MPOX VIRUS: Infection Prevention and Control (IPC) in Healthcare and Community Settings in Cameroon.
- Nkengacha Marcellous Agendia
- Aug 18, 2024
- 5 min read
Infection Prevention and Control (IPC) is a scientific approach aimed at preventing harm caused by infections to patients and healthcare personnel (WHO, 2020). The primary objective of IPC is to minimize the risks of infection transmission, particularly within healthcare facilities (HCFs) and the community.
What is Mpox Virus?
Mpox, formerly known as Monkeypox, is a zoonotic viral disease that is similar to smallpox, though generally less severe. It is caused by the monkeypox virus, a member of the Orthopoxvirus genus in the Poxviridae family. The disease presents with fever, rash, and swollen lymph nodes and may lead to a range of medical complications. The first human case of Mpox was recorded in 1970 in the Democratic Republic of the Congo.
Mode of Transmission of Mpox Virus
1. Human-to-Human Transmission:
The virus is primarily transmitted through direct contact with infected skin or mucosal lesions, as well as through respiratory droplets and short-range aerosols, especially during close and prolonged contact. It can enter the body through broken skin, mucous membranes (oral, pharyngeal, ocular, genital), or the respiratory tract. The infectious period varies, but individuals are generally considered contagious until the crusts from lesions detach and a new layer of skin forms underneath. Transmission can also occur from contaminated clothing or linens, as contagious skin particles can be dispersed into the air, inhaled, or deposited on broken skin or mucous membranes.
2. Animal-to-Human Transmission:
The virus can be transmitted from animals to humans through direct contact with lesions on the animal, respiratory secretions, or during activities such as hunting, skinning, preparing, or consuming contaminated wild game.
IPC IN HEALTHCARE SETTING
In healthcare settings, IPC for Mpox starts with understanding the transmission modes and adhering to standard and additional precautions.
Standard Precautions
Standard precautions are a set of measures aimed at reducing the risk of transmission of infectious agents between healthcare workers, patients, and the environment. These precautions should be applied universally, regardless of the patient's diagnosis.
1 - Hand Hygiene: Hand hygiene is crucial and can be performed using alcohol-based hand sanitizers or soap and water. Healthcare workers must clean their hands:
Before and after patient contact
Before performing aseptic tasks
After exposure to bodily fluids
After contact with the patient’s environment
2 - Personal Protective Equipment (PPE): PPE includes masks (e.g., N95, FFP2), gloves (latex, nitrile), gowns, and eye protection. PPE should be donned before entering the patient’s room and removed outside the room after use.
3 - Environmental Cleaning: All surfaces that come into contact with patients should be cleaned and disinfected regularly, with special attention to frequently touched surfaces like door handles and bed rails.
4 - Management of Soiled Linen: Due to the contagious nature of Mpox, soiled linen must be handled according to strict protocols to prevent the spread of the virus.
5 - Safe Injection Practices and Prevention of Needle Stick Injuries: Adhering to safe injection practices and preventing exposure to bloodborne pathogens are critical.
6 - Waste Management: Biomedical waste should be disposed of in leak-proof bags or double bags, following local regulations (Decree No. 003/MINEPDED of October 15, 2012, on the management of medical and pharmaceutical waste).
Additional Precautions
Due to uncertainties in the current outbreak's transmission modes, additional precautions are recommended, particularly concerning airborne and contact transmission.
Isolation: Suspected, probable, and confirmed cases should be immediately isolated in a negative-pressure room or a private room with the door closed.
Patient Movement: Patients should wear a medical mask if they need to leave the isolation room.
Skin Lesion Management: Skin lesions should be covered with clothing or bandages, except during examination.
Dedicated Equipment: Where possible, use single-patient equipment. Reusable equipment should be cleaned and disinfected according to manufacturers' guidelines.
IPC IN THE COMMUNITY
Transmission Chain in the Community
Community transmission can occur through contact with an infected person or animal, as well as through contaminated objects. The primary modes of community transmission include:
Direct Contact: Contact with infectious skin lesions or bodily fluids from an infected person or animal.
Contaminated Objects: Touching contaminated surfaces or materials such as bedding or clothing.
Handling Infected Carcasses: Direct contact with contaminated animal carcasses can lead to infection.
Standard Precautions in the Community
Hand Hygiene: Regular handwashing with soap and water or using an alcohol-based hand sanitizer is essential.
Avoid Close Contact: People should avoid close contact with suspected Mpox cases, whether human or animal.
Environmental Disinfection: Areas contaminated by infected individuals or animals should be thoroughly disinfected.
Avoid Handling Carcasses: Individuals should avoid handling animal carcasses without proper protective measures.
Handling of Human Bodies and Animal Carcasses
The WHO recommends that handling the remains of individuals who died from Mpox should be done with appropriate precautions. The body should be handled minimally, and staff should wear PPE (gloves, gown, N95 respirator, and eye protection). The body should be wrapped in cloth or a shroud and transferred to the morgue as soon as possible. Cultural and religious practices should be respected, but family members should avoid touching or kissing the body.
The disposal of animal carcasses should be done following local regulations, ensuring that the carcasses are disinfected, properly buried, or incinerated to prevent environmental contamination.
Waste Management
Waste generated during Mpox outbreaks must be managed in an environmentally sound manner, adhering to local environmental laws and regulations, such as the Law No. 96/12 of August 5, 1996, on environmental management and related decrees.
Waste Management Process
The waste management process should include the following steps:
1. Identification of Storage and Disposal Sites: Sites should be selected based on criteria like location, accessibility, and distance from water sources and food storage areas.
2. Characterization of Waste: Waste should be categorized by type (e.g., biological, chemical), and potential hazards should be identified.
3. Waste Segregation and Collection: Waste should be segregated at the source and collected in appropriate containers with color-coded bags.
4. Storage: Waste should be stored securely, with regular cleaning and disinfection of storage areas. Storage duration should not exceed 48 hours.
5. Transportation: Waste should be transported using dedicated vehicles that are regularly cleaned and disinfected.
6. Treatment and Disposal: Treatment methods may include chemical disinfection, incineration, or burial, depending on the waste type. Incineration should meet national standards, with temperatures between 850-1100°C for effective destruction of the virus.
In summary, the IPC measures for Mpox in both healthcare and community settings are critical for breaking the chain of transmission and protecting public health. By adhering to these IPC measures, the spread of Mpox virus can be effectively controlled within healthcare settings and the community, protecting public health and preventing further outbreaks.
In line with its mission to enhance the overall health and well-being of the community, HELP Foundation remains steadfast in its commitment to staying informed on the latest developments regarding Mpox disease. We are dedicated to providing up-to-date information and resources to ensure that our communities are well-equipped to prevent and manage the spread of this virus. Through continuous education, outreach, and advocacy, HELP Foundation will continue to support efforts to safeguard public health.
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