Amid COVID precautions, employers are now facing the challenge of reducing the new public health threat posed by the monkeypox virus (MPV). As of October 4, 2022, the Centers for Disease Control recorded 26,194 cases of monkeypox in the U.S.1
Because this is the first time MPV has caused widespread illness, it can be difficult for Employee Health (EH) and Occupational Medicine (OccMed, or OM) to know what steps they need to take to reduce transmission and protect employees.
Below, we’ll look at what EH and OM practitioners need to know about monkeypox in the workplace, including ways to prevent its spread.
What Is Monkeypox?
Monkeypox is a disease caused by the monkeypox virus.2 MPV is a member of the same family of viruses that cause smallpox. However, the symptoms of monkeypox are much milder. In May 2022, the world experienced its first known widespread outbreak of the disease in areas where it is not endemic, including Europe and North America.3
The symptoms of monkeypox vary, and not every person experiences the full range of symptoms. In most patients, symptoms appear roughly three weeks after exposure to the virus and include rash, fever, body aches, respiratory symptoms, and more.
While the illness subsides in most patients within 2 to 4 weeks, monkeypox can also cause complications such as scars, blindness, susceptibility to other infections, and in very rare cases, death.4
How Does the Monkeypox Virus Spread?
Because monkeypox has only recently been studied in-depth in humans, we don’t yet have a complete picture of all the ways the disease may spread.5 However, we do know that:
- Monkeypox is spread via close physical contact, such as touching the rash, scabs, or bodily fluids of an infected person, as well as touching surfaces and fabrics that were used by a person with monkeypox.6
- MPV can be spread via contact with infected animals.
- A pregnant person with monkeypox can spread it to their fetus.
- An infected person is capable of spreading monkeypox to others from the time their symptoms start until they are healed.
- Anyone, regardless of sexual orientation, can get monkeypox after contact with someone who has the disease, even though the majority of cases have been recorded in men who have sex with men.7
The likelihood of spreading MPV via respiratory secretions is still under investigation, as is the possibility of an infected person transmitting the virus before the onset of symptoms.
Who May Be At Risk For Monkeypox In the Workplace?
While MPV does not spread easily, the possibility that it may spread via bodily secretions such as coughing and sneezing can potentially put anyone at risk of contracting monkeypox in the workplace if they’re not protected by personal protective equipment (PPE) such as facemasks.
Healthcare professionals are considered at higher risk because they are more likely to come into contact with sick patients. This includes doctors, nurses, home health aides, physician’s and medical assistants, dentists, and dental hygienists. Other people in caring professions, such as daycare workers, may also need extra precautions. In addition, massage therapists, nail technicians (who have close skin-to-skin contact with clients), and hotel workers (who often touch dirty linens of guests) may have an increased risk of exposure to MPV.
The CDC recommends following their Guidelines for Isolation Precautions when providing care for patients with monkeypox in healthcare settings.8
Preventing Monkeypox in the EH/OM Workplace
The first step towards preventing monkeypox in the workplace is to ensure EH and OccMed staff are educated about the virus so they can pass relevant information on to employees and implement necessary precautionary measures.
Steps EH and OccMed professionals can take to reduce MPV among employees include:
Provide accurate and up-to-date information from reliable sources such as the CDC about the number of local cases and new research on transmission. Use education to avoid stigmatizing workers who may be infected with monkeypox.9
Encourage germ-free greetings, frequent hand-washing, and the use of hand sanitizer.
Clean and disinfect surfaces that may harbor the monkeypox virus, such as door handles.
Personal Protective Equipment or PPE
Supply gloves for those who may come into contact with skin, soiled surfaces, or dirty linens.
Have policies in place that allow sick workers to stay home, such as telework. Remind workers of non-discrimination policies that will also apply to those who contract monkeypox.
Educate employees about MPV transmission, signs and symptoms of monkeypox, any non-punitive sick leave options, and longer-term options such as job-protected leave under the Family and Medical Leave Act (FMLA) or income replacement via disability insurance.10
Because pregnant and immunocompromised employees are at higher risk for complications, ensure policies include ways to provide a safe work environment for all.
While healthcare or laboratory staff may be eligible for one of two vaccines (JYNNEOS and ACAM2000) that prevent the virus, most other workers are not eligible at this time. Stay up-to-date via the CDC about new vaccine recommendations.11 While employers may not currently mandate the vaccines since they are in short supply, if cases increase, it may be wise to plan ahead for vaccine distribution if your employees are at high risk.12
Knowledge of employee infection status should be treated as private information and kept separate from employee personnel files. Utilize a software system that can track relevant medical information while keeping it confidential.13 You may want to track infections to ensure employees are abiding by a 4-week isolation protocol. However, the Americans With Disabilities Act (ADA) prohibits releasing any identifying information about employees with monkeypox infections.14
Monkeypox cases must be reported to public health authorities by treating entities, so healthcare workers need a reliable way to record cases. However, workplaces are not required to report cases to any agency, though they can inform employees of possible exposure in the workplace.
Note that your state may have more specific protocols, such as California’s Guidance on Protecting Workers from Monkeypox (MPX).15 Thus far, OSHA has not issued any guidance specific to monkeypox.
Employee Health, Occupational Medicine, and Monkeypox
Monkeypox transmission in the workplace is rare, and there’s no need to panic about a widespread outbreak of the virus in its current form. However, workplace exposure is not impossible. That’s why it’s crucial that Employee Health and Occupational Medicine professionals stay aware of the latest monkeypox news and take time to prepare policies that reduce its transmission, especially for vulnerable workers.
Note: Net Health makes no representations as to accuracy, completeness, correctness, suitability, or validity of any of the information presented herein. All information is provided on an as-is basis. It is the viewer’s responsibility to verify any and all information presented herein.
Manual For Navigating COVID-19 and the Flu Season
1 Centers for Disease Control (CDC), “2022 U.S. Map & Case Count,” October 4, 2022.
2 Centers for Disease Control (CDC), “About Monkeypox,” July 22, 2022.
3 World Health Organization (WHO), “Monkeypox Outbreak 2022,” October 3, 2022.
4 Mayo Clinic, “Monkeypox: What is it and how can it be prevented?” August 19, 2022.
5 Centers for Disease Control, “Monkeypox: How It Spreads,” July 29, 2022.
6 Eurosurveillance, “Evidence of surface contamination in hospital rooms occupied by patients infected with monkeypox, Germany, June 2022,” June 30, 2022.
7 Morbidity and Mortality Weekly Report (MMWR), “Epidemiologic and Clinical Characteristics of Monkeypox Cases — United States, May 17–July 22, 2022,” August 12, 2022.
8 Centers for Disease Control, “Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings,” 2007.
9 Centers for Disease Control (CDC), “Reducing Stigma in Monkeypox Communication and Community Engagement,” September 27, 2022.
10 Centers for Disease Control (CDC), “Monkeypox: Workplaces and Businesses Toolkit,” September 12, 2022.
11 Centers for Disease Control (CDC), “Monkeypox Vaccination Basics,” September 28, 2022.
12 Society for Human Resource Management (SHRM), “Monkeypox: Who’s at Risk at Work?” August 2, 2022.
13 EHS Today, “How Employers Should Handle Monkeypox,” August 9, 2022.
14 Employment Law Watch, “What do U.S. employers need to know about Monkeypox?” August 17, 2022.
15 State of California, Department of Industrial Relations, “Cal/OSHA Posts Guidance on Protecting Workers from Monkeypox,” September 15, 2022.