In a report today of 313 healthcare workers (HCWs) exposed to monkeypox in Colorado, none of them contracted the virus, despite few wearing the recommended personal protective equipment (PPE) or receiving postexposure prophylaxis (PEP) vaccination.

The study, by researcher with the Colorado Department of Public Health and Environment and the Centers for Disease Control and Prevention (CDC) was published in Morbidity and Mortality Weekly Report.

Just 23% wore recommended PPE

The study took place from May 1 to Jul 31, with 313 healthcare workers interacting with patients who subsequently were diagnosed as having monkeypox. Only 23% of the HCWs wore all recommended PPE during their exposures.

Of the 313 HCWs, 28% were considered to have had high- or intermediate-risk exposures and were therefore eligible to receive PEP with the Jynneos vaccine. Almost half (48%) of the workers (12% of all exposed HCW), received the vaccine.

"No HCP developed a monkeypox infection during the 21 days after exposure. These results suggest that the risk for transmission of monkeypox in health care settings is low. Infection prevention training is important in all health care settings, and these findings can guide future updates to PPE recommendations and risk classification in health care settings," the authors said.

Most encounters between HCWs and monkeypox patients were short, with 69% lasting only 5 to 30 minutes. Only one HCW was exposed for more than 3 hours. Only seven (2%) were exposed during an aerosol-generating procedure.

Current CDC recommendations suggest HCWs wear a gown, gloves, eye protection, and an N95 (or higher-level) respirator while caring for patients who have suspected or confirmed monkeypox. Adherence to PPE recommendations was lowest in primary care and urgent care settings, and highest in sexually transmitted infection clinics and hospitals.

Among the 313 workers in the study, 38% reported wearing N95s.