Mpox: An Update on the New Public Health Emergency
Mpox, previously known as monkeypox virus, is an infectious disease spread through close contact and respiratory droplets.1 Exposure to the virus can occur during travel to an area with sustained human-to-human transmission; contact with a confirmed, probable, or suspected case; contact with a dead or live wild animal or exotic pet that is a central African endemic species; or use of a product derived from such animals (e.g., game meat, creams, lotions, powders, etc.).2 Mpox symptoms typically start within 21 days of exposure with influenza-like symptoms, followed by a vesicular or pustular rash one to four days later. The rash is generally located on the palms of hands, soles of feet, genitalia, and anus.3
The disease is drawing more attention in the health community due to the ease of transmission and higher fatality rate as compared to previous years.2 The World Health Organization has declared mpox a global public health emergency for the second time in two years.4 The two circulating clades are responsible for confirmed cases identified in 116 countries worldwide, including the United States.4 As of August 2024, subclade Ib is responsible for the upsurge of severe cases of mpox in several African countries, Europe, and Asia.
Providers are urged to include mpox in their list of differential diagnoses when vesicles or pustules are present with influenza-like illness. Patients should be assessed for contact with others who have a rash and recent travel to areas where mpox cases have been identified.2
Infection can be confirmed by various methods, including polymerase chain reaction (PCR) testing, next-generation sequencing (NGS), or mpox culturing from clinical specimens.5 Consult public health authorities for access to mpox treatment recommendations. Oral treatment with tecovirimat can be considered for patients who meet eligibility criteria.5
People can protect themselves by
Getting vaccinated if appropriate. To determine eligibility and locate vaccines see https://www.cdc.gov/poxvirus/mpox/vaccines/vaccine- recommendations.html
Avoiding close, skin-to-skin contact with people who have a rash that looks like mpox
Avoiding contact with objects and materials that a person with mpox has used
Washing hands often6
References
- World Health Organization. Mpox (Monkeypox). WHO website.https://www.who.int/health- topics/monkeypox/. Published 2024. Accessed August 2024.
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Centers for Disease Control and Prevention. Mpox Case Definitions. CDC website. https://www.cdc.gov/mpox/hcp/case-definitions. Updated September 12, 2024. Accessed August 2024.
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Centers for Disease Control and Prevention. Mpox. CDC website.https://www.cdc.gov/mpox/. Published March 2024. Accessed August 2024.
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World Health Organization. Mpox Global Strategic Preparedness and Response Plan. https://www.who.int/publications/m/item/mpox-global-strategic-preparedness-and-response-plan. Published August 26, 2024. Accessed August 2024.
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Centers for Disease Control and Prevention. Mpox: For Professionals. CDC website. https://www.cdc.gov/mpox/. Published August 2024. Accessed August 2024.
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Centers for Disease Control and Prevention. Preventing Mpox. CDC website. https://www.cdc.gov/mpox/prevention/. Published September 12, 2024. Accessed August 2024.
Patient Safety Authority Keys to Investigation
Take a deep dive into how you conduct investigations.
Keys to Investigations
Want to learn the best ways to identify risk reduction strategies in your healthcare facility?
Patient safety officers of all Pennsylvania healthcare facilities must “ensure the investigation of all reports of serious events and incidents,” which is vital to the identification of patient safety concerns and implementation of risk reductions strategies. During review and analysis of patient safety event reports in the Pennsylvania Patient Safety Reporting System (PA-PSRS), the Patient Safety Authority identified opportunities for improvement related to event investigations as evidenced in the limited information provided and follow-up communication with facilities.
To address this issue, PSA conducted a yearlong project to assess current practice at healthcare facilities and provide education to patient safety professionals about event investigation concepts. In addition to the assessment, facilities were offered focused, monthly webinars that culminated in three in-person workshops on various investigative skills and techniques. This toolkit provides a compendium of the webinars, as well as a summary of several key concepts presented to provide support for facilities’ investigations, which will lead to improved reporting; better analysis; and ultimately, more appropriate and effective risk reduction strategies.
CHANGEMAKERS STORIES THAT MAKE A DIFFERENCE
Reducing Surgical Site Infections
Surgical site infections (SSI) in the United States are the leading cause of morbidity and mortality among all hospital-acquired infections, and they also are among the most preventable healthcare-associated infections. As such, decreasing SSI has become a priority for orthopedic surgeons around the nation. SSIs are reportable events and tracked by the health network. In 2014 after noting a rise in SSI throughout a health network (2.8% compared to the statewide average of 0.82– 0.89%), the staff at one hospital established a Surgical Unit Safety Practice (SUSP) committee to address the issue. The multidisciplinary team was tasked with reviewing all processes and procedures around total joint replacement surgery, from patient consultation through rehabilitation. Of particular concern was the timing of administering antibiotics before and after surgery.
The SUSP team used gap analysis and tracers to identify ways to reduce SSI in total hip and knee arthroplasty. In January 2015, they introduced a standardized care bundle to monitor antibiotic compliance and documentation, which includes a checklist that follows the patient from the orthopedic surgeon's office through discharge. The staff was required to sign their initials on this bundle tag beside the tasks for which their department was responsible as they were completed.
The whole staff embraced the new tool, collaborating with the SUSP team to implement it and help refine and improve the process. The impact on patient safety and outcomes was immediate and dramatic. SSI associated with hip and knee arthroplasty fell to 1.2% in 2015, less than 1% in 2016, and 0% in the first quarter of 2017. Following this success, the team has been expanding the tool to other surgical procedures.
The Patients Companion
Sometimes it seems like patients and healthcare providers aren't on the same page, or even the same book. That's why we wrote a handbook to help everyone in the care team speak the same language—and now that includes Simplified Chinese!
The Patient's Companion is also available in English and Spanish. Download it at no cost at
patientsafety.pa.gov.