Monkeypox Flashcards
What is Monkeypox?
Rare disease caused by the Monkeypox virus
Orthopoxvirus
First human case?
1970 in DRC
How is Monkeypox spread?
- Close/Direct contact with:
lesions, bodily fluids, or resp secretions - Spread from an infected animal or animal products
- Vertical transmission from mother to fetus
T/F: Monkeypox can be spread by OBJECTS that have had contact with lesion crusts or body fluids-current outbreak
TRUEE
How to clasify the sx?
Similar to but milder than symptoms of smallpox
Monkeypox Sx being with:
Fever Headache Muscle aches Backache Lymphadenopathy Chills Exhaustion
How to distinguish Monkeypox from Smallpox?
LAD
What sx develop w/in 1-3 days after appearance of fever?
Rash
Lesions progress through the following stages over 2-3 weeks:
Enanthem Macules Papules Vesicles Pustules Scabs "Ew, Monkey pox, very pus-y & scary"
Can the lesions be umbilicated?
yes
DDx:
- Molluscum contagiosum
- Syphilis
- VZV
- Smallpox
- Chickenpox
T/F: Smallpox is an agent of bioterrorism
True
Chickenpox
- Starts inward and grows out.
- Body wide
Smallpox
- Papule to pustule to vesicle
- Can be umbilicated
- No LAD
T/F: hard to determine clinical diff b/w monkeypox & smallpox?
True
Has smallpox been erradicated?
Yes
Key Characteristics of ID Monkeypox
Lesions are:
- Lesions well circumscribed, deep seated, and often umbilicated
- Lesions are relatively the same size and stage on a single body site
- Lesions on palms and soles
- Lesions are painful until crust appears when they become itchy
Key Characteristics of ID Monkeypox
___ prior to ____
Fever prior to rash
Key Characteristics of ID Monkeypox
Disseminated rash is ______
Disseminated rash is centrifugal (more lesions on face and extremities)
Key Characteristics of ID Monkeypox
Differentiator from Smallpox
Lymphadenopathy
Incubation of Monkeypox
Sx?
Contagious?
average 7-14 days, Range 5-21 days
Asymptomatic during this time
Not contagious
Enanthem vs Exanthem
Exanthem: “breaking out,”
used to describe cutaneous eruptions that arise abruptly and on several skin surfaces at once.
Enanthem: refers to mucous membrane (tongue & mouth) involvement
Prodrome phase
Characterized by:
time?
Contagious?
Prodrome of fever after the incubation phase
1-3 days
contagious
Onset of the rash phase
Characterized by
Time?
Contagious?
Enanthem (mouth & tongue) then macules then papules then vesicles then pustule then scab
Lasts 2-3 weeks
Contagious until all scab have fallen off AND a fresh layer of intact skin has formed underneath
Unroofing a lesion: how is transmission spread?
- Respiratory spread
- By scab
Testing
PCR test of lesion material available through State Health Department/CDC
When is pt no loger contagious?
when scab falls off and new layer of skin grown
T/F: Monkeypox can cause hemorrhagic PNA
True
Severe dizeases caused by Monkeypox that need hospitalization?
confluent lesions, sepsis, encephalitis,
Pt education
Isolation at home is necessary until case is confirmed
If case confirmed, isolate until no longer contagious ie scabs fall off
T/F: Most cases are relatively mild and self limiting
True
Pts at high risk for severe dz?
- Immunocompromise (HIV/AIDS, leukemia, lymphoma, generalized malignancy, solid organ transplant, tx w/ alkylating agents, antimetabolites, radiation, TNF inhibitors, high-dose corticosteroids, hematopoietic stem cell transplant <24mo)
- Patients <8yo
- Pregnant or breastfeeding
- AD
- Pt w/ eczema, burns, impetigo, VZV, infection,HSV, severe acne, severe diaper dermatitis with extensive areas of denuded skin, psoriasis, or Darier disease [keratosis follicularis])
- Pts w/ secondary bacterial skin infection; gastroenteritis with severe N/V/D or dehydration; bronchopneumonia; concurrent disease or other comorbidities
Is there a Monkeypox specific treatment? What drug class can we use?
No specific treatment
BUT antivirals developed for smallpox may be beneficial:
Tecovirimat
Cidofovir (FDA approved for CMV)
Vaccinia Immune Globulin
Prophylaxis recommendations:
- Avoid skin to skin close contact if lesions present
- If respiratory symptoms present, those in contact should mask (N95)
- Avoid contact with objects that may have come into contact with monkeypox
contact with objects that may have come into contact with monkeypox
Bedding/linens
Towels
Sex gear and toys
Monkeypox PEP
Jynneos vaccine
Is Jynneos vaccine available in colorado?
Yes
Is monkeypox an extremely contagious dz?
Yes
Shoudl we wear an N95 for Monkeypox?
yes
Who should get Monkeypox PEP?
Close contacts
after consultation with the State Health Dept
Progression of Monkey Pox lesions
Enanthem, Macule Papule Vesicle Pustule Scab Marissa- "Ew, Moneky Pox, Very Pus-y & Scary"
Rash/Scab is ____ then ______.
Painful
itchy
