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Hot Topic: Mpox

Information for Congregate Living Settings

Steps to Help Reduce the Spread of Mpox in Congregate Living Settings

If mpox is introduced into a facility in which people live in close proximity, it could spread within the facility. Following prevention recommendations can help keep residents, staff, and volunteers healthy.

Visit the CDC website for the most up to date information regarding reducing mpox transmission in congregate living settings.

Recognize Symptoms of Mpox

Staff, volunteers, and residents should be aware of mpox symptoms. Mpox often causes a painful or itchy rash that can initially look like pimples or blisters but goes through several stages, including scabs, before healing. Some people also have flu-like symptoms before or after the rash appears.

Report Cases of Suspected Mpox to Public Health Authorities

Local public health authorities must be notified of all residents, staff, or volunteers who might have mpox. Public health officials can also provide guidance on cleaning and disinfecting, exposure and isolation, vaccination, and treatment options. If someone associated with your facility might have mpox, immediately contact the local public health authority for the county where the facility is located.

Understand How Mpox Spreads

Mpox can be spread from the time symptoms start until the rash has healed, all scabs have fallen off, and a new layer of skin has formed, which typically takes two to four weeks. Anyone can get mpox through close, personal, often skin-to-skin contact including:

  • During prolonged face-to-face or intimate physical contact with someone who has mpox.
  • Through direct contact with rash, scabs, or body fluids of someone who has mpox.
  • By touching items like clothing, towels, or bedsheets after being touched by rash or body fluids of someone who has mpox.
  • Through the placenta from a pregnant woman who has mpox to a fetus.
  • By being scratched or bitten by an infected animal or by preparing or eating meat or using products from an infected animal.

Communicate with Staff, Volunteers, and Residents

Provide clear information to staff, volunteers and residents about mpox prevention, including the potential for transmission through close, sustained physical contact, including sexual activity. Provide prevention guidance including considerations for safer sex. Keep messages fact-based to avoid introducing stigma when communicating about mpox.

Ensure Patients Receive Prompt Medical Care

Staff, volunteers, or residents who might have mpox should be seen by a healthcare provider and tested for mpox. People who have had a high degree of exposure to someone with mpox might benefit from vaccination. Contact the local health authority as soon as mpox is suspected to help ensure the best care possible is provided for the person who is sick and their close contacts.

Prevent Additional Exposures

Anyone who is identified to have mpox should isolate away from others until all scabs fall off and a fresh layer of healthy skin has formed. Staff or volunteers who have mpox should isolate at home until they are fully recovered. Flexible, non-punitive sick leave policies for staff members are critical to prevent spread of mpox.

Resident isolation spaces should have a door that can be closed and a dedicated bathroom that is not used by people who are not ill. Residents who test positive for mpox can stay in the same room. If residents with mpox need to leave the isolation area or if an isolation area is not available, they should wear a well-fitting disposable mask over their nose and mouth and cover any skin lesions with long pants, long sleeves, and gloves. Reduce the number of staff who enter the isolation areas to staff who are essential to isolation area operations.

Provide Adequate Personal Protective Equipment (PPE) and Training

  • Entering isolation areas — Staff who enter isolation areas should wear a gown, gloves, eye protection, and a National Institute for Occupational Safety and Health (NIOSH) approved particulate respirator equipped with N95 filters or higher. If the facility requires an employee to wear an N95 mask or a respirator, proper Occupational Safety and Health Administration (OSHA) respiratory guidelines must be followed including fit testing and a mandatory training program.
  • Laundry — Anyone handling soiled laundry from people with known or suspected mpox infection should wear a gown, gloves, eye protection, and a well-fitting mask or respirator. Soiled laundry should be gently and promptly contained in a laundry bag and never be shaken or handled in a manner that may disperse infectious material. Linens can be laundered using regular detergent and warm water. PPE is not necessary after the wash cycle is completed. Covering mattresses in isolation areas with sheets, blankets, or a plastic cover can facilitate easier laundering.
  • Cleaning and disinfection — Anyone cleaning areas where people with mpox spent time should wear a gown, gloves, eye protection or face shield, and a well-fitting mask or respirator.

Clean and Disinfect

In addition to frequent, routine cleaning of communal areas, areas where people with mpox spent time and items they touched while ill should be cleaned and disinfected. Avoid activities that could spread dried material from lesions, such as the use of fans, dry dusting, sweeping, or vacuuming. A disinfectant with an Emerging Viral Pathogens claim from the U.S. Environmental Protection Agency (EPA)’s List Q should be used in accordance with manufacturer directions.

Properly Dispose of Contaminated Waste

Manage waste from isolation areas (i.e., handling, storage, treatment, and disposal of soiled PPE, patient dressings, etc.) in accordance with U.S. Department of Transportation (DOT) Hazardous Materials Regulations (HMR; 49 CFR, Parts 171-180.). Waste from patients during the current outbreak is classified as regulated medical waste (Category B).  Visit the Environmental Compliance Assistance Platform to learn more about how to properly handle regulated medical waste in Nevada.

Additional Resources

Hotel/Motel Cleaning and Sanitizing Guidance