CDC/AAMC Resource Guide on Monkeypox
The Centers for Disease Control and Prevention (CDC) and the Association of American Medical Colleges (AAMC) have asked for our assistance in sharing this guidance with all physicians and physician assistants licensed in Alabama. The guidance includes the latest information and resources to plan and prepare for monkeypox virus outbreaks.
As of June 10, health officials have confirmed 49 cases of monkeypox in 16 states and DC. The CDC and AAMC have asked us to share this guidance with our licensees to provide you with updated facts and case counts, to provide resources that can be shared with your patients, and to help assist you with the clinical assessment of a patient with suspected monkeypox.
CDC/AAMC Resource Guide on Monkeypox
Monday, June 13, 2022
You have heard from your public health departments about the monkeypox virus outbreak in the United States. To help inform practicing physicians, the Centers for Disease Control and Prevention (CDC) and the Association of American Medical Colleges (AAMC) have compiled the latest information and resources to plan and prepare for monkeypox.
The CDC has been working closely with international and state health partners to respond to global outbreaks of monkeypox. As of June 10, 2022, more than 1,400 cases of confirmed and suspected monkeypox had been reported in 33 countries. In the United States, as of June 10, 2022, health officials have confirmed 49 cases in 16 states and the District of Columbia.
Currently, the West African variant of monkeypox has been found in the U.S. According to the CDC, physicians and healthcare providers should know the following for a clinical assessment of a patient suspected of having monkeypox:
- Symptoms: Historically, people with monkeypox report flu-like symptoms – such as a fever, body aches, and swollen lymph nodes – before a characteristic rash appears on the body, often on the face, arms, and hands. During the current outbreak, some patients have developed a rash around the genitals or anus before any other symptoms, and some have not developed flu-like symptoms at all. The rash may resemble a rash found with herpes simplex, varicella/shingles, or syphilis. (For more details: Symptoms)
- Diagnosis: The orthopox PCR test is the accurate diagnostic tool performed within a laboratory in order to accurately detect the virus. Currently, labs that are part of the national Laboratory Response Network are performing an orthopoxvirus PCR test that was cleared by the Food and Drug Administration. CDC labs can further characterize the strain of monkeypox with a specific viral test and genome sequencing. An orthopox positive test alone is sufficient for full public health action.
- Specimen Collection: Use sterile dry polyester, nylon, or Dacron swabs. Do not use cotton swabs. Swab or brush lesion vigorously with two separate sterile dry swabs. If possible, swab two different lesions. If the specimen is not sent to a lab within your immediate proximity, the sample should be frozen. (For more details: Samples)
- Isolation: Isolate patients suspected of having monkeypox. Keep patients’ doors closed. Make sure personnel wear appropriate PPE.
- Positive Test Results: If a test is positive, work with your public health department. A positive orthopoxvirus test is enough to take the actions necessary to care for the patient and help prevent additional spread – the same actions they would take for a positive monkeypox test result.
- Health authorities can isolate the patient, start treatment if needed, begin contact tracing, and offer post-exposure vaccination to contacts while confirmatory tests for monkeypox are under way.
- Treatment Protocol: Consult the CDC interim treatment guidance for monkeypox for clinical guidance and available medical countermeasures. Although there is not a specific treatment for monkeypox at this time, outbreaks can be mitigated.
Information for Patients:
Johns Hopkins University Bloomberg School of Public Health, an AAMC member institution, has published What You Need To Know About Monkeypox, which you may want to share with patients.
The following resources will help you stay up to date.
- Case Counts and Map: U.S. Monkeypox 2022: Situation Summary
- Resource Guide: Signs and Symptoms
- Frequently Asked Questions: Clinician FAQs contains information about how to identify symptoms and counsel patients.
- Clinician Outreach and Communication Activity (COCA) Stakeholder Call: May 24, 2022: What Clinicians Need to Know about Monkeypox in the United States and Other Countries.
- During COCA calls/webinars, subject matter experts present key emergency preparedness and response topics, followed by meaningful Q&A sessions with participants. Each COCA call/webinar will offer the most up to date information and guidance for clinicians on emerging health threats and public health emergencies. For more information, join the COCA email list.
AAMC and Member Institutions:
- CDC/AAMC Clinician Checklist
- Johns Hopkins University Bloomberg School of Public Health: What You Need to Know About Monkeypox
- Johns Hopkins Center for Health Security: Monkeypox Alerts and Updates
- National Emergency Special Pathogens Training and Education Center: Resource Library
- World Health Organization: Monkeypox: Key Facts
- JAMA: What You Need to Know About Monkeypox
Rochelle P. Walensky, MD, MPH
David J. Skorton, MD
President and CEO, AAMC