On July 23, 2022, the global monkeypox outbreak was designated a public health emergency of international concern. As the virus spreads across countries, including the U.S., here are 10 things for nurses to know to help you in clinical practice and public health education.
Monkeypox is a close relative of smallpox; the smallpox vaccine also prevents monkeypox infection. Two vaccines
are currently available in the U.S.
Transmission occurs from one person to another by close contact with lesions, body fluids, respiratory droplets and contaminated materials, such as bedding.
The incubation period of monkeypox can range from five to 21 days. It is usually a self-limited disease with the symptoms typically lasting from 2 to 4 weeks.
Monkeypox presents with fever, a characteristic rash
and usually swollen lymph nodes. The lymphadenopathy of monkeypox distinguishes it from smallpox; it may be generalized or localized to several areas, such as the neck and axillae.
Clinicians should be alert for patients who have rash illnesses consistent with monkeypox. The clinical course
includes the development of lesions, which often appear simultaneously and evolve through the enanthem through the scab stage
together, on any given part of the body.
The preferred laboratory test for monkeypox is detection of viral DNA by polymerase chain reaction (PCR). Specimens should include two swabs from two different lesions, preferably from different locations on the body or from lesions which differ in appearance.
Standard, contact, and droplet precautions are recommended when caring for a patient with monkeypox; an airborne infection isolation room should be used for procedures that may aerosolize secretions, such an intubation and extubation.
For inpatients, discontinuation of isolation precautions should be made in consultation with the local or state health department. For outpatients, isolation precautions should be maintained until all lesions have crusted and fallen off, and a fresh layer of healthy skin has formed.
Severe cases occur more commonly among children and are related to the extent of exposure, and the patient’s underlying health status. Immune deficiencies may lead to worse outcomes.
Complications can include secondary infections, bronchopneumonia, sepsis, encephalitis, and infection of the cornea which may cause vision loss.