The Biden administration recently declared the monkeypox outbreak in the U.S. a public health emergency. With monkeypox cases on the rise globally and nationally, here’s what you need to know about monkeypox and how you can prepare to combat it as a healthcare traveler in the coming months.
Note: The following information was up to date at the time of publication, but changes after the time of publication may impact the accuracy of the information.
- What is monkeypox?
- How is monkeypox transmitted?
- What are the symptoms of monkeypox?
- How can healthcare workers protect themselves from monkeypox?
- How can healthcare travelers prepare for monkeypox?
What is monkeypox?
Monkeypox is a viral zoonosis (a virus transmitted from animals to humans) with symptoms like smallpox, but less severe. The monkeypox virus belongs to the same family of viruses as the virus that causes smallpox. In fact, the monkeypox virus is not new. The first case of monkeypox was discovered in 1958 in colonies of monkeys and the first human case of monkeypox was recorded in 1970.
In comparison to COVID-19 and smallpox, monkeypox is far less deadly. Additionally, monkeypox mainly spreads through close contact and doesn’t spread as easily as respiratory viruses like COVID. However, monkeypox is still a concern to public health as the disease can be quite painful and in some cases lead to secondary health infections like encephalitis, sepsis, bronchopneumonia, or infection of the cornea with possible vision loss.
Vulnerable populations like children, people with other health conditions, and those with weak immune systems are especially at risk. Currently, 94 percent of U.S. monkeypox cases are men who reported recent male-to-male sexual or intimate contact and racial and ethnic minorities also appear to be disproportionately affected, according to the CDC.
How is monkeypox transmitted?
Although the virus was first introduced to humans by animals, the virus is now mainly transmitted from human to human. From what we currently know about monkeypox, the virus is most easily transmitted through large droplets, by touching bodily fluids and/or skin lesions, often for prolonged periods of time.
Even though gay men and racial and ethnic minorities are currently groups primarily contracting the virus, monkeypox can spread to anyone through close, skin-to-skin contact including:
- Direct contact with monkeypox rash, scabs, or body fluids from a person with monkeypox
- Touching objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with monkeypox
- Contact with respiratory secretions
This direct contact can happen during intimate contact, including:
- Oral, anal, and vaginal sex or touching the genitals or anus of a person with monkeypox
- Hugging, massage, and kissing
- Prolonged face-to-face contact
- Touching fabrics and objects that were used by a person with monkeypox and that have not been disinfected
Pregnant people can also spread the virus to their fetus through the placenta. It’s also possible to still contract monkeypox from infected animals either by being scratched or bitten by the animal or by preparing or eating animal products from an infected animal. Animals can also contract monkeypox from humans, so make sure to follow the CDC’s recommendations for monkeypox with pets in the home.
What are the symptoms of monkeypox?
One of the most prominent symptoms of monkeypox is a rash that may be located anywhere on the body including near the genitals, anus, and other areas like hands, feet, chest, face, or mouth. This rash goes through several stages before it heals. Initially, the rash may look like pimples or blisters and eventually it turns into scabs that fall off. This rash is painful and/or itchy.
Other symptoms of monkeypox may include:
- Swollen lymph nodes
- Muscle aches and backache
- Respiratory symptoms (sore throat, nasal congestion, cough)
Someone with monkeypox may experience all or only a few of these symptoms. Additionally, some people will experience flu-like symptoms before the rash appears, some people will get the rash first followed by other symptoms, and some may only experience a rash.
Monkeypox symptoms usually develop within three weeks of exposure to the virus. If someone is experiencing flu-like symptoms, they will usually develop a rash 1-4 days later. It’s also important to note that monkeypox can be spread from the time symptoms start until the rash has healed, which is only when all scabs have fallen off, and a fresh layer of skin has formed. The illness typically lasts two to four weeks total.
How can healthcare workers protect themselves from monkeypox?
Obviously monkeypox should be taken seriously, but rest at ease the risk for contracting monkeypox in the healthcare setting is not only low, but preventable. Here are the CDC’s general recommendations for preventing monkeypox:
- Avoid close, skin-to-skin contact with people who have a rash that looks like monkeypox
- Do not touch the rash or scabs of a person with monkeypox.
- Do not kiss, hug, cuddle or have sex with someone with monkeypox.
- Avoid contact with objects and materials that a person with monkeypox has used
- Do not share eating utensils or cups with a person with monkeypox.
- Do not handle or touch the bedding, towels, or clothing of a person with monkeypox.
- Wash your hands often
- Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially before eating or touching your face and after you use the bathroom.
Correct use of personal protective equipment (PPE) and infection control practices, similar to those used for COVID, are likely to be effective at reducing the risk of transmission of the monkeypox virus when seeing a patient or handling contaminated materials. Dr. Bernard Camins, medical director for infection prevention at New York City's Mount Sinai Health System recommends surgical gowns, N-95 masks, and gloves for healthcare workers interacting with patients who may have monkeypox.
Disinfect contaminated areas
During the infectious period of monkeypox, bodily fluids, respiratory secretions, and lesion material can contaminate the environment a person with monkeypox inhibits. The virus can survive in linens, clothing, and on surfaces, especially in dark, cool, and low humidity environments. To combat this contamination, healthcare workers need to be diligent and cautious about decontamination and cleaning surfaces or any areas where fluid may have spread.
Receive vaccines if necessary
There are currently two vaccinations available for protecting against monkeypox, JYNNEOS and ACAM2000. The CDC recommends vaccination for people who have been exposed to monkeypox and people who are most at risk for contracting monkeypox. The CDC isn’t currently encouraging pre-exposure vaccination for healthcare workers who aren’t part of high-risk groups, however that may change as the vaccines become more readily available or we learn more about monkeypox.
How can healthcare travelers prepare for monkeypox?
Monkeypox has a low hospitalization and death rate, so the outbreak isn’t expected to place a large burden on health systems. In fact, most people with monkeypox recover within two to four weeks without the need for medical treatment.
"We are not anticipating that there will be a significant surge within the hospital because most individuals who are impacted by monkeypox are able to be supported and treated as outpatients," Fritz Francois, MD, chief of hospital operations at New York City-based NYU Langone Health, said. "Nevertheless, there's a small subset of individuals who might need to be hospitalized, and I think it's important that hospitals be prepared for those individuals and to provide symptomatic relief and other treatments as needed."
Even though health systems aren’t currently expecting a big impact on inpatient care, it doesn’t hurt to be prepared. As we learned from COVID, public health emergencies require healthcare travelers to jump in and help at the most in demand locations. So, if you want to be ready in the case of needing to help with the monkeypox outbreak, here’s a few things you can do as a healthcare traveler to prepare:
- Get your compact license so you can easily practice in multiple states
- Get licensed in states with the most cases of monkeypox (New York, California, Texas, Florida)
- Some states like New York and California aren’t NLC states so you will need additional licenses to practice there even if you have a compact license
Being licensed in the areas that may need your help the most ensures you’ll be able to quickly take assignments when they’re posted, meaning you’ll be able to jump in and help as soon as possible.
Now that you know what monkeypox is, you can take the steps to take care of yourself and prepare to jump in as a healthcare traveler if needed. Stay updated on public health emergencies with Fusion Marketplace and know that in the case the monkeypox outbreak heightens, we’ll have easy access to travel jobs so you can get out there and help on the frontlines as quickly as possible.