Are you seeing Monkeypox cases in your EDs?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
I haven’t seen it but nearby departments have according to public health.
As an aside - is the monkey pox scare much to do about nothing? A relatively mild self limited illness with an ugly rash? It feels like a non emergency that will add additional strain to already grossly overburdened EDs.
 
Haha yep just had two this morning 🙂. Granted i work in the highest rate area in the country, but it’s a pretty interesting presentation.
 
RuralEDDoc said:
I haven’t seen it but nearby departments have according to public health.
As an aside - is the monkey pox scare much to do about nothing? A relatively mild self limited illness with an ugly rash? It feels like a non emergency that will add additional strain to already grossly overburdened EDs.
Click to expand...
According to the WHO website, mortality rates have ranged from 3-6% with monkeypox. I was surprised by that. It may not be the strain currently circulating, but definitely seems higher than Covid.

One thing you have to remember is you can get it from contaminated sheets. Remember the HIV scare in the 1980s where people were afraid of getting HIV from a toilet seat? Monkeypox apparently can be transmitted by surfaces. Your EVS staff can get it from changing bed linens if I've read everything correctly (as it can be transmitted through contaminated sheets).
 
southerndoc said:
According to the WHO website, mortality rates have ranged from 3-6% with monkeypox. I was surprised by that. It may not be the strain currently circulating, but definitely seems higher than Covid.

One thing you have to remember is you can get it from contaminated sheets. Remember the HIV scare in the 1980s where people were afraid of getting HIV from a toilet seat? Monkeypox apparently can be transmitted by surfaces. Your EVS staff can get it from changing bed linens if I've read everything correctly (as it can be transmitted through contaminated sheets).
Click to expand...
Those mortality rates I believe are from the parts of Africa where monkeypox is endemic. I don't think there have been any deaths with this outbreak in non endemic countries.
 
VA Hopeful Dr said:
Those mortality rates I believe are from the parts of Africa where monkeypox is endemic. I don't think there have been any deaths with this outbreak in non endemic countries.
Click to expand...
Yes there have been some deaths outside of Africa.
 
VA Hopeful Dr said:
Those mortality rates I believe are from the parts of Africa where monkeypox is endemic. I don't think there have been any deaths with this outbreak in non endemic countries.
Click to expand...
Spain has had several deaths in young men in their thirties.

Monkeypox is generally most dangerous to children under the age of 8, for whom there is no approved vaccine.
 
thegenius said:
So what do you do if you suspect monkeypox?
Click to expand...


depends. notify infection control, place pt in single person room if possible, keep door closed, mask pt and cover lesions if they leave the room. staff should use gloves, gown, eye protection, and n95/respirator.

in our state you’d assess for risk factors to have it and risk factors for serious illness, order testing either from the state public health lab or commercial lab, and testing for other things that can be confused for monkeypox (we‘ve seen syphilis, chickenpox, dermatitis, in ppl originally thought to have monkeypox). testing in our state was manual so approval was initially required with a phone call to a health dept epi, but they’ve ramped up now and commercial labs can do testing so it’s much easier to order testing now.

patients at risk for more serious illness can get tecovirimat. it’s hard to get some places but is being distributed to local hot spots to increase access. if sending home, they need to isolate.

notify health dept. health dept will do contact tracing and try to do PEP vaccination of contacts at risk.

CDC has good website resources on all things monkeypox and has put on several COCA calls for clinicians that were very good according to my colleagues. they were recorded and are available here: Home | Clinician Outreach and Communication Activity (COCA)

Monkeypox Outbreak: Updates on the Epidemiology, Testing, Treatment, and Vaccination

This COCA Call will provide updates on the epidemiology of the monkeypox outbreak.
www.emergency.cdc.gov www.emergency.cdc.gov
 
Yea I think I need to read up on it. All I know is "viral syndrome", then you get a "rash", and men having sex with men seem to be the biggest risk factor...although it is not an STD.

And it's in the family with smallpox.

Not transmitted via respiratory droplets, right?
 
We’re seeing around 10-20 presumed positive cases per day down here our adult ED. I/our ED diagnosed the first reported pediatric case of monkey pox in the US a couple months ago, and got like 100 annoying emails about it.

Large LGBT and Travel hub in Miami along with lots of multi-generational and communal households has increased the spread significantly.

Our hospital also has a ridiculous policy that only physicians can swab for monkeypox (which is done by manually unroofing the blisters and expressing the pus) which makes the process of seeing these patients x10 more unpleasant.
 
WHO on their website states that case fatality rate is between 3-6 percent.

What!?!?!? That’s terrible! Any actual data supporting this?

www.who.int

Mpox

WHO fact sheet on mpox: includes key facts, definition, outbreaks, transmission, symptoms, diagnosis, treatment, prevention, WHO response.
www.who.int www.who.int
 
thegenius said:
Yea I think I need to read up on it. All I know is "viral syndrome", then you get a "rash", and men having sex with men seem to be the biggest risk factor...although it is not an STD.

And it's in the family with smallpox.

Not transmitted via respiratory droplets, right?
Click to expand...

I don’t think they’re entirely sure the extent to which it could be transmisssible via respiratory droplets. it’s not considered to hang out in the air, but CDC changed PPE guidance to include respirators and indicated some transmission via resp droplets is possible.

I think our understanding of the ideas of airborne vs droplet transmission is in need of some serious updating
 
cyanide12345678 said:
WHO on their website states that case fatality rate is between 3-6 percent.

What!?!?!? That’s terrible! Any actual data supporting this?

www.who.int

Mpox

WHO fact sheet on mpox: includes key facts, definition, outbreaks, transmission, symptoms, diagnosis, treatment, prevention, WHO response.
www.who.int www.who.int
Click to expand...

The data is likely based on all reported cases to WHO. One of the strains has historically had a 10% cfr and the other 1%

But as we found with ebola and covid, baseline health status of people infected and quality of care after infection can hugely swing that number.

correction: the 10% comes from intensive surveillance im the DRC in the mid 80’s and was consistent with previous reports. didn’t do a deep read as it was a long paper, but didn’t see the 3-6% info.
 
Last edited:
The Congo variant has a cfr of 10%. The South African variant is 1%. The stain here is presumed to have descended from the South African variant. I am not aware of any deaths in the US from monkeypox.
 
Breaking news:
Sexually active Americans should consider limiting partners and avoiding sex parties to reduce the risk of contracting monkeypox until they get vaccinated, according to updated guidance from the Centers for Disease Control and Prevention released Friday.
Click to expand...
Thanks god that it's only temporary, so I can go back to attending monkey sex parties soon enough
 
You must log in or register to reply here.

Similar threads

Jabbed
  • Poll Poll
How much of your income are you investing?
2
Replies
58
Views
3K
Janders
J
P
Your worst bounceback cases
2
Replies
57
Views
6K
hoot504
hoot504
wareagle726
Are diabetics immunocompromised in your practice?
2
Replies
92
Views
5K
ShockIndex
ShockIndex
The Knife & Gun Club
Some fun cases.
Replies
12
Views
2K
CajunMedic
CajunMedic
T
  • Poll Poll
Whose heads are you scanning?
2
Replies
58
Views
5K
DocEspana
DocEspana
Top