Monkeypox patients should be isolated, and those treating them should wear personal protective equipment (PPE), guidance from Public Health Ontario says.
The health agency made a series of recommendations for the treatment of Monkeypox patients in the health-care settings across the province, in an infection prevention and control document published earlier this month.
In the document, Public Health Ontario said the Monkeypox virus can be transmitted “from animals-to-humans (i.e., zoonotic transmission) or person-to-person by contact with infected lesions, skin scabs, body fluids or respiratory secretions.”
“It can also be transmitted by contact with materials contaminated with the virus,” the document said, such as through clothing or bedding.
According to Public Health Ontario, historically there has been “limited person-to-person transmission” of Monkeypox.
The agency said the “primary” mode of transmission between people is through respiratory secretions or direct contact with skin lesions or with items that have been contaminated.
“However, given the respiratory system involvement during infection, the possible transmission during the prodromal period and similarities to variola virus (smallpox), the potential for airborne transmission has been suggested,” the document reads.
According to the document, the average incubation period is seven to 14 days but can range from five to 21 days.
The health agency said a person is “most commonly contagious from the onset of initial lesions (typically on the tongue and in the mouth), until scabs have fallen off and new skin (is) present.”
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However, the document said some cases “may be contagious” during the early set of symptoms including fever, malaise and headache “before the rash develops.”
Public Health Ontario said in addition to “routine practices” several “additional precautions” used for airborne, droplet and contact viruses should be used in health-care settings when treating a patient with Monkeypox.
The agency said patients with the disease should be put in airborne isolation rooms with negative pressure ventilation.
When such rooms are not available, the patients should be put in a single room with “with the door closed” and should have a “dedicated toileting facility.”
“If neither option is feasible, then precautions should be taken to minimize exposure to surrounding individuals such as having the patient don a medical mask over their nose and mouth as tolerated and covering exposed skin lesions with clothing, sheet or gown as best as possible,” the document reads.
Health-care workers treating patients with Monkeypox should also wear PPE including a fit-tested and seal-checked N-95 respirator, gloves, a gown and eye protection such as goggles or a face shield.
According to Public Health Ontario, these additional precautions should be maintained “until all scabs have fallen off and new skin is present.”
The recommendations come as health officials in Toronto are investigating the city’s first suspected case of the virus.
On Saturday, Toronto Public Health said a man in his 40s who had recent contact with someone who travelled to Montreal is being investigated.
In a news release, the department stated that although “the risk of infection to the general public is low, those who visited an event at the Axis Club at 772 College St. on May 14 and Woody’s bar, located at 476 Church St., on May 13 and 14 may have been exposed.”
On Tuesday, Rosamund Lewis, head of the Smallpox Secretariat within the World Health Organization (WHO) Emergencies Programme said there have been 131 confirmed Monkeypox cases and 106 further suspected cases globally, but the latest outbreak was “containable.”
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