Rapid Response for Notification of Monkeypox Exposure, Exposure Risk Assessment and Stratification, and Symptom Monitoring

Abstract

Objective. Public health authorities recommend symptom monitoring of healthcare personnel (HCP) after defined exposures to Monkeypox (MPX). We report on the rapid development and implementation of mobile responsive survey solutions for notification of possible exposure, exposure risk assessment and stratification, and symptom monitoring. Setting. Academic health center in Boston, Massachusetts, after admission of first diagnosed case of MPX in the United States during the current global outbreak. Participants. Research Electronic Data Capture (REDCap) design and programmers, Infection Control, Occupational Health, and Emergency Preparedness specialists, and HCP with possible exposure to MPX. Interventions. Design and deployment of Research Electronic Data Capture (REDCap) tools to identify HCP with possible exposure to MPX, perform exposure risk assessment and stratification for post-exposure prophylaxis (PEP), and conduct symptom monitoring during the exposure window. Project enhancements included dashboards for HCP tracking and SMS text reminders for symptom monitoring. Results. Tools to support the contact tracing and exposure investigation were deployed within 24 hours of identification of a patient with suspected MPX, with the full suite in production within 4 days of confirmation of the diagnosis of MPX. Clinical follow up of HCP was integrated into the design, and real-time versioning allowed for adjustments leading to improvements in HCP symptom monitoring compliance and enhanced tracking. Conclusions. During the current MPX outbreak, timely and comprehensive evaluation of potential HCP exposures is necessary but presents logistical challenges. Rapid development of MPX-specific solutions using REDCap enabled flexibility in design and approach, and integration of targeted clinical support enhanced functionality.