COCA Now
October 18, 2022
Important Safety Information for Monkeypox Specimen Collection and Infection Control
The Centers for Disease Control and Prevention (CDC) continues to receive reports of unsafe specimen collection practices involving sharps (e.g. needles, scalpels). In the United States, at least three healthcare personnel have acquired monkeypox infection from sampling lesions while using a sharp instrument. It is not necessary or recommended to unroof, open, or aspirate monkeypox lesions with sharps to increase sample yield. Injuries sustained from sharps used during specimen collection pose a high risk of exposure, given the large amounts of infectious virus the lesions from monkeypox disease contain. Postexposure prophylaxis (PEP) should be offered when a healthcare worker is injured by contaminated sharps during specimen collection or another clinical activity (e.g., phlebotomy).

CDC recommends that healthcare providers adhere to all recommended infection prevention and control measures, including using proper personal protective equipment (PPE) to reduce the risk of monkeypox virus transmission in healthcare settings. This includes outpatient settings such as urgent care clinics, emergency departments, and clinics providing evaluation for sexually transmitted infections where monkeypox patients are frequently initially evaluated. 

Safe Specimen Collection
  • Train and educate healthcare personnel on safe methods for monkeypox specimen collection.
  • Practice methods to safely collect monkeypox specimens using swabs. 
  • Vigorously swab lesion specimens to maximize the probability of achieving accurate diagnostic results, safely.
  • Do not unroof or aspirate lesions using sharp instruments during monkeypox lesion specimen collection. It is dangerous and not necessary for diagnostic accuracy.
Healthcare Personnel Exposures
  • Know the signs and symptoms of monkeypox. 
  • Do not report to work if any signs or symptoms develop after exposure. 
  • Leave work if signs or symptoms develop while at work, and notify supervisor or other appropriate group (e.g., occupational health services) for further evaluation. 
  • Provide flexible, non-punitive sick leave policies at healthcare facilities to allow healthcare providers to take leave when needed. 
  • Support healthcare personnel's access to counseling and care in the event of a possible monkeypox exposure.
  • Quickly administer PEP for higher risk exposures (e.g., sharps injury while collecting a specimen or performing phlebotomy).
Infection Prevention and Control
  • Establish a process to screen patients for signs and symptoms of monkeypox at or before arrival so that they can be identified promptly. 
  • Dedicate adequate resources to support infection prevention practices, including access to all recommended PPE. 
  • Review infection prevention and control practices including carefully putting on and taking off PPE to ensure healthcare personnel are properly trained and provided the opportunity to ask questions and practice their technique. 
  • Evaluate cleaning and disinfection practices to ensure they are being completed effectively. Cleaning and disinfecting rooms and equipment between patients is important to prevent transmission to others.
Additional Resources
The Emergency Risk Communication Branch in the Division of Emergency Operations, Center for Preparedness and Response is responsible for the management of all COCA Products. 
 
For information about this update or other clinical issues, or to send your feedback, please contact us at coca@cdc.gov
Clinician Outreach and Communication Activity—resources for healthcare providers
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Crisis & Emergency Risk Communication Training—training program that draws from lessons learned during public health emergencies, and incorporates best practices from the fields of risk and crisis communication
Health Alert Network—CDC's primary method of sharing cleared information about urgent public health incidents with public information officers; federal, state, territorial, and local public health practitioners; clinicians; and public health laboratories

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