4 Key Things to Know about Infection Prevention and Control for Mpox (formerly Monkeypox)

Mpox virus is an orthopox virus, from the same family of viruses as smallpox. There are two clades, or types, of mpox: Clade I and Clade II. The current outbreak is a Clade II virus. Although the virus was originally called "monkeypox virus," because it was first identified in monkeys, the actual source of the virus is unclear. Recently, the American Medical Association spoke with Dr. Abigail Carlson, an infectious disease doctor at the Centers for Disease Control and Prevention, about infection prevention and control for mpox.

1. Mpox is primarily spread through the “touch pathway.”

   Close contact, often skin-to-skin, is the most common way to transmit the virus. The risk is low for getting mpox by touching things that the virus has contacted (for example, towels, fetish gear, clothing). If objects with viral particles on them are shaken out, there is a theoretical potential for aerosol transmission. However, data on respiratory transmission is inconclusive.

2. Use appropriate personal protective equipment (PPE) when entering a patient’s room who has suspected or confirmed mpox.

   The PPE used by healthcare personnel should include:

   • Gown
   • Gloves
   • Eye Protection
   • N95 Respirator

3. Healthcare personnel might be eligible for mpox vaccination.

   Laboratory personnel who work with orthopox viruses and some healthcare personnel may be eligible for pre-exposure prophylaxis (PrEP) vaccination. Local public health departments can assist in determining eligibility. Post-exposure prophylaxis (PEP) is available for people who have been or might have been exposed to someone with mpox, including healthcare or laboratory personnel with accidental exposure. Consult the CDC’s mpox vaccination webpages for additional information.

4. Limit exposure to mpox in your healthcare setting.

   Getting patients safely in and out of offices, hospitals and clinical spaces is important – for both patients and the healthcare team. Some ways to minimize exposures include:

   • asking patients if they were exposed to mpox or if they have a rash before they arrive
   • placing patients who report an exposure or rash directly into a room, rather than having them wait in the lobby
   • having all healthcare personnel use appropriate PPE when seeing patients who report an exposure or rash
   • cleaning patient rooms using wet cleaning techniques rather than dry dusting or mopping, which can theoretically aerosolize infectious particles

This post provides highlights from episode five of the Stories of Care podcast, Monkeypox (Mpox) Infection Prevention and Control in Health Care Settings. To hear the full episode with Dr. Carlson, listen here.

Project Firstline is a national collaborative led by the U.S. Centers for Disease Control and Prevention (CDC) to provide infection control training and education to frontline health care workers and public health personnel. The American Medical Association is proud to partner with Project Firstline, as supported through CDC-RFA-CK20-2003. CDC is an agency within the Department of Health and Human Services (HHS). The contents of this article do not necessarily represent the policies of CDC or HHS and should not be considered an endorsement by the Federal Government.