Infection Control for New York Health Care Professional ‒ 2024 Update ________________________________
Evidence-Based Practice Mpox is an infectious disease caused by the monkeypox virus. It can spread from person to person and through contact with infected animals in enzootic areas. The clinical presentation is similar to that seen in the past with smallpox but less severe. In 2022 and 2023, a large global outbreak of mpox affected more than 110 countries, driven by human-to-human transmission through sexual contact. In just over a year, more than 90,000 cases and 150 deaths were reported to the World Health Organization (WHO). Person-to-person transmission of mpox can occur through direct contact with infectious skin or other lesions such as in the mouth or on genitals, or respiratory droplets or short-range aerosols from prolonged close contact. Mpox causes signs and symptoms that usually begin within a week but can start 1 to 21 days after exposure. Symptoms typically last 2 to 4 weeks but may last longer in someone with a weakened immune system. Common symptoms of mpox are rash, fever, sore throat, headache, muscle aches, back pain, low energy, and swollen lymph nodes. Several antivirals, such as tecovirimat, originally developed to treat smallpox have been used to treat mpox. Further studies are underway. Source: [26]
II. Management strategies for potentially communicable conditions . A. Appropriate evaluation and treatment; B. Limiting contact with susceptible; C. Furlough until noninfectious. III. Specific occupational health strategies for prevention and
The NYSDOH requires the same immunizations as recom- mended by the CDC [1]. Tuberculosis Screening and Control The CDC issued updated guidelines for preventing trans- mission of Mycobacterium tuberculosis in healthcare settings including [27]: • Baseline TB screening and testing. • Postexposure screening and testing. • Serial screening and testing for health care personnel without latent TB infection (LTBI). • Evaluation and treatment of health care personnel with positive test results . A TB infection-control program in a healthcare setting should be based on a three-level hierarchy of control measures and include the following: 1. Administrative controls. 2. Environmental controls. 3. Use of respiratory protective equipment. Maintenance of Records, Data Management, and Confidentiality Maintaining records of work-related medical evaluations, screening tests, immunizations, exposures, and postexposure management can monitor the health status of healthcare workers. Such records must be kept in accordance with all applicable state and federal laws. Examples of laws that might apply include the Privacy Rule of the Health Insurance Porta- bility and Accountability Act (HIPAA) of 1996, 45 CFR 160, 162, and 164, and the Department of Labor rule expanding submission requirements for injury, illness data provided by employers in high-hazard industries final rule which takes effect on January 1, 2024 [28; 29]. Healthcare settings qualify as high-hazard settings.
control of bloodborne pathogen transmission. A. Healthcare worker exposure risk education: 1. Potential agents (HBV, HCV, HIV) 2. Prevention strategies
a. HBV vaccination (including safety, efficacy, components, and recommendations for use) b. Hand hygiene c. PPE and barrier precautions; d. Sharps safety e. Standard and Universal Precautions.
IV. Post-exposure evaluation and management. A. Bloodborne pathogens:
1. Prompt evaluation by licensed medical profes- sional; 2. Risk assessment in occupational exposures; 3. Recommendations for approaching source patient and healthcare Worker. Immunization and Screening Programs According to the CDC, healthcare workers are at risk to acquire and spread vaccine-preventable illnesses, including hepatitis B, influenza, measles, mumps, rubella (MMR), varicella, teta- nus, diphtheria, pertussis (Tdap), and meningococcal disease. Updated recommendations for meningococcal and mpox vac- cination were approved at the October 25–26, 2023, Advisory Committee on Immunization Practices (ACIP) meeting and will be published in the CDC’s print and digital resources in the coming months [25].
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