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Monkeypox: What a Fire and EMS Chief Needs to Know

This week, there have been media reports of monkeypox outbreaks both in the United States and Europe. While outbreaks of this disease are rare, fire and EMS chiefs should be prepared for the rare instance of a monkeypox case in their community.

What is monkeypox?

Monkeypox is a rare, but serious, viral disease. It was discovered in 1958 among colonies of monkeys. The first human case of monkeypox was found in the Democratic Republic of Congo in 1970. Subsequent cases have been found in central and west African countries. There have been occasional cases in the United States.

According to the Centers for Disease Control and Prevention (CDC), monkeypox symptoms begin with fever, headache, muscle aches, back aches, chills, and exhaustion. Monkeypox also will cause the lymph nodes to swell. Within one to three days, the patient develops a rash, often beginning on the face and then spreading to other parts of the body. Lesions then develop and fall off. The illness usually lasts for two to four weeks. In Africa, monkeypox has been shown to cause death in as many as one in ten patients who contract the virus.

How is monkeypox transmitted?

According to the CDC, “the monkeypox virus occurs when a person comes into contact with the virus from an animal, human, or materials contaminated with the virus. The virus enters the body through broken skin (even if not visible), respiratory tract, or the mucous membranes (eyes, nose, or mouth) …. 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.”

How is monkeypox different than COVID-19?

COVID-19 is a respiratory virus, while monkeypox results in telltale lesions.

COVID-19 is spread in three main ways:

  • Breathing in air when close to an infected person who is exhaling small droplets and particles that contain the virus.
  • Having these small droplets and particles that contain virus land on the eyes, nose, or mouth, especially through splashes and sprays like a cough or sneeze.
  • Touching eyes, nose, or mouth with hands that have the virus on them.

The monkeypox virus is transmitted through large respiratory droplets that only can travel a few feet. So prolonged face-to-face contact is required, along with direct contact with body fluids or lesion material. Transmission of the monkeypox virus also can occur through indirect contact with lesion material, such as through contaminated linens or clothing.

What steps should fire and EMS departments take to avoid contracting the disease?

The National Emerging Special Pathogens Training and Education Center makes the following recommendations:

  • Follow the “identify, isolate, and inform” strategy to reduce exposure.
  • Be alert for patients who have illness and a rash consistent with monkeypox, regardless of the risk of exposure or travel histories.
  • Be aware that monkeypox infection begins with flu-like symptoms and may result in lesions and rashes that are hard to distinguish from syphilis, herpes simplex virus, chancroid, varicella zoster, and more common infections.
  • Be aware that people with close personal contact with monkeypox patients also could be at risk of infection.
  • Take a combination of standard, contact, and droplet precautions in all settings when a patient presents with fever and vesicular/pustular rash.
  • Personal protective equipment should be donned before entering the room or making contact with a potential patient with monkeypox. Minimize the number of personnel who are exposed.
  • If monkeypox is suspected, please consult with state health department of the CDC’s Emergency Operations Center, 770-488-7100.

Here are some further resources on monkeypox:

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