Table 1.
Demographic and clinical characteristics, course of disease and treatment provided in published cases of occupational MPOX virus infections during the current outbreak.
| Location and timing | Mode of exposure | Clinical symptoms | PCR Swabs | MPOX related treatment and vaccination | Use of PPE | |
|---|---|---|---|---|---|---|
| Carvalho et al., Emerg Infect Dis, 2022 | Brazil July 2022 | Needlestick injury (finger). while gathering materials to discard in a sharps container when a needle perforated the glove | - Inoculation site after 5 d (nodule turned to vesicle) - Spread of lesions (hands, thigh, face). Total 7 lesions. Preceded generalized symptoms of fever and lymphadenopathy |
Positive from the lesion Positive from OPX. | None | Wearing personal protective equipment, including gown, gloves, goggles, and mask. |
| Caldas JP et al., Emerg Infect Dis, 2022 | Portugal July 2022 | Needlestick injury (finger). There was no wound or bleeding. | - Inoculation site after 4 d(vesicle) | Positive from the lesion. Negative from OPX. | Since no signs appeared after the injury, at first the incident was not reported as an occupational exposure and was not considered for postexposure prophylaxis treatment. | Wearing the recommended personal protective equipment; the gloves appeared intact. |
| Mendoza et al., Emerg Infect Dis, 2022 | Florida July 2022 | Needlestick injury (finger), while recapping the used needle after using it to create an opening in the vesicular lesion to facilitate direct contact of the swab with fluid in the lesion. | - Inoculation site after 10 d. - No additional lesions or other clinical signs or symptoms were reported |
Positive from the lesion. | 15 h after exposure first dose of a 2-dose JYNNEOS vaccination series was given for postexposure prophylaxis. | Not mentioned |
| Salvato et al., Emerg Infect Dis, 2022 | Brazil July 2022 | Suspected to be transmitted through fomite exposure with surfaces in the patient's home, own PPE, or outer surfaces of the specimen transport box. | HCP 1: - after 5 d - single lesion on finger. - systemic symptoms (lymphangitis in her left upper arm and worsened hyperemia). - Another local lesion. HCP 2: - after 5 d – single lesion on the forearm. - Systemic symptoms (fever and lymphadenopathy) - Spread of lesions (face). |
Positive from the lesion. Selected samples from the patient and HCP-1 for whole-genome sequencing analysis which showed that the sequenced genomes were 100% identical. | none | HCPs wore PPE, including safety glasses, disposable isolation gowns, and N95 respiratory masks – during the sample collections. However, during the interview with the patient – did not wear gloves. |
| Le Pluart et al, Open Forum Infect Dis, 2022 | France July 2022 | Needlestick injury (Right thumb) during swab collection by medical resident. | - Inoculation site after 4 d – 1 single lesion (vesicle). - No systemic symptoms. |
Positive from the lesion. Negative from OPX. | Within 3 h after exposure - received a dose of third-generation smallpox vaccine (Imvanex) for postexposure prophylaxis. The HCP's flat mates were also vaccinated. | Wearing appropriate PPE consisting of disposable gown, disposable gloves, FFP2 mask, and goggles. |
| Alarcón et al., Emerging infectious diseases, 2022 | USA August 2022 | Inadvertent contamination during specimen collection, contact with contaminated environmental surfaces or unrecognized skin contamination during glove doffing. | - Short prodrome of myalgia, fatigue, and mild headache. - Small, raised skin lesion on her left middle finger progressed to a blister with umbilication. - Systemic symptoms (fever, cough, sore throat) - Spread of lesions throughout her body (10 lesions). |
Positive from the lesion. | 2 wk course of oral tecovirimat. (It should be noted HCP's medical history significant for rheumatoid arthritis - treated with etanercept (Anti-TNF). | Wearing full PPE (N95 respirator, gown, and eye protection) when examining suspected patients and swabbing lesions. However, in 2 cases the HCP did not wear full PPE at first, and only when patient's symptoms raised her suspicion, changed to full PPE before swabbing the lesions. |
| Our case | Israel July 2022 | Contact with infected fomites in the patient's vicinity, or minor and unnoticed trauma penetrating both glove and skin during specimen collection. | - After 4 d – 1 vesicle (index finger left hand). - Systemic symptoms (weakness and ascending lymphangitis in left arm) - Spread of lesions (back and toe). |
Positive from the lesion. Negative from OPX. Whole genome sequencing were analyzed, comparing the mpox positive patients along with the sample from the affected physician identifying the most likely source of disease transmission. | On day 13, family members were vaccinated with third-generation smallpox vaccine (JYNNEOS) | Wearing appropriate PPE consisting of disposable gown, gloves, N-95 mask, and glasses. |
PCR, polymerase chain reaction; PPE, personal protective equipment; USA, United States of America; OPX, oropharynx; HCP, health care personnel; TNF, tumor necrosis factor; d, days; h, hours; wk, weeks.