Abstract
Monkeypox* is a disease caused by the monkeypox virus, which is from the same family of viruses (Variola) responsible for smallpox (O’Shea et al., 2022). Monkeypox is endemic in several countries in Central (Clade I) and West (Clade IIa & IIb) Africa (World Health Organization, 2022). The outbreak in the United States started on May 17, 2022, and was reported as a public health emergency on August 4, 2022. The type of monkeypox identified in this outbreak is the “West African” type (Clade II) and is rarely fatal. Special considerations are required with people who have weakened immune systems, suffer from eczema, are pregnant or breastfeeding, and have children below the age of 8 years (O’Shea et al., 2022).
The most common presentation of monkeypox includes flu-like symptoms and a rash. A worker can present with a painful or itchy rash that can initially look like a pimple (vesicular) or blister (pustular). Locations of the rash can include the face, mouth, hands, feet, chest, genitals, or anus. Other symptoms are fever, chills, swollen lymph nodes, fatigue, muscle aches, headache, sore throat, nasal congestion, and cough. Symptoms usually start within 3 weeks of exposure and can last 2 to 4 weeks and an exposed individual can experience some or all of the symptoms. A person is considered infectious until there is full healing of the rash (Centers for Disease Control and Prevention [CDC], 2022a).
Transmission of the monkeypox virus occurs by direct contact with lesions or infected body fluids or exposure from respiratory secretions from prolonged face-to-face contact. Individuals most at risk of monkeypox are people who have had contact with someone diagnosed with monkeypox (CDC, 2022a; O’Shea et al., 2022). According to O’Shea and colleagues (2022), the populations most disproportionately affected are gay, bisexual, men who have sex with men, and racial and ethnic minority groups.
Occupational health nurses must educate employees, colleagues, and the community about the monkeypox virus. The role of the occupational health nurse in any real or potential health threat is to stay abreast of evolving information about the transmission, risk factors, signs and symptoms, and prevention strategies of the disease. The occupational health nurses must be cognizant of the stigma that might accompany a diagnosis of monkeypox. The CDC has a wealth of information available on their website listed in the references.
Prevention of monkeypox transmission includes avoiding close skin-to-skin contact with people who have a suspected monkeypox rash, avoiding contact with objects handled by a person with monkeypox, and frequent handwashing or using an alcohol-based hand sanitizer especially before eating, touching your face, and after using the bathroom (CDC, 2022a).
Congregate living settings (e.g., seasonal worker housing, correctional facilities) have people living in close proximity to each other. In these places, the occupational health nurses must educate the staff and residents about the high risk for transmission of monkeypox. Responsibilities of the occupational health nurses include testing those individuals suspected of having monkeypox; setting up isolation quarters for infected individuals; providing adequate personal protective equipment (PPE) for staff and residents, including respiratory protection and access to handwashing; setting up cleaning and disinfection protocols; and complying with the Occupational Safety and Health Administration’s (OSHA) Bloodborne Pathogens Standard (U.S. Department of Labor, Occupational Safety and Health Administration, n.d.).
Because monkeypox and smallpox are genetically similar, two vaccines developed for smallpox are being used for prevention, which include the JYNNEOSTM vaccine, a live nonreplicating virus, administered as two subcutaneous injections 4 weeks apart that is approved for the prevention of monkeypox and smallpox disease, and the ACAM2000 vaccine, a live Vaccinia virus inoculated into the skin by pricking the skin surface, which is approved for immunization against smallpox disease and made available for use against monkeypox under an Expanded Access Investigational New Drug (EA-IND) protocol (CDC, 2022b). Antivirals such as Tecovirimat (TPOXX), Cidofovir, and Brincidofovir may be recommended for people who are immunocompromised (O’Shea et al., 2022).
The CDC has a wealth of information available on their website listed in the references to guide the occupational health nurses in various settings.
