Monkey Pox: What We Know So Far and Ways to Prevent Transmission

In the recent news, there have been talks about the monkeypox cases in Europe and now the United States. President Biden called it something “to be concerned about” and is being very closely monitored here and internationally. Monkeypox was first identified in 1970 in the Democratic Republic of the Congo and has since expanded over the last 10 years to many other African nations. Despite the name, monkeys, like humans, are accidental hosts. The wild animal reservoir remains unknown.

Here is some current information on the situation and monkeypox in general.

From the CDC About Monkeypox | Monkeypox | Poxvirus | CDC as of today:

  • A patient was confirmed in Massachusetts to be infected with a West African strain after returning to the US from Canada, they are currently being isolated and poses no risk to the public. See 2022 United States Monkeypox Case | Monkeypox | Poxvirus | CDC for more information.
  • Monkeypox is a rare viral disease. The virus belongs to the same family and genus as variola virus (causing smallpox), vaccinia virus (used in the smallpox vaccine), and cowpox. The rash is indistinguishable from smallpox.
  • CDC is also tracking multiple clusters of monkeypox cases reported in several countries that don’t normally report monkeypox, including in Europe and North America.
  • The rash associated with monkeypox involves vesicles or pustules that are deep-seated, firm or hard, well-circumscribed, and grow synchronously (all lesions at the same stage as the disease progresses, as opposed to chickenpox); the lesions may umbilicate or become confluent and progress over time to scabs.
  • Presenting symptoms typically include fever, chills, a distinctive rash, or new lymphadenopathy (swollen lymph nodes).
  • The rash associated with monkeypox can be confused with other diseases that are encountered in clinical practice (e.g., secondary syphilis, herpes, chancroid, and varicella-zoster).
  • The illness typically lasts for 2−4 weeks. Although rare, in Africa, monkeypox has been shown to cause death in as many as 1 in 10 persons who contract the disease.
  • Based on the limited information available at this time, the risk to the public appears low.

Transmission

  • Transmission of monkeypox virus occurs when a person comes into contact with the virus from an animal, human, or materials contaminated with the virus. The virus enters the body through broken skin (even if not visible), respiratory tract, or mucous membranes (eyes, nose, or mouth).
  • Human-to-human transmission is thought to occur primarily through large respiratory droplets. Respiratory droplets generally cannot travel more than a few feet, so prolonged face-to-face contact is required.
  • Other human-to-human methods of transmission include direct contact with body fluids or lesion material, and indirect contact with lesion material, such as through contaminated clothing or linens.
  • The secondary attack rate is estimated 10% in contacts unvaccinated against smallpox.

Prevention

  • The vaccine JYNNEOSTM (also known as Imvamune or Imvanex) has been approved by the U.S. Food and Drug Administration for the prevention of monkeypox. The Advisory Committee on Immunization Practices (ACIP) is currently evaluating JYNNEOSTM for the protection of people at risk of occupational exposure to other orthopoxviruses such as smallpox and monkeypox in a pre-event setting.
  • Smallpox (vaccinia) and monkeypox vaccines are effective at protecting people against monkeypox when given before exposure to monkeypox. Experts also believe that vaccination after a monkeypox exposure may help prevent the disease or make it less severe. In addition to smallpox vaccine, vaccinia immune globulin and some limited use medications are available for monkeypox outbreak control.
  • Routine vaccination of the American public against smallpox stopped in 1972 after the disease was eradicated in the United States and is no longer available to the public. Those of us that are old enough have a faded but unique vaccination scar on their left upper arm.

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About the Author

Dr. Joe Mignogna is Acuity’s Chief Medical Officer.  Connect with him at jmignogna@acuityinternational.com

Dr. Joe Mignogna, MD, MPH, CIME, FACOEM, Chief Medical Officer

Acuity Spotlight: Kevin Jackson-Beleski, The United States Air Force

The Acuity Spotlight is our way of highlighting some of the incredibly talented individuals that we’re lucky enough to have on our team. At Acuity, we value diversity and inclusion and focus our attention on bringing candidates who have a wide range of backgrounds and experiences onboard. Our mission is to build enduring relationships that provide secure, stable, and long-term predictable outcomes and we are grateful for the men and women of Acuity who embody our corporate values in everything they do.

Which branch of the military did you serve in?
I served in The US Army

What are some of the things you remember about adapting to military life?
The hardest part of adapting to the Army was learning to cope with the strict regimen. It truly felt like I was starting a new life after graduating from high school. Eight months later I was deployed to Iraq in support of the US mission set. I learned to adapt over time, but it was a definite change.

When did you leave the military? What were your first few months out of the service like?
I got out of the military in June of 2016. The first month was slow; I took time to readjust myself. I took the time to develop a plan and establish priorities for what I wanted to do with my life. I ended up finding the perfect balance of traveling, using my military experience, and being financially stable through the contracting world.

How would you describe the work you do at Acuity and the impact it is making?
I think the work I do at Acuity benefits the relations between Iraq and the United States as well as helps facilitate the demise of terrorist organizations that both countries suffer the effects of.

What is your proudest career moment?
My proudest career moment I would have to say is being afforded the opportunity to progress from one department to another and further use my previous career’s tools and knowledge. The skillsets and knowledge I learned from The US Army were ideal for my transition to the contracting world.


About the Author


Kevin Jackson-Beleski, Balad Air Base Life Support/Security Services Project, Security Directorate, Quick Reaction Force (QRF) Team Member, The United States Air Force

Acuity Spotlight: Christopher Hendricks, The United States Air Force

The Acuity Spotlight is our way of highlighting some of the incredibly talented individuals that we’re lucky enough to have on our team. At Acuity, we value diversity and inclusion and focus our attention on bringing candidates who have a wide range of backgrounds and experiences onboard. Our mission is to build enduring relationships that provide secure, stable, and long-term predictable outcomes and we are grateful for the men and women of Acuity who embody our corporate values in everything they do.

Which branch of the military did you serve in?
I served 20 years in The United States Air Force as a member of their security forces.

What are some of the things you remember about adapting to military life?
The whole process of transitioning from being a civilian to becoming a military member was challenging. Going through basic training and tech school (which included having a very strict daily agenda) to getting my first duty station and adapting to being in another country while performing my duties as a US Air Force airman was an adjustment.

When did you leave the military? What were your first few months out of the service like?
I retired from The United States Air Force in 2014.  My first few months out of the service were “odd” to say the least.  Being able to plan and schedule things and no longer having to follow a set schedule established around mission requirements allowed me to decompress from the military life. At first, it proved to be a hard adjustment, even though I found the change both therapeutic and refreshing. I took the time to travel domestically visiting family, and friends and exploring different locations that I didn’t get to visit while I was in the military.

How would you describe the work you do at Acuity and the impact it is making?
The work that I do at Acuity has been phenomenal and it’s something related to what I did in The United States Air Force as a Security Forces member. I’d like to thank Acuity for providing me with my first job as a civilian after serving in The United States Air Force.  Always and forever grateful.

What is your proudest career moment?
My proudest career moment was being part of the Phoenix Raven Program as a team member and then as a team leader. Getting selected as the Phoenix Raven Team Leader of the Year at a US Air Force headquarters was amazing and completed unexpected.

Being able to fly on different aircraft to different locations all over the world providing security support was incredible and something that I put my heart and soul into. I will always be thankful, grateful, and blessed to have been given the opportunity to be a part of, and experience, something of that magnitude.  My dream was to see the world and meet people from all walks of life; The United States Air Force was able to make that dream and vision a reality. I feel such a sense of accomplishment because of my experience, and I’d like to thank The United States Air Force for helping me become the person that I am today.

 



Christopher Hendricks, Balad Air Base Life Support/Security Services Project, Security Directorate, Flight Line Security Chief, The United States Air Force

Wellness Programs: Using Healthcare Analytics to Support Employee Health

Most well-designed corporate wellness programs are successful, but we’ve all seen well-intended short-lived efforts come and go over the years. The challenge is defining “well-designed” and “successful.” This third edition will focus on practical considerations for using employee healthcare analytics in your business setting to support employee health and wellness. But first, a brief background on employer-based wellness programs.

A thriving “culture of health” at any organization relies on many factors, from leadership support at all levels to shared corporate values, to formal and informal systems reinforcing healthy behaviors, to accurate, reliable, and reproducible tools to measure all aspects of the culture of health.

It’s been well-documented that custom-designed wellness products can support corporate performance, both in dollars and human capital. Examples of highly developed wellness models include the ACOEM Corporate Health Achievement Award or CHAA, HERO Employee Health and Well-Being Best Practices Scorecard, Health Risk Assessments, The Health Project C. Everett Koop National Health Awards, and health & wellness “contracts” using The Transtheoretical Model (Stages of Change) model.

Studies have shown a link between stock market price growth, financial performance, and having a great employee health program (CHAA, Koop Award). Employers attesting to comprehensive wellness programs outperformed the S&P index at rates ranging from 7-16 percentage points per year, representing a nearly doubling or tripling of earnings.

  • Stock performance is tied to companies with high ratings for corporate social responsibility, employee job satisfaction, spending on human resources and acknowledged as a best place to work
  • Stock values for a portfolio of companies that received high corporate health & wellness scores appreciated by 235% compared to the S&P Index of 159% over a six-year period
  • Investing in funds to develop a great wellness program will not make stock prices go down
  • Great wellness programs may be reliable indicators of future stock performance
  • Investing in funds to create a great wellness program will not make stock prices go down
  • Great wellness programs may be reliable indicators of future stock performance
  • A 2018 UK study by Glassdoor of over 35,000 reviews across 164 employers found those with more satisfied employees returned ~16% more than those with less satisfied employees
  • Koop Award companies outperformed the S&P Index over a 14-year period (2000-2014)

It’s also important to understand the practical concepts regarding CDC: Clinical Prevention Models. Most corporate wellness programs focus on primary and secondary prevention.

  • Primary prevention aims to prevent disease or injury before it ever occurs.
  • Secondary prevention focuses on early diagnosis to prompt timely interventions to prevent or minimize morbidity, reduced productivity and additional costs.
  • Tertiary prevention addresses effective interventions and employee disposition once disease or impairment is evident.

Most cookie-cutter wellness programs, despite great intentions, are often doomed to failure. You can create customized, focused programs that “learn” as they grow using well-designed analytics tools to harness your unique populations’ health data. Tap into those databases we discussed in an earlier blog, such as indemnity and workers’ compensation claims, demographics, HRAs and employee surveys to customize your wellness programs for maximal impacts on your bottom line and employee health, well-being, retention and productivity.

Stay tuned for further predictive healthcare analytics blogs covering a variety of other common and important business topics.

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About the Author:

Dr. Joe Mignogna is Acuity’s Chief Medical Officer.  Connect with him at jmignogna@acuityinternational.com

Dr. Joe Mignogna, MD, MPH, CIME, FACOEM, Chief Medical Officer

Acuity Spotlight: Jacqueline Rodriguez Valdes, Chief Nursing Officer

The Acuity Spotlight is our way of highlighting some of the incredibly talented individuals that we’re lucky enough to have on our team. At Acuity, we value diversity and inclusion and focus our attention on bringing candidates who have a wide range of backgrounds and experiences onboard. Our mission is to build enduring relationships that provide secure, stable, and long-term predictable outcomes and we are grateful for the men and women of Acuity who embody our corporate values in everything they do.

When and why did you decide to become a nurse? What do you like most about being a nurse?

When I was fifteen, I realized the desire to provide care for others was innate. Caring for others is a passion and my driving force for choosing the nursing profession. Being there for my patients at their most vulnerable times and advocating for their well-being was all I wanted to do at an early age.

When I provide bedside care for patients and their loved ones, I take on the role of a family member, always upholding their best interests at the forefront. My aunt encouraged me to become a nurse leader to serve and motivate nurses who in turn will share in this altruistic vision. As a nurse leader, I have the privilege to mentor, motivate, and foster innovation and passion amongst our nursing team.

Can you describe a situation where you felt proud of your healthcare team?

In April 2020, we created a field hospital in New York City during the worst COVID-19 wave in the United States at the time. Nurses from all over the country came to the emergent call for help. This selfless team left their loved ones and the comfort of their homes to serve these critical patients by quickly making the altruistic decision to get on a plane and travel to the unknown that was waiting on the other side. This brave team arrived in New York with a variety of nursing backgrounds, training, and experience focused on one mission, to save lives. It was astonishing to see how this team of professionals melded to form a unified medical unit to provide compassionate nursing care during this most challenging, testing time.

How would you describe the work you do at Acuity and the impact it is making?

I have worked in this organization for five years and during this time we have provided high-quality nursing excellence in a variety of clinical environments. The nursing team champions lead the execution of medical programs such as shelter services, COVID-19 field hospitals, COVID-19 testing centers, emergency response support following natural disasters, mobile medical units, medical reviews, and performing occupational health exams in austere environments. The care provided by our nursing professionals cultivates evidence-based practices, and holistic and compassionate care, which is essential for providing clinical excellence for our examinees and patients.

 



Jacqueline Rodriguez Valdes, MSN, ARNP, FNP-BC, COHC, is the Chief Nursing Officer. You can connect with her at jrodriguezv@acuityinternational.com.