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Monkeypox Information For Public Health

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Information on the interim case definition for human and animal monkeypox disease surveillance can be found from the CDC:

Transmission Routes

Monkeypox virus can spread when a person comes into contact with the virus from an infected animal, infected person, or materials contaminated with the virus. The virus can also cross the placenta from the mother to the fetus.

Person-to-person transmission of monkeypox is primarily through direct contact with infectious lesions, scabs, or body fluids. However, prolonged exposure to an infected person’s respiratory secretions can also transmit the virus. A person with monkeypox is infectious to others from their symptom onset to until their rash has fully healed.

Examples of activities that may spread monkeypox from one person to another are wrestling, cuddling, kissing, or intimate sexual contact, including oral, anal, and vaginal sex, massage, mutual masturbation, or touching fabrics and objects that a person with monkeypox used during sex. At this time, it is not known if monkeypox can spread through semen or vaginal fluids.

Healthcare providers can become exposed to monkeypox virus while caring for infected patients. Unprotected contact with a patient’s skin, lesions, or body fluids (e.g. ungloved contact; splashing of patient’s saliva into eyes or mouth) could expose a person to monkeypox virus. Being in a patient’s room or within six feet of a patient during aerosolizing procedures (e.g. shaking used linens; contact with oral secretions or skin lesions) without the use of eye protection, a respirator or other personal protective equipment (PPE) can lead to exposure. Patient interactions where a healthcare provider uses Standard Precautions are generally not considered high risk.

There have been no documented cases of sick people infecting animals with monkeypox virus. However, it is possible that monkeypox virus may spread from animals to people through the bite or scratch of an infected animal, handling infected wild game, or using or consuming products made from infected animals. It is unknown what animal maintains the virus in nature, although African rodents are suspected of being involved in monkeypox transmission to people. A 2003 outbreak of monkeypox in the United States that caused 35 confirmed human cases in six states was associated with exposure to prairie dogs housed with small mammals imported from Africa by a Texas animal distributor.

Prevention

People can take several measures to prevent infection with the monkeypox virus:

  • Avoid contact with people who have a new or unknown rash, lesions, or scabs. This contact can happen during activities such as wrestling, cuddling, or intimate sexual contact.
  • Avoid contact with animals that could harbor the virus, such as prairie dogs, rabbits, rope squirrels, Gambian rats, wallabies, and African tree squirrels. This includes sick or dead animals from areas where monkeypox is endemic (Central or West Africa).
  • Avoid contact with any materials, such as bedding that has been in contact with a sick person or animal.
  • Isolate infected patients from others who could be at risk for infection. For example, after consulting with your local or state health department, patients who do not require hospitalization for medical indications may be isolated at home using protective measures. 

  • The home and other areas where an infected person spent significant time should be cleaned using an EPA registered disinfectant. Cleaning methods such as disinfectant wipes, sprays, and mopping are preferred. Dry dusting and sweeping should be avoided, as these activities might spread infectious particles.
  • Use personal protective equipment (PPE) and follow standard donning and doffing procedures when caring for patients. PPE used by healthcare personnel who enter the patient’s room should include a gown, gloves, eye protection (i.e., goggles or a face shield covering the front and sides of the face), NIOSH-approved N95 filtering facepiece or equivalent, or a higher-level respirator. 
  • Practice good hand hygiene after contact with infected animals or humans. For example, washing your hands with soap and water or using an alcohol-based hand sanitizer, when soap and water are not available.
  • JYNNEOS (also known as Imvamune or Imvanex) is an attenuated live virus vaccine approved by the U.S. Food and Drug Administration to prevent monkeypox. On November 3, 2021, The Advisory Committee on Immunization Practices (ACIP) unanimously voted to recommend JYNNEOS pre-exposure prophylaxis as an alternative to the live smallpox vaccine ACAM2000 for certain persons at risk for exposure to orthopoxviruses. ACIP evaluated JYNNEOS to protect research laboratory personnel, clinical laboratory personnel performing diagnostic testing for orthopoxviruses, designated response team members, and health care personnel who administer ACAM2000 or care for patients infected with orthopoxviruses.
    Last updated September 22, 2022