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First COVID, Now Monkeypox: Implications for Healthcare Workers

NEW YORK (Reuters Health) – The re-emergence of monkeypox virus in the U.S. and elsewhere may add fuel to the fire for healthcare workers stretched to the limit by the ongoing COVID-19 pandemic.

“Although monkeypox is unlikely to reach the pandemic spread of COVID-19, physicians and other healthcare workers must be vigilant, with a high index of suspicion and careful adherence to appropriate infection control precautions as the outbreak unfolds,” write the authors of a new commentary in Annals of Internal Medicine.

“Importantly,” the infection-control response must avoid stigmatizing the most affected patient population to date – men who have sex with men (MSM), write Dr. David Henderson of the National Institutes of Health Clinical Center in Bethesda, Maryland, and Dr. Tara Palmore of George Washington School of Medicine in Washington, D.C.

Monkeypox is a virus that belongs to the Orthopoxvirus genus of the Poxviridae family, which also includes the smallpox and cowpox viruses. Monkeypox is endemic in western and central Africa and outbreaks have been smoldering there for years, with cases occasionally making their way to the United States and Europe.

As of June 8, 2022, there are 1,233 confirmed cases of monkeypox on six continents.

In their commentary, Dr. Henderson and Dr. Palmore offer guidance to healthcare workers who may come in contact with patients with monkeypox.

They advise healthcare workers to follow Centers for Disease Control and Prevention (CDC) guidelines to protect themselves and safely manage a case of monkeypox.

The guidelines include advice to wear personal protective equipment (PPE), use approved disinfectants, not engage in procedures that aerosolize the virus, and engage in careful contact tracing to prevent further spread.

Careful management of monkeypox cases will help prevent monkeypox from adding to ongoing staffing shortages, the authors say.

They note that healthcare workers exposed to monkeypox do not need quarantine but should undergo active surveillance during the 21-day incubation period, including twice-daily temperature checks and daily occupational-health symptom screening before reporting to work.

They acknowledge that the COVID-19 pandemic has already depleted public-health resources and public desire to engage in risk mitigation and exhausted healthcare providers and the public-health workforce.

The prospect of a new communicable pathogen may add to their existing stress and this should be acknowledged and mitigated whenever possible, the authors say.

SOURCE: https://bit.ly/39aGM8s Annals of Internal Medicine, online June 13, 2022.

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