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CDC Issues Warning Regarding MONKEYPOX

  • On July 17, 2021 CDC issued a Health Alert (attached) concerning potential exposures to a traveler who traveled from Lagos, Nigeria to Dallas, Texas via Atlanta, Georgia on July 8-9, 2021. Travelers on these flights were required to wear masks as well as in the U.S. airports due to the ongoing COVID-19 pandemic. Therefore, it’s believed the risk of spread of monkeypox via respiratory droplets to others on the planes and in the airports is low.

  • Med news
  • Monkeypox is a rare but potentially serious viral illness that typically begins with flu-like illness and swelling of the lymph nodes and progresses to a widespread rash on the face and body. Most infections last 2-4 weeks. Monkeypox is in the same family of viruses as smallpox but causes a milder infection.

  • CDC has notified NJDOH of a small number of N.J. travelers who were on one of these flights. These travelers will be contacted, assessed for exposure risk, and if indicated, monitored for symptoms by N.J. local health departments (LHD) for 21 days or through July 30, 2021.

  • Travelers who develop symptoms will be advised to self-isolate and notify the LHD. Action Items:

  • LHDs with travelers who have been identified as contacts should contact the traveler within 24 hours, assess exposure risk, and if indicated, establish active symptom monitoring to continue through July 30, 2021. Detailed instructions will be provided to those LHDs having travelers needing monitoring.

  • Healthcare providers should continue to ask about international travel as a routine part of patient triage.

  • If Monkeypox is suspected, healthcare providers should immediately notify infection control and their local health department: www.localhealth.nj.gov.

  • As a reminder a combination of standard, contact, and droplet precautions should be applied in all healthcare settings when a patient presents with fever and vesicular/pustular rash. In addition, because of the theoretical risk of airborne transmission of monkeypox virus, airborne precautions should be applied whenever possible. Patients suspected of having monkeypox should be isolated in a negative air pressure room as soon as possible. If a negative air pressure room is unavailable, place patients in a private examination room.

Background Information:

  • Monkeypox is endemic to several Central and West African nations. Recent cases outside of Africa either reported recent travel to one of these countries or contact with a person with confirmed monkeypox. In 2003, there was an outbreak of Monkeypox in the United States with 47 cases reported from 6 states associated with a shipment of animals from Ghana.

  • The symptoms of monkeypox are similar to but milder than the symptoms of smallpox. Monkeypox begins with fever, headache, muscle aches, and exhaustion. The main difference between symptoms of smallpox and monkeypox is that monkeypox causes lymph nodes to swell (lymphadenopathy) while smallpox does not. The incubation period (time from infection to symptoms) for monkeypox is usually 7−14 days but can range from 5−21 days. The illness begins with fever, headache, muscle aches, backache, swollen lymph nodes, chills, and exhaustion. Within 1 to 3 days (sometimes longer) after the appearance of fever, the patient develops a rash, often beginning on the face then spreading to other parts of the body. Lesions progress through the following stages before falling off: macules, papules, vesicles, pustules, scabs. The illness typically lasts for 2−4 weeks.

  • Human-to-human transmission is thought to occur primarily through large respiratory droplets. Respiratory droplets generally cannot travel more than a few feet, so prolonged face-to-face contact is required. Other human-to-human methods of transmission include direct contact with body fluids or lesion material, and indirect contact with lesion material, such as through contaminated clothing or linens.

  • Animal-to-human transmission may occur by bite or scratch, bush meat preparation, direct contact with body fluids or lesion material, or indirect contact with lesion material, such as through contaminated bedding.

  • The reservoir host (main disease carrier) of monkeypox is still unknown although African rodents are suspected to play a part in transmission.

    Contact Information:

• The Communicable Disease Service, 609-826-5964 during business hours; or 609-392-2020 after hours.

References and Resources:

  • -  CDC Health Alert Potential Exposure to Person with Confirmed Human Monkeypox Infection — United States, 2021, July 17, 2021

  • -  CDC Web Resources on Monkeypox

  • -  CDC Guidance for Clinicians

  • -  2003 United States Monkeypox Outbreak

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