Monkeypox transmission following exposure in healthcare facilities in nonendemic settings: Low risk but limited literature

Abstract

Transmission risk of Monkeypox (MPX) in healthcare settings outside of endemic regions has not been well-defined. A rapid review of the literature, including cases outside of MPX-endemic regions from 2000-2022 identified a single reported case of transmission. Available literature is limited by non-standardized exposure definitions and limited detail describing exposures.

Health Care Personnel Exposures to Subsequently Laboratory-Confirmed Monkeypox Patients — Colorado, 2022

“…In Colorado, monkeypox transmission did not occur to 313 HCP with varying levels of exposure to patients with monkeypox during patient care or through contaminated materials. These findings are consistent with literature review from previous U.S. outbreaks ( 1 ) and internationally imported cases ( 4 , 5 ), with one case report of transmission to a health care worker after contact with contaminated patient linens in the United Kingdom during a previous outbreak ( 6 ), and one case of transmission to a health care worker in the United States during the current outbreak ( 7 ). Most HCP exposures in this analysis (72%) were classified as low or uncertain risk; only seven HCP (2%) were exposed during an aerosol-generating procedure.…”

“…The risk for monkeypox transmission to health care personnel (HCP) caring for symptomatic patients is thought to be low but has not been thoroughly assessed in the context of the current global outbreak ( 1 ). Monkeypox typically spreads through close physical (often skin-to-skin) contact with lesions or scabs, body fluids, or respiratory secretions of a person with an active monkeypox infection.…”

“…Monkeypox typically spreads through close physical (often skin-to-skin) contact with lesions or scabs, body fluids, or respiratory secretions of a person with an active monkeypox infection. CDC currently recommends that HCP wear a gown, gloves, eye protection, and an N95 (or higher-level) respirator while caring for patients with suspected or confirmed monkeypox to protect themselves from infection † ( 1 , 2 ). The Colorado Department of Public Health and Environment (CDPHE) evaluated HCP exposures and personal protective equipment (PPE) use in health care settings during care of patients who subsequently received a diagnosis of Orthopoxvirus infection (presumptive monkeypox determined by a polymerase chain reaction [PCR] DNA assay) or monkeypox (real-time PCR assay and genetic sequencing performed by CDC).…”

Severe disseminated clinical presentation of monkeypox virus infection in an immunosuppressed patient: first death report in Brazil

“…However, Zachary and Shenoy described the risk of contamination among healthcare professionals involved in the medical care of previously endemic cases. Therefore, it is essential to understand the factors involved in the risk of contamination for these professionals to generate preventive information and post-exposure recommendations 8 .…”

Monkeypox and occupational exposure: Potential risk toward healthcare workers and recommended actions

“…Although human-to-human transmission of the disease has become more evident in the recent outbreak, the risk of occupational exposure, particularly in healthcare settings, should be carefully addressed. A recent review highlighted that there is a low risk of exposure to MPX in non-endemic healthcare settings; however, the level of evidence remains limited ( 4 ). A dreaded picture was seen during the COVID-19 pandemic when more than 115,000 healthcare workers (HCWs) lost their life due to this fatal disease ( 5 ).…”