On May 17th, 2022, the Massachusetts Department of Public Health (MDPH) laboratory confirmed the presence of orthopoxvirus DNA via PCR from lesion swabs obtained from a Massachusetts resident. Further testing by the CDC confirmed the patient was infected with the West African clade of Monkeypox virus. (1) Since then, there have been 6326 (as of August 2nd, 2022) confirmed cases of Monkeypox virus in the United States alone and a total of 25,391 in 80 countries (2).
Monkeypox is a zoonotic disease caused by the Monkeypox virus of the family Orthopoxviridae. Symptoms may include fever, headache, muscle aches, swollen lymph nodes and fatigue. A blister like rash filled with pus typically develops within three days of the onset of fever. The rash usually starts on the face but may begin on other body parts like the genitals (3). The raised bumps of the rash go through stages before becoming crusted, scabbing, and falling off. The illness may last between 2 – 4 weeks.
Public health data suggest that the Monkeypox virus is transmitted from person to person through prolonged body to body contact. Evidence suggests that live viruses can be found on surfaces up to 15 days after an infected person recovers (4). During the infectious period, body fluids, respiratory secretions and lesion materials from people with Monkeypox can contaminate the environment.The virus can survive in linens, clothing and on environmental surfaces. Despite the ability of Orthopoxviruses to persist in the environment, they are sensitive to many disinfectants. Disinfection is recommended for all areas where a person with monkeypox has spent time or have contaminated items. The purpose of this article is to highlight 4 reasons why the current Monkeypox outbreak is a janitorial concern.
Healthcare facilities, laboratories and homeowners need to continue working with their janitorial team to ensure staff are well trained and informed about the Monkeypox virus. Janitorial staff are an integral part of the infection prevention and control of communicable disease outbreaks. Janitorial providers should be mindful of the following aspects of environmental infection prevention:
1. Environmental Surfaces
Not all environmental surfaces are created equal. Janitorial training must emphasize tailored disinfection of environmental surfaces regardless of location. Studies show that the monkeypox virus is likely to survive for a longer duration in linens, clothing, and environmental surfaces. Therefore, cleaning must be specific to these areas. Linens should be laundered with the recommended temperature and non-porous surfaces disinfected with the proper Environmental Protection Agency (EPA) registered disinfectants. Homeowners should consider hiring upholstery cleaning experts for their couches and cushioned furniture after exposure.
2. Disinfectants
The EPA recommends using disinfectants registered as being able to kill rare and re-emerging viral pathogens for the Monkeypox outbreak. When rare viruses cause outbreaks of disease, there may be few if any disinfectants that have been tested and registered for use against that specific pathogen. To prepare for situations like these, the EPA created the EVP guidance, which allows disinfectant manufacturers to submit data to EPA demonstrating a product’s efficacy against difficult-to-inactivate viruses (5).
3. Personal Protective Equipment
Janitorial team members working in healthcare and non-healthcare facilities must be encouraged to wear personal protective equipments (PPE) at all times. Personal protextive equipments serve as the gatekeepers between the skin and toxic chemicals or human bodily fluids that may be contaminated with bacteria and viruses. Without proper PPE, the cleaner may be exposing themselves to germs or exposing the environment to germs if they are sick.
4. Training
Janitorial members should be included in-service trainings in healthcare facilities. Since most cases are likely to be diagnosed in healthcare settings, inclusion of janitorial teams makes for a robust infection prevention practice. Hospital Infection Control Preventionists (ICP) can work seamlessly with their environmental department to ensure that proper disinfection is done and linens are well laundered.
Resources:
Here are additional resources for you to further increase your janitorial knowledge and stay updated on new trends in facility maintenance
Distinct Cleaning News and Media Post: Easy to read blog articles on various topics and trends in the commercial janitorial space.
Janitorial Work and Tutorial Videos: Quick cleaning tutorial and before and after videos intended to give the audience a glimpse into various janitorial work.
Janitorial Business Hub : This is a great place for anyone who has a regular job yet wants to start their own janitorial business. You can find coaching and other strategic opportunities available.
References (see number in parenthesis)
1. Minhaj, Faisal, et al. Morbidity and Mortality Weekly Report Monkeypox Outbreak -Nine States, May 2022.
2. “2022 U.S. Map & Case Count | Monkeypox | Poxvirus | CDC.” Www.cdc.gov, 14 June 2022, www.cdc.gov/poxvirus/monkeypox/response/2022/us-map.html.
3. Nicoletta Lanese. “What Is Monkeypox?” Livescience.com, 27 July 2022, www.livescience.com/what-is-monkeypox-symptoms-treatment. Accessed 3 Aug. 2022.
4. CDC. “Monkeypox in the U.S.” Centers for Disease Control and Prevention, 18 July 2022, www.cdc.gov/poxvirus/monkeypox/specific-settings/home-disinfection.html. Accessed 3 Aug. 2022.
5. US EPA, OCSPP. “Disinfectants for Emerging Viral Pathogens (EVPs): List Q.” Www.epa.gov, 25 May 2022, www.epa.gov/pesticide-registration/disinfectants-emerging-viral-pathogens-evps-list-q.
