The Human Monkeypox Virus here in referred as hMPX/hMPV is a rare disease caused by infection with the monkeypox virus. Monkeypox virus is part of the same family of viruses as variola virus, the virus that causes smallpox. Monkeypox symptoms are similar to smallpox symptoms, but milder, and monkeypox is rarely fatal. Monkeypox is not related to chickenpox.
History – The virus is a pox virus that was first discovered in monkeys in 1958, hence the name. It is believed that the virus naturally lives and reproduces in rodents in central and western Africa. The first human case of hMPX was identified in the Democratic Republic of Congo in 1970, and it has also been found in other central and western African countries. Past outbreaks have typically involved a relatively small number of cases among residents of rural hunting villages in the African rainforest. Over the past half century there have been several outbreaks of hMPX in other parts of the world, including an outbreak in the U.S. in 2003 related to Gambian giant rats imported by an exotic pet dealer (Fenway Health, 2022).
Current Response – hMPX can impact anyone of any gender identity or sexual orientation. However, it’s particularly impacting cisgender men who have sex with men and their sex partners. Current media reporting of the outbreak has related the vast majority of cases to gay and bisexual men and other men who have sex with men (MSM) without painting an accurate reflection of the overall outbreak. This misinformed reporting may be caused by the focus of response efforts to equitably care for the communities most impacted currently–not those singularly impacted. This reporting has caused concern among the LGBTQIA+ community, both globally and here in the Central Ohio region.
Community Information and Resources
- Building Healthy Online Communities (BHOC)
- Equitas Health
- Fenway Institute
- Human Rights Campaign (HRC)
- John Hopkins Medicine
- LA LGBT Center
- San Francisco Aids Foundation (SFAF)
Below information is aggregated information and was not created by Stonewall Columbus
- Communicate with staff, volunteers, and residents — Provide clear information to staff, volunteers and residents about hMPX prevention, including the potential for transmission through close physical contact such as sexual activity. Provide prevention guidance including considerations for safer sex. Keep messages fact-based to avoid introducing stigma when communicating about monkeypox.
- Respond to cases — Consider the following actions to respond to cases in the facility:
- Staff, volunteers, or residents who are suspected to have hMPX should be medically evaluated and tested for hMPX. Anyone who is identified to have hMPX should isolate away from others until all scabs separate and a fresh layer of healthy skin has formed underneath. Decisions about discontinuation of isolation should be made in consultation with the local or state health department.
- Staff or volunteers who have hMPX should isolate at home until they are fully recovered. Flexible, non-punitive sick leave policies for staff members are critical to prevent spread of hMPX.
- Some congregate living facilities may be able to provide isolation on-site while others may need move residents off site to isolate. Resident isolation spaces should have a door that can be closed and a dedicated bathroom that other residents do not use. Multiple residents who test positive for hMPX can stay in the same room.
- Staff should only enter isolation areas if they are essential to isolation area operations.
- If residents with hMPX need to leave the isolation area, they should wear a well-fitting disposable mask over their nose and mouth and cover any skin lesions with long pants and long sleeves, or a sheet or gown.
- Waste from isolation areas (i.e., handling, storage, treatment, and disposal of soiled PPE, patient dressings, etc.) should be managed in accordance with U.S. Department of Transportation (DOT) Hazardous Materials Regulations (HMR; 49 CFR, Parts 171-180.) Required waste management practices and category designation can differ depending on the Monkeypox virus clade (strain) the patient has. Cases in the current outbreak have been identified to be West African clade and waste from these patients is classified as regulated medical waste (Category B). See the DOT website for more information. Facilities should also comply with state and local regulations for handling, storage, treatment, and disposal of waste.
- Identify people who might have been exposed to hMPX — Facilities should work with their state or local health department to identify and monitor the health of any staff, volunteers, or residents who might have had close contact with someone who has hMPX. Contact tracing can help identify people with exposure and help prevent additional cases. However, this might not be feasible in all settings.
- Where contact tracing is feasible, use exposure risk assessment recommendations to identify people who had high degree of exposure to someone with hMPX. The state or local health department can provide post-exposure vaccination for people with high degree exposures.
- In facilities where contact tracing is not feasible, staff, volunteers, and residents who spent time in the same area as someone with monkeypox should be considered to have intermediate or low degree of exposure, depending on the characteristics of the setting (e.g. level of crowding). Post-exposure vaccination is not necessary for low or intermediate degree exposures unless deemed appropriate by the state or local health department.
- Ensure access to handwashing — Soap and water or hand sanitizer with at least 60% alcohol should be available at all times and at no cost to all staff, volunteers, and residents. Anyone who touches lesions or clothing, linens, or surfaces that may have had contact with lesions should wash their hands immediately.
- Clean and disinfect the areas where people with hMPX spent time — Avoid activities that could spread dried material from lesions (e.g., use of fans, dry dusting, sweeping, or vacuuming) in these areas. Perform disinfection using an EPA-registered disinfectant with an Emerging Viral Pathogens claim, which may be found on EPA’s List Q. Follow the manufacturer’s directions for concentration, contact time, and care and handling. Linens can be laundered using regular detergent and warm water. Soiled laundry should be gently and promptly contained in a laundry bag and never be shaken or handled in a manner that may disperse infectious material. Covering mattresses in isolation areas (e.g. with sheets, blankets, or a plastic cover) can facilitate easier laundering.
- Provide appropriate personal protective equipment (PPE) for staff, volunteers, and residents — Employers are responsible for ensuring that workers are protected from exposure to hMPX virus and that workers are not exposed to harmful levels of chemicals used for cleaning and disinfection. PPE should be worn by staff, volunteers, or residents in these circumstances:
[Updated August 13, 2022]