An investigation by Colorado public health authorities found no monkeypox cases among 313 health care workers exposed to 55 patients with the virus, despite low adherence to preventive measures among the workers.
The report adds to evidence that the overall risk to health care workers appears low. At least one US health care worker had a work-related monkeypox infection during the current outbreak and a health care worker in the UK became infected after handling patient linens during a 2018 outbreak.
In the recent study, the Colorado Department of Public Health and Environment collected information on health care workers who interacted with a patient with monkeypox between May 1 and July 31, 2022. Workers who treated patients, were within 6 ft of them, or handled their linens were included. Twenty workers had high-risk exposures, 67 had intermediate-risk exposures, while 226 had low- or uncertain-risk exposures.
Only 23% of the workers followed all the CDC’s recommendations for personal protective equipment (PPE) during encounters with patients with monkeypox, which consists of a gown, gloves, eye protection, and an N95 or higher-level respirator. Adherence varied widely across clinical settings, with only 4% of those working in primary or urgent care following the recommendations compared with about half of those working in community health or sexually transmitted infection clinics.
Overall, 38% of the workers wore an N95 respirator, 64% wore gloves, 40% wore gowns, and 31% used eye protection. Workers with high- or intermediate-risk exposures were offered postexposure prophylactic vaccination with the JYNNEOS vaccine and were closely monitored for 21 days. Only 43% of these 87 workers received the vaccinations. Public health authorities instructed those with lower-risk exposures to self-monitor for symptoms for 21 days.
The authors said workers’ lack of awareness about several factors—the patients’ symptoms before the encounter, the CDC’s PPE recommendations, the presence of monkeypox in the community, and monkeypox signs and symptoms, including atypical presentations—may have contributed to low adherence to preventive measures. They noted that community health and sexually transmitted infection clinics acted as monkeypox referral centers, which may have contributed to higher adherence in these settings.