Yale New Haven Health has developed two Care Signature pathways for diagnosing and managing patients with monkeypox, based on its success in creating and using standardized clinical pathways during COVID-19.
The new Care Signature pathways include standardized processes for diagnosing and treating patients with suspected or confirmed monkeypox in both the outpatient and Emergency Department settings, supporting prompt and consistent care across YNHHS.
“For monkeypox, and future infectious disease outbreaks, we are leveraging our Care Signature approach to ensure that all clinicians have immediate, efficient access to the most up-to-date recommendations, which continue to evolve rapidly,” said Deborah Rhodes, MD, YNHHS vice president, Care Signature. “The pathways will ensure that we are safely and effectively managing patients with suspected or confirmed monkeypox, and that clinicians and other staff members are well supported.”
See excerpts from YNHHS’ frequently asked questions about monkeypox below. For more information, clinicians may refer to the Care Signature pathways, available in Epic and via the “Resources” tab on the Employee intranet, and the YNHHS High Impact Pathogen Plan on the Emergency Management SharePoint site. Additional information on monkeypox is available on the federal Centers for Disease Control and Prevention.
What is monkeypox?
A viral illness characterized by fever, headache, muscle aches and backache, lymph node swelling, chills, exhaustion and a rash that can look like pimples or blisters that appears in the mouth and other body parts, such as the hands, feet, chest, genitals or anus. While the monkeypox virus is related to the smallpox virus, it is a far less-dangerous disease than smallpox.
How widespread is the current monkeypox outbreak?
Most of the more than 2,000 cases documented have occurred in Europe. Monkeypox cases in the U.S have been seen mostly among travelers returning from countries with known outbreaks.
How does monkeypox spread?
The virus can spread when people are in close contact with one another for prolonged periods, or when there is direct skin contact with monkeypox skin lesions. Fortunately, monkeypox has not been shown to spread through the air over longer distances.
If I am involved in caring for a suspected or confirmed monkeypox patient, how should I protect myself?
Healthcare staff should wear gloves, a disposable gown, eye protection and a fit-tested respirator.
Do I need to monitor myself for symptoms if I am caring for a patient with monkeypox?
Yes. Watch for fever or chills, lymph node swelling and/or skin rash. You may continue to work, unless you develop symptoms. If you do, stay home and call Occupational Health at the Employee Resource Center (1-844-543-2147, select option 2, then press 2 to speak to an occupational telehealth nurse).
Is there a monkeypox vaccine?
The CDC does not currently recommend vaccination for people providing routine care for monkeypox patients. However, a recently developed smallpox vaccine (JYNNEOS) can be made available if a significant, unprotected exposure occurs.
How is monkeypox treated?
Fortunately, most people will recover on their own in two to four weeks. However, some people, including children, pregnant women and people with suppressed or weakened immune systems, may be at higher risk of severe illness. Currently there are no specific medications or therapies approved for monkeypox treatment. If you have questions about treatment, consult an Infectious Disease specialist.
