Monkey Pox Notice

Monkeypox Notice

BHHC LOSS CONTROL – MONKEY POX (MPX) INFORMATION, RESOURCES, AND ADVISORY SUGGESTIONS

Cal OSHA issued new guidance on September 13, 2022, regarding protecting workers from Monkeypox. Click here for the official CalOSHA monkey pox guidance details. To learn more, find additional BHHC resources on Monkeypox exposure control and the basics of Monkeypox.

 

Monkey Pox is a viral infection that is part of the zoonotic virus family. The virus was initially identified in 1958; thus, there is significant history associated with the virus. Additionally, while there is a readily available vaccine but at this time, only specific populations that meet certain established guidelines are being provided access to the vaccine.

The current situation in the United States regarding monkey pox involves identified outbreaks according to the CDC and other local (state and county) jurisdictions. As of the date of this resource, there are approximately 17,000 cases in the United States, with sporadic concentrations of cases in several states. These states include and have the highest case counts at this time:

  • California
  • New York
  • Texas
  • Florida
  • Illinois
  • Georgia

While these states have the highest case counts, the virus has been identified in all fifty (50) states.

Monkey Pox Symptoms

People with monkeypox get a rash that may be located on or near the genitals (penis, testicles, labia, and vagina) or anus (butthole) and could be on other areas like the hands, feet, chest, face, or mouth. Additional symptoms include:

  • Fever
  • Chills
  • Swollen lymph nodes
  • Exhaustion
  • Muscle aches and backache
  • Headache
  • Respiratory symptoms (sore throat, nasal congestion, cough, etc.)

Infected persons typically can experience some, if not all, of these symptoms. Additional information regarding Monkey Pox signs and symptoms can be found at the Centers for Disease Control (CDC) website.

California Specific Information

While most local health departments in California have seen a flattening of the rise in Monkey Pox (MPX) cases in the last several weeks, the California Occupational Safety and Health Administration (CAL-OSHA) recently enacted specific guidelines regarding employer responsibilities for providing a safe workplace regarding exposure to the Monkey Pox virus.

Monkey Pox is covered under the Aerosol Transmissible Disease (ATD) standard in 8CCR5199.

Basic requirements under this standard focus on the following:

Monkey Pox Transmission (MPX):

MPX spreads primarily by close or direct contact with infectious rashes, lesions, scabs, or body fluids. It can also spread through touching materials used by a person with MPX that haven’t been cleaned, such as clothing, towels, and bedding. The virus can become airborne during changing or handling of contaminated linen.

Public health recommendations to prevent the spread of MPX for employees entering into rooms in which persons with suspected or confirmed MPX are located or were recently located include:

  • Use of NIOSH-approved particulate respirators equipped with fit-tested N95 filters or higher
  • Eye protection (i.e., goggles or a face shield that covers the front and sides of the face)
  • Gowns and gloves.

 

In short, the ATD applies to a specific list of employers which are found in the information provided in the link above and has three (3) recognized employer types: referring, laboratory, and others) and regardless of the employer type, incident reporting and post-reporting procedures are similar and, at the time of this publication, require the following:

Implement written procedures for exposure incidents (also known as a “significant exposure”).

An exposure incident is when all of the following occurs:

  1. An employee has been exposed (i.e., has been in prolonged close contact) to a person with suspected or confirmed MPX; or in contact with a work area or to equipment that is reasonably expected to contain monkeypox. This includes contact with lesions, bodily fluids, or other materials, such as used linens, likely to contain virus particles;
  2. The exposure occurred without applicable exposure controls required by the ATD Standard, such as respiratory protection and PPE; and
  3. Transmission of disease is sufficiently likely to require medical evaluation.

Employers must do the following for workers who had a significant exposure to MPX9 :

  • Notify workers of the date, time, and nature of the exposure.
  • Provide a post-exposure medical evaluation by a physician or other licensed healthcare professional (PLHCP) knowledgeable about MPX, including appropriate vaccination, prophylaxis, and treatment.
  • Provide post-exposure prophylaxis (i.e., vaccination for MPX) as soon as possible; often done through the local health department.
  • Report the exposure to the local health officer.
  • Remove the employee from the workplace if the PHLCP or local health officer recommends precautionary removal. Maintain the employee’s pay, rights, benefits, etc., during precautionary removal. When an exposure does not meet the criteria for “significant” exposure, workers should still monitor themselves for symptoms for 21 days after exposure and report to their employer if they develop symptoms.

Also, please refer to your local health department, which may be county or city run. The listing of these LHDs in California can be found at the link:

Local Health Services/Offices

In addition to the information provided here, please feel free to contact BHHC Loss Control for additional guidance and recommendations to assist in addressing this exposure in the workplace should the need arise or for prevention suggestions.