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Healthcare Settings

  • Suspected or Confirmed Mpox Patient Placement
    • Single-person room and door should be kept closed (if safe to do so)
    • Dedicated bathroom
    • If patient is transported outside their room, then a well-fitting source control such as a medical mask and coverage of exposed skin lesions with a sheet or gown is recommended
    • Airborne infection isolation room recommended for procedures that spread oral secretions such as intubation and extubation
  • Healthcare Personnel Personal Protective Equipment
    • Gown
    • Gloves
    • Eye protection that covers the front and sides of the face
    • NIOSH-approved particular respiratory equipped with N95 filers or higher

Healthcare Personnel Risk Assessment, Monitoring, and PEP Recommendations
Exposure Risk High Risk Intermediate Risk Low/Unknown Risk No Risk
Definition
  1. Unprotected contact between an exposed individual's broken skin or mucous membranes and mpox skin lesion.
  2. Inside the patient's room or within 6 feet of a patient with mpox during aerosol-generating procedure from oral secretions (e.g., CPR, intubation), or activities that may resuspend dried exudates (e.g., shaking soiled linens), without wearing an N95 respirator and eye protection.
  1. Being within 6 feet for a total of 3 hours or more (cumulative) of an unmasked patient with mpox without wearing a facemask or respirator.
  2. Unprotected contact between an exposed individual's intact skin and the skin lesions or bodily fluids, or soiled materials (e.g., linens, clothing).
  3. Activities resulting in contact between clothing and skin lesions or bodily fluids, or soiled materials (e.g., during turning, bathing, or assisting with transfer) while not wearing a gown.  
 Healthcare worker not wearing a mask, but the exposure was less than 3 hours. Healthcare worker was wearing gloves and mask for all contact with patients and did not meet any of the above exposure categories. 
Monitoring Active monitoring x 21 days. Active monitoring x 21 days. Self-monitoring x 21 days. None
Post-exposure prophylaxis

Recommended

  • Vaccination within 4 days or by 14 days
  • Daily contact with healthcare facility human resources or infection control for 21 days after exposure
  • Symptom screen daily
  • Exposed personnel may continue to work or go outside their homes
  • Any potential symptoms must be reported ASAP to LACDPH

Discuss risk/benefit with MD

  • Vaccination within 4 days or by 14 days
  • Daily contact with healthcare facility human resources or infection control for 21 days after exposure
  • Symptom screen daily
  • Exposed personnel may continue to work or go outside their homes
  • Any potential symptoms must be reported ASAP to LACDPH
 No No

For additional information including environmental infection control, please refer to CDC’s guidance on healthcare infection control: https://www.cdc.gov/poxvirus/mpox/clinicians/infection-control-healthcare.html?CDC_AA_refVal=https://www.cdc.gov/poxvirus/monkeypox/clinicians/infection-control-hospital.html  

Congregate Settings

  • Infectious diseases, including mpox, can spread more easily via person-to-person contact in congregate settings among staff and residents
  • Congregate living settings are non-healthcare settings that can include:
    • Correctional and detention facilities
    • Homeless, emergency, and domestic violence shelters
    • Transitional housing
    • Group homes
    • Dormitories at institutions of higher education (IHE) such as college and universities
    • Seasonal worker housing
    • Residential substance use treatment facilities
    • Assisted living communities
    • Hotels, motels, and hostels
  • Clear and non-stigmatizing communication with staff and residents regarding Mpox prevention
  • Provide appropriate personal protective equipment for staff that enter isolation areas
    • Gown
    • Gloves
    • Eye protection that covers the front and sides of the face
    • NIOSH-approved particular respiratory equipped with N95 filers or higher
  • If there is a mpox case within a congregate living facility, then:
    • Test and evaluate staff and residents with suspected Mpox
    • Isolate staff who are suspected of having mpox away from congregate settings until fully recovered
    • Isolate residents with mpox away from others to the extent possible, until shedding of rash crusts with formation of healthy pink tissue at all lesion sites, which can typically take 2-4 weeks
    • Isolation space considerations
      • Door that can be closed
      • Dedicated bathroom that other residents do not use
      • Reduce the number of staff who are entering the isolation areas to staff who are essential to the isolation area operations
      • Residents who are not under isolation for mpox should not enter the isolation area
      • Dedicated laundry space should be identified for residents in isolation
      • Dedicated lined trash care in the isolation room
      • Multiple poeple who test positive for mpox can stay in the same room
    • Contact LACDPH before ending isolation
  • If someone may have been exposed to mpox within a congregate living facility, then:
    • Congregate living facility should contact LACDPH for assistance with contact tracing to help identify and monitor the health of any staff or residents who might have had close contact with someone who has mpox
    • Ensure access to handwashing with soap and water or hand sanitizer with at least 60% alcohol should bae available at all time
      • Anyone who touches the rash, or clothing, linens, or surfaces that may have had contact with the rash should wash their hands immediately

Reference: CDC Guidance on MPox Congregate Settings: https://www.cdc.gov/poxvirus/mpox/community/congregate.html

Additional Site-Specific Recommendations

Waste Management Resources