A low risk of spread of monkeypox has been noted among healthcare workers

In today’s report of 313 health care workers (HCWs) exposed to monkeypox in Colorado, none contracted the virus, even though few wore the recommended personal protective equipment (PPE) or received post-exposure prophylaxis (PEP) vaccination.

The study, conducted by researchers from the Colorado Department of Public Health and Environment and the Centers for Disease Control and Prevention (CDC), was published in Morbidity and Mortality Weekly Report.

Only 23% wore the recommended PPE

The study was conducted from May 1 to July 31, with 313 healthcare workers interacting with patients who were subsequently diagnosed as having monkeypox. Only 23% of HCWs wore all recommended PPE during their exposure.

Of the 313 HCWs, 28% were considered to have had high- or moderate-risk exposures and were therefore eligible to receive PEP with the Jynneos vaccine. Almost half (48%) of the workers (12% of all exposed HCWs) received the vaccine.

“No medical professionals developed monkeypox infection in the 21 days after exposure. These results suggest that the risk of monkeypox transmission in healthcare facilities is low. “Infection prevention education is important in all health care settings, and these findings may guide future updates to PPE Recommendations and risk classification in health care settings,” the authors said.

Most encounters between healthcare workers and monkeypox patients were brief, with 69% lasting only 5 to 30 minutes. Only one health aid was exposed for more than 3 hours. Only seven (2%) were exposed during an aerosol generation procedure.

Current CDC recommendations suggest that healthcare workers wear a gown, gloves, safety glasses, and an N95 (or higher level) respirator while caring for patients who have suspected or confirmed monkeypox. Adherence to PPE recommendations was lowest in primary and emergency care settings and highest in STI clinics and hospitals.

Among the 313 workers in the study, 38% reported wearing N95s.

Monkey pox vaccine equity program launched

Yesterday, the CDC announced the launch of a new initiative called the Monkeypox Vaccine Equity Pilot Program.

The program allows local, state and territory health departments, as well as tribal governments and non-governmental organizations, to submit requests for access to monkeypox vaccine and aims to reach populations that may face barriers to monkeypox vaccination smallpox.

“Up to 50,000 doses of Jynneos vaccine have been allocated for the Monkeypox Vaccine Equity Pilot. Successful proposals will demonstrate new, innovative ways to reach populations most affected by monkeypox based on local or national data,” CDC said in a press statement.

The program also aims to address vaccine disparities for black and Latino communities. It follows the large-event pop-up program, which recently administered 11,000 vaccines at social gatherings and festivals over the past few weeks in an effort to expand the pool of vaccine recipients.

“We have a responsibility to address the disparities that have been highlighted by this epidemic, and this program will help make a difference,” said CDC Director Rochelle Walensky, MD, MPH. “This epidemic disproportionately affects members of the gay, bisexual, and other men who have sex with men and has disproportionately affected black and Hispanic communities.”

In related news, both New York and Oregon recently expanded access to monkeypox vaccines to include anyone at risk of exposure (in New York) and anyone who expects to have or has had recent skin-to-skin contact and who knows someone who has had monkeypox, regardless of sexual preference or gender (Oregon).

CDC clarifies the use of Tpoxx

Also yesterday, the CDC updated treatment guidelines for the use of the antiviral Tpoxx (tecovirimate), recommending that the drug be limited to people at high risk of severe disease.

“Consider severe disease when the patient has conditions such as hemorrhagic disease; a large number of lesions that merge; sepsis; encephalitis; eye or periorbital infections; or other conditions requiring hospitalization,” the CDC said.

Patients with lesions in anatomical areas that may result in serious symptoms or scarring should also receive the drug, as should patents experiencing severe immune compromise due to uncontrolled HIV, organ transplantation, or cancer therapy.

Pregnant women and children over 8 should also be offered treatment.

As of today, US cases have risen to 23,117.

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