7 Things Nurses Should Know About Monkeypox
- Monkeypox is rare and caused by a virus in the smallpox family.
- The condition is milder than smallpox and rarely fatal; it is unrelated to chickenpox.
- Public health experts recognize monkeypox is primarily a sexually transmitted disease, but it can also spread through bodily fluids or contact with the lesions.
According to the U.S. Centers for Disease Control and Prevention, monkeypox is a rare disease caused by a virus in the same family as smallpox. It is milder than smallpox and rarely fatal. Although the name is similar, it is not related to chickenpox.
Historically, the condition has been reported in several African countries. Recently the illness was reported more frequently in other countries, including over 13,000 cases in the U.S. Read on for crucial information to help inform your nursing care.
1. State of the Disease
The orthopoxvirus, which primarily affects people in the tropical rainforest of central and west Africa, causes monkeypox. It is often a self-limiting disease transmitted by close contact with someone with lesions.
The clinical presentation resembles smallpox, but is less contagious and causes less severe illness.
The Centers for Disease Control and Prevention (CDC) is tracking the global monkeypox outbreak. You may view the number of worldwide cases and deaths based on location.
The World Health Organization (WHO) believes they can limit the spread. The WHO believes it will not grow to the proportions of SARS-CoV-2 that causes COVID-19.
Adults and children can contract monkeypox. There are a limited number of children reported with the illness. However, historical data from other countries indicate that children may be prone to more severe illnesses than adolescents and adults.
According to the WHO, the monkeypox virus spreads through close contact with someone who has the monkeypox rash. This includes skin-to-skin, mouth-to-mouth or mouth-to-skin, and sexual contact.
However, while data from 16 countries showed 95% of the cases were transmitted through sexual contact, this is not the only transmission mode. In that study, 95% had the rash, and 73% had anogenital lesions.
The WHO believes transmission may also happen from interaction with inanimate objects that came into contact with lesion fluid. This includes:
- Other unsanitized surfaces
Monkeypox is a zoonotic virus that can infect rodents and primates. Thus far, there is no documented spread to pets (dogs, cats, or hamsters) or livestock.
Before May 2022, monkeypox circulated for decades in regions of Africa. This circulation was without clear evidence of transmission through semen or vaginal fluid. The current spread disproportionately affects men who have sex with men.
3. How to Get Tested
At this time there is only one FDA-approved test. It is the Non-variola Orthopoxvirus Real-time PCR Primer and Probe Set that only CDC-designated labs can use.
This PCR test does not use blood, nasal swabs, or saliva. Instead, the test involves a swab of the monkeypox lesion.
The American Society for Microbiology recommends that patients contact their healthcare provider if they were exposed through close contact with a person diagnosed with monkeypox, or if they develop symptoms.
Although the WHO has declared a public health emergency, testing and vaccination distribution are not firmly established. Patients should call their primary care provider or the public health department for information about testing locations in their city.
4. What PPE Is Needed
The CDC finds that transmission in healthcare settings is rare. They recommend following infection control and prevention guidelines established in 2007. These guidelines aim to prevent the transmission of infectious agents inside healthcare facilities.
Use personal protective equipment (PPE) when handling any bodily fluids, or risk fluids spraying in your eyes, mouth, or nose. You can also use masks, goggles, and face shields during procedures, or extreme care where a patient is likely to generate fluid.
Use gowns and gloves when handling bedding, patient care equipment, or instruments and devices that have contacted bodily fluid.
5. Signs and Symptoms of Monkeypox
There are a variety of symptoms that often last no more than four weeks and resolve with only supportive care. The monkeypox incubation period is up to 21 days after exposure to an infected individual.
The illness begins with flu-like symptoms, including:
- Muscle aches
A rash with lesions also occurs, often near the genitals. However, the rash can occur over the hands, feet, chest, face, and mouth.
Some people get the flu-like symptoms first and then the rash. In others, the rash appears first. In some cases, people may have only a rash.
A person is infectious from the time they have symptoms until all the scabs have fallen off. You can help prevent the spread of monkeypox by avoiding close contact with anyone while you are sick with flu-like symptoms or have skin lesions.
6. What to Do If You Are Diagnosed
The CDC recommends that if you are diagnosed with monkeypox you should notify anyone with whom you had close contact. This includes anyone with whom you had any type of sexual contact, hugged, cuddled, or kissed. Notify anyone with whom you shared utensils, bedding, or other objects that may have contacted your skin.
There is no specific FDA-approved treatment for monkeypox. The type of treatment depend on the severity of the illness. The CDC says that most people recover without medical treatment.
You can take several steps to care for yourself if you get monkeypox:
- Like with chickenpox, do not pick the lesions or peel off the scabs.
- Cover any lesions with bandages to help prevent the spread of the virus to your home environment.
- Keep the lesions clean and dry.
- Do not shave the areas where there are lesions until a new layer of skin has formed and the scabs have fallen off.
- Wash your hands to prevent the spread of the virus.
- If there are lesions on your hands, consider wearing non-irritating gloves when you are handling shared objects.
- If you have lesions in your mouth, rinse with salt water four times daily. If needed, local anesthetics can be used to manage the pain. Oral antihistamines and calamine lotion may help with the itching.
- Always consult with your pharmacist or healthcare provider if you are on other medication before taking an over-the-counter drug.
7. Can You Get a Vaccine and Where?
Since smallpox and monkeypox are genetically similar, vaccine researchers may use smallpox vaccines to prevent monkeypox infections. There are two — Jynneos and Acam2000 — which the government has stockpiled.
The CDC recommends vaccinations for a limited number of people with potential exposure or who may have a higher risk of contracting the virus. For example, you may be eligible for vaccination if you have been in contact with someone diagnosed with monkeypox, including a sexual partner.
Contact your local health department or primary care provider if you are eligible for a vaccine. The CDC does not recommend widespread vaccination during this outbreak.
- About Monkeypox. (2022). https://www.cdc.gov/poxvirus/monkeypox/about.html
- FDA monkeypox response. (2022). https://www.fda.gov/emergency-preparedness-and-response/mcm-issues/fda-monkeypox-response
- Frequently asked questions. (2022). https://www.cdc.gov/poxvirus/monkeypox/faq.html#Vaccination
- Isolation precautions. (2007). https://www.cdc.gov/infectioncontrol/guidelines/isolation/index.html
- Monkeypox. (2022). https://www.who.int/news-room/fact-sheets/detail/monkeypox
- Monkeypox treatment guide. (2022). https://www.nytimes.com/2022/07/21/well/live/monkeypox-vaccine-treatment.html
- Monkeypox virus infection in humans across 16 countries april -- june (2022). https://www.nejm.org/doi/full/10.1056/NEJMoa2207323
- Monketoox: when to get tested and what to do if exposed. (2022.) https://asm.org/Articles/2022/August/Monkeypox-When-to-Get-Tested-and-What-to-Do-if-Exp
- What to do if you are sick. (2022). https://www.cdc.gov/poxvirus/monkeypox/if-sick/what-to-do.html
- 510(k) premarket notification. (n.d.). https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm?ID=K221834
- 2022 monkeypox outbreak global map. (2022). https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.html
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