carry over.”

Based on information currently available from the CDC about transmission,  “widespread respiratory isolation is probably going to be less of a player, but managing waste and soiled linens is probably going to be more of a focus,” notes MacArthur.

For more on managing waste, find information here.

The CDC activated its emergency response operations for monkeypox response on June 28.

For more on clinical diagnosis, infection control, hazardous waste management, handling of remains during autopsy and other measures for healthcare settings, go to the CDC’s main monkeypox information page: https://www.cdc.gov/poxvirus/monkeypox/clinicians/index.html