- A presumptive positive monkeypox case has been identified in Northern Virginia associated with international travel to an endemic area.
- The Virginia Department of Health and the local health departments are investigating and contacting people known to have been exposed.
- Healthcare providers who suspect monkeypox infections should immediately call the Fairfax County Health Department’s Communicable Disease/Epidemiology Unit at 703-246-2433 (normal business hours) or 703-409-8449 (evenings and weekends) for guidance on testing and infection control measures.
- Maintain an increased index of suspicion for monkeypox in clinically compatible cases at all times and particularly if a patient presents with fever and rash and has history of international travel or recent exposure to a potential case.
- Take the following actions for a patient with fever and a rash who you suspect has monkeypox:
- Place a surgical mask on the patient as soon as possible. If referring a suspected monkeypox case to another health care facility, notify the facility before sending the patient so that appropriate infection control measures can be implemented at the receiving facility.
- A patient with suspected or confirmed monkeypox infection should be placed in a single-person room; special air handling is not required. The door should be kept closed (if safe to do so). The patient should have a dedicated bathroom. Transport and movement of the patient outside of the room should be limited to medically essential purposes. If the patient is transported outside of their room, they should use well-fitting source control (e.g., medical mask) and have any exposed skin lesions covered with a sheet or gown.
- Standard Precautions should be applied for all patient care, including for patients with suspected monkeypox. If a patient seeking care is suspected to have monkeypox, infection prevention and control personnel should be notified immediately.
- PPE used by healthcare personnel who enter the patient’s room should include gown, gloves, eye protection (i.e., goggles or a face shield that covers the front and sides of the face), and NIOSH-approved N95 filtering facepiece or equivalent, or higher-level respirator.
- Intubation and extubation, and any procedures likely to spread oral secretions should be performed in an airborne infection isolation room.
- Monkeypox is an immediately reportable disease. Contact the Health Department’s Communicable Disease/Epidemiology Unit immediately at 703-246-2433 (normal business hours) or 703-409-8449 (evenings and weekends) to report the suspected case and for guidance on testing and infection control measures.
- The incubation period (time from infection to symptoms) for monkeypox is usually 7−14 days but can range from 5−21 days.
- Monkeypox is a rare but potentially serious viral illness. The first symptoms of monkeypox include fever, malaise, headache, and sometimes sore throat and cough. A distinguishing feature of monkeypox from smallpox is lymphadenopathy which may affect submandibular, cervical, axillary, or inguinal nodes unilaterally or bilaterally. This typically occurs with fever onset, 1 to 2 days before rash onset, or rarely with rash onset. Generally, within 1 to 3 days after the appearance of fever, the patient develops a rash, often beginning on the face and spreading centrifugally, and commonly involving the palms and soles. Lesions progress from macules to papules, vesicles, pustules, and scabs over 2 to 4 weeks.
- Monkeypox is endemic in some areas of Central and West Africa. The case fatality rate in Africa has been 4-11%, depending on the virus clade. Risk of a fatal outcome may be elevated due to limited healthcare in some African countries; there is no record of any case outside Africa having died from monkeypox.
- In 2022, several monkeypox clusters have been identified in countries in Europe and North America among persons without travel to endemic areas. Cases have often been identified among men who have sex with men. In the US several cases (confirmed and presumptive) have been identified. CDC is urging healthcare providers in the U.S. to be alert for patients who have rash illnesses consistent with monkeypox, regardless of whether they have travel or specific risk factors for monkeypox and regardless of gender or sexual orientation.
- Additional information for clinicians is available on the CDC website.