How to prevent monkeypox transmission in outbreak scenario when the healthcare system is overburdened and the patient needs to get isolated in home? If a person tests positive for monkeypox, he must isolate himself to avoid spread of virus to nearby people. In order to get isolated patient must strictly follow few guidelines or measures at home. Monkeypox suspected or confirmed patient should remain isolated during the whole duration of infection until the complete healing of skin lesions, the scabs have fallen off, and a fresh layer of intact skin has formed. Following measures should be taken during isolation period in domestic setting rather than in monkeypox patient isolation in healthcare setting.
How to Prevent Monkeypox Transmission by Avoiding Visitors?
Visitors should not be allowed in isolation area including friends and family. Visitors to patients with monkeypox infection should be limited to those essential for the patient’s care and wellbeing (e.g., parents of a child, spouse).
In order to take decisions about the visitors including whether the visitor stays or sleeps in the room with the patient must consider the patient’s age, the patient’s ability to advocate for themselves, ability of the visitor to adhere to infection prevention and control recommendations and it must be considered that whether the visitor already had higher risk exposure to the patient etc.
In general, visitors with contagious diseases should not be visiting patients in domestic settings to minimize the risk of virus spread to others. Only necessary attendant must be allowed to enter isolation room after wearing proper PPE’s.
How to Prevent Monkeypox Transmission by Avoiding Close Person to Person Contact?
Monkeypox patient in isolation must avoid close contact with anyone to prevent spread of virus. Additionally, patient must Wear well-fitting mask when contact is necessary to avoid contamination of nearby environment or surfaces which may come in contact with others.
How to Prevent Monkeypox Transmission by Avoiding Close Animal Contact?
Patient must not come in close contact with pets or other animals. If pet or animal who came in contact with suspected patient and shows symptoms e.g. lethargy, lack of appetite, coughing, bloating, nasal or eye secretions or crust, fever, rash) immediately inform the health officials and contact veterinarian. Consider steam cleaning as additional precautionary measure in case of pets in house.
How to Prevent Monkeypox Transmission by Avoiding Sharing of Items?
Limit use of spaces, items, and food that are shared with other household members specially dishes and other eating utensils. Avoid sharing of potentially contaminated items e.g. Bed linens, clothing, towels, wash cloths, drinking glasses or eating utensils etc.
How to Prevent Monkeypox Transmission by Avoiding Contact with Commonly Touched Surfaces?
All commonly touched surfaces and items, such as counters or light switches must be routinely cleaned and disinfected.
How to Prevent Monkeypox Transmission by Decontamination of Furniture?
Place coversheets, waterproof mattress covers, blankets, or tarps over surfaces of upholstered furniture and other porous materials that cannot be laundered to avoid contamination.
How to Prevent Monkeypox Transmission by Avoiding Sexual Activity?
Monkeypox transmission has strong ties with sexual activity therefore it is not recommended to engage in sexual activity.
How to Prevent Monkeypox Transmission by Proper Bathroom usage?
Patient must use separate bathroom preferably but if there is not a separate bathroom in the home then the patient should clean and disinfect surfaces such as counters, toilet seats and faucets.
How to Prevent Monkeypox Transmission by Proper Cleaning and disinfection?
In case of domestic setting, the local health official should be contacted for cleaning and disinfection to arrange specialist for decontamination of the affected areas and disposal of any waste.
How to Prevent Monkeypox Transmission by Proper Cleaning of Interior or Cars?
In domestic setting interiors including cars should be cleaned using a HEPA filtered vacuum cleaner and the vacuum cleaner contents should be disposed of as Category A waste.
How to Prevent Monkeypox Transmission by Proper Cleaning of Hard surfaces?
All hard surfaces in a domestic setting should be cleaned using detergents followed by disinfection with 1000ppm available chlorine and then they should be allowed to air dry. As an alternative, 5000ppm available chlorine may be used on its own.
How to Prevent Monkeypox Transmission by Proper Cleaning of Soft furnishings?
Carpets, sofas, curtains, mattresses and car interiors, should then be professionally steam cleaned by handlers wearing appropriate PPE’s.
How to Prevent Monkeypox Transmission by Decontamination of Laundry in Domestic Settings?
- Collect contaminated clothing before cleaning the room without shaking them so that it may not disperse infectious particles.
- Place all contaminated clothing or linen in a water soluble (alginate) bag and seal the bag tightly then place inside an impermeable bag for transport to the laundry facility.
- Clothing that has been in direct contact with the skin of patient e.g. duvets, pillows, blankets, sheets, towels or underwear can be sealed, bagged and destroyed as Category A waste.
- In washing facility contaminated laundry must be washed in a standard washing machine with hot water (over 60° C) and detergent however bleach may also be added but is not necessary.
- The handler must wear appropriate PPE’s.
- Washed clothing should not be placed into areas where they may be re-contaminated during the cleaning process.
How to Prevent Monkeypox Transmission by Waste Management in Domestic Setting?
Waste produced by monkeypox suspected or confirmed patient should be treated as healthcare or clinical waste category B rather than domestic waste because it has high risk of monkeypox spread to community if treated as domestic waste.
How to Prevent Monkeypox Transmission: Other precautions?
- Patient should avoid use of contact lenses to prevent inadvertent eye infection and
- Patient should avoid scratching and shaving of rash covered skin to avoid spread of monkeypox virus.
For Further details Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings (2007) can be studied