Hermano Rocha, MD, PhD

DISCLOSURES | November 12, 2024

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A recent webinar held by the World Health Organization (WHO) discussed safety guidance for patients and healthcare professionals involved in treating mpox cases. Speakers included Victoria Willet from the WHO’s health emergencies program, Andy Bulabula, a senior infection prevention and control technician at the Africa Centers for Disease Control and Prevention, and Gertrude Nsambi, director of the Ministry of Public Health, Hygiene, and Prevention in the Democratic Republic of Congo. 

The experts highlighted essential infection prevention and control measures that should be observed in both basic and specialized health units.

Screening and Patient Isolation

The speakers stressed the importance of prompt identification of suspected mpox cases at the entry points of healthcare facilities. Screening tools, such as symptom questionnaires, were recommended to help identify potential cases. The WHO advises isolating suspected or confirmed case patients in well-ventilated individual rooms when possible. In resource-limited settings, the experts suggested using segregated areas within the same facility to minimize transmission.

Hand sanitization stations should be set up at facility entrances, and social distancing of at least 1 meter (approximately 3 ft) is recommended when feasible. Transmission of the mpox virus typically occurs through skin or mucosal surfaces, such as oral, anogenital, or ocular tissues. In Africa, 10 cases of nosocomial transmission have been identified, though hospital-based infectivity appears to be low.

A recent study reported that among 113 contact cases monitored after 221 commercial flights, no transmission was identified. Additionally, data from a healthcare facility in Colorado showed that despite the limited use of personal protective equipment (PPE) and postexposure vaccination, none of the 313 doctors exposed during routine care contracted mpox.

Recommended PPE and Infection Control

The use of appropriate PPE was highlighted as important. The recommended precautions include:

• Use of surgical masks or N95/PFF2 respirators for aerosol-generating procedures
• Use of disposable gloves and gowns to prevent contact contamination
• Use of goggles or face shields to protect against respiratory secretions

The speakers emphasized that overuse of PPE is not recommended but rather the correct use of protection based on risk assessments. As noted on Medscape, aerosols are not the main route of transmission of the disease. Healthcare professionals should also perform hand hygiene in line with WHO guidelines, before and after using PPE.

Surface Cleaning and Waste Disposal

Regular cleaning and disinfection of surfaces were presented as essential for disease prevention, as mpox virus can survive on surfaces for several weeks. The WHO suggests that the virus can be inactivated within 1 minute of contact with 0.05% hypochlorite solutions and by washing fabrics at 70 °C (158 °F) or with soap and water combined with disinfectants. Care should be taken when handling used sheets and fabrics, and excessive shaking should be avoided to prevent dispersing infectious particles into the air. 

The seminar also addressed the need to treat biomedical waste and patient bodily fluids as infected waste. Safe disposal protocols include proper separation of contaminated waste and treatment in accordance with local regulations and WHO guidelines. In areas lacking local regulations, WHO’s global guidance for safe waste management should be followed.

Other Preventive Measures

Beyond hospitals, the specialists discussed preventive measures in community settings such as schools, prisons, and refugee camps, where transmission risks may be higher. Home isolation strategies for patients with mild symptoms were also covered, with clear recommendations for sanitation, waste disposal, and caregiver protection.

The speakers underscored the importance of balancing infection control with patient well-being. Controlled interaction with family members and safe visitor access, provided they follow PPE and prevention guidelines, were encouraged to support patients’ mental health and reduce the psychologic impact of isolation. 

Future disease control measures, such as vaccination campaigns, were also discussed at the seminar.

WHO is developing various training materials for community health workers to enhance local response capacity; guidelines are continuously updated and made available on the organization’s website.

The seminar provided a comprehensive set of guidelines and practical tools for healthcare professionals and managers in both clinical and community settings. Implementing these measures is essential to ensure the safety of all involved in care and to minimize mpox’s impact on health systems, while promoting safe, high-quality patient care and contributing to effective disease control.

Hermano Rocha, MD, PhD, is a physician with a postdoctorate in epidemiology from the Harvard School of Public Health and an alumnus of the Effective Writing for Health Care course at Harvard Medical School. He is a professor of epidemiology at the Faculty of Medicine, Federal University of Ceará in Brazil and a child development scientist, leading epidemiologic studies aimed at creating public policies to increase international human capital. His research also focuses on applying artificial intelligence–driven statistical methods to public health. 

This story was translated from Medscape’s Portuguese edition using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. 

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