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Published 25 May 2022
Monkeypox is a virus which is endemic in Central and West Africa but there have been increasing numbers of cases reported, with potential community infection, in the rest of the world including the UK. There are 2 variants of the virus (1) Central African and (2) West African.
The usual incubation period of Monkeypox is 6 to 13 days but can range from 5 to 21 days and symptoms include:
Swollen lymph nodes
Skin rash predominately to the face (95% of cases) and hands and feet (75% of cases), mouth (70% of cases) and genitalia (30% of cases)
Monkeypox is self-limiting and symptoms will resolve within 2 to 4 weeks.
The primary route of infection where the virus is endemic is animal to human following contact with infected animals.
Where the virus is not endemic human-to-human infection can occur as a result of
Most adults who are infected suffer relatively mild symptoms. However more severe disease can be found in young children or those with suppressed immune systems.
The swelling of the lymph nodes is a distinctive feature of Monkeypox when compared to other rash illnesses such as chickenpox, measles or scabies and will form part of the clinical diagnosis of the virus. PCR tests are available to confirm the infection.
The number of cases reported in the UK and indeed globally remain low but the evidence of community infection in non-endemic areas are a concern. Given the routes of transmission those likely to be at risk of infection are
As stated above the number of infections is low at present and the risk is relatively small. However, employers and service provides should ensure that the infection control policies are reviewed and updated to consider the potential risk of Monkeypox. Control measures may include:
Many of the control measures which may have been considered for reducing the risk of COVID-19 infections may be appropriate to mitigate the risks of Monkeypox although no analogy is drawn between the 2 conditions save for that.
The UK Government has provided guidance in relation to environmental cleaning and contamination and primary patient care
The UK Health Security Agency (UKHSA) are to advise those who have been diagnosed or those who have had direct contact with an infected person to self-isolate for 21 days and provide their details for contact tracing.
The usual suite of EL Regulations would apply:
COSHH may apply on the basis that Monkeypox is a “substance hazardous to health” being a “biological agent” i.e. a “micro-organism…which may cause infection, allergy, toxicity or otherwise create a hazard to human health” (Reg. 2(1))
Reg. 6 prohibits work which may expose employees to a substance hazardous to health unless control measures are in place. There is an argument that the “work” referred to in COSHH should be confined to the definition of a task or operation or whether it could be interpreted as the wider definition of any task completed by the employee during the course of his/her employment i.e. the work must involve known and direct contact with the virus.
Subject to the availability of PCR testing diagnosis is likely to be made on a clinical basis. Given the low incidence levels of the virus causation is not likely to be an significant issue. However, consideration will be required as to alternative sources of exposure. The usual ‘but for’ test would apply.
Overall the risks of claims, EL or PL, are low but employers and service providers in at risk industries ought to ensure that their risk assessments and infection control policies have been reviewed (not necessarily updated) to ensure that the potential risk is being managed effectively. As with all emerging risks the risk assessments and policies should be regularly updated if and when new evidence emerges.
For more information or advice, please contact one of our experts in our Disease Team.
+44 (0)117 918 2122
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