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Volume 29, Number 5—May 2023
Dispatch

Case Report and Literature Review of Occupational Transmission of Monkeypox Virus to Healthcare Workers, South Korea

Yunsang Choi, Eun-bi Jeon, Taeyoung Kim, Seong Jin Choi, Song Mi Moon, Kyoung-Ho Song, Hong Bin Kim, and Eu Suk KimComments to Author 
Author affiliations: Seoul National University Bundang Hospital, Seongnam, South Korea (Y. Choi, E.-b. Jeon, S.J. Choi, S.M. Moon, K.-H. Song, H.B. Kim, E.S. Kim); Seoul National University College of Medicine, Seoul, South Korea (Y. Choi, S.J. Choi, S.M. Moon, K.-H. Song, H.B. Kim, E.S. Kim); Korea Disease Control and Prevention Agency, Cheongju, South Korea (T. Kim)

Main Article

Table

Case report of occupational transmission of monkeypox virus to a healthcare worker in South Korea and literature review of healthcare-associated cases of monkeypox virus transmission during the 2022 mpox outbreak*

Characteristics Case reports
1 2 3 4 5†   6† 7‡ 8
Country
 France
 Brazil
 Portugal
 Florida, USA
 Brazil
 Brazil
 California, USA
 South Korea
Exposure date, 2022
 July
 July
 July
 July
 July
 July
 August
 November
HCW, age/sex
 25/F
 20s/F
 29/M
 NA
 NA/F
 NA/F
 40/F
 33/F
HCW occupation
 Doctor
 Nurse
 Doctor
 Nurse
 Nurse
 Nurse
 Doctor
 Doctor
Patient source, age/sex
 30/M
 20s/M
 NA
 NA
 40/M
 40/M
 NA
 20s/F
Exposure
Type Needlestick Needlestick Needlestick Needlestick Fomites Fomites Other§ Needlestick
Site
 Right thumb¶
 Thumb
 Left index finger
 Index finger
 Left ring finger
 Forearm
 Left middle finger
 Left index finger#
PCR results
Vesicle Positive Positive Positive Positive Positive Positive Positive Positive
Oropharynx Negative Positive Negative NA NA NA NA Negative
Blood
 Negative
 Positive
 Negative
 NA
 NA
 NA
 NA
 Negative
Incubation period, d
 4
 5
 4
 10
 5
 5
 7
 3
Dissemination
 No
 Yes
 Yes
 No
 Yes
 Yes
 Yes
 No
Vaccination**
 Imvanex, <3 h
 No
 No
 JYNNEOS, <15 h
 No
 No
 No
 JYNNEOS,<20 h
Isolation of HCW after symptoms, d
 21
 19
 24
 19
 21
 22
 20
 26
Tecovirimat treatment
 No
 No
 No
 No
 No
 No
 Yes, 14 d
 Yes, 14 d
Major symptoms
Skin lesion(s) Yes Yes Yes Yes Yes Yes Yes Yes
Lymphadenopathy No Yes Yes No Yes Yes No No
Other
 Seropurulent fluid from wound
 Fever
 Fever, chills, myalgia
 No
 Hyperemia
 Fever
 Fever, cough, sore throat
 Myalgia
Reference (5) (6) (7) (8) (9) (9) (10) This case

*Cases 1–7 were collected from the literature; case 8 is the patient described in this report. HCW, healthcare worker; NA, not available. †Cases 5 and 6 were described in 1 report. ‡Medical history of rheumatoid arthritis, treated with etanercept. §Inadvertent contamination during specimen collection or contact with contaminated environment. ¶Puncture from 25G needle. #Puncture from 26G needle. **Postexposure prophylaxis vaccination with third-generation smallpox vaccines (JYNNEOS, also known as Imvanex; Bavarian Nordic A/S, https://www.bavarian-nordic.com) conducted within specified hours after exposure to monkeypox virus.

Main Article

References
  1. WHO Emergency Response Team. Vaccines and immunization for monkeypox: interim guidance, 16 November 2022 [cited 2022 Dec 27]. https://www.who.int/publications/i/item/WHO-MPX-Immunization
  2. Vivancos  R, Anderson  C, Blomquist  P, Balasegaram  S, Bell  A, Bishop  L, et al.; UKHSA Monkeypox Incident Management team; Monkeypox Incident Management Team. Community transmission of monkeypox in the United Kingdom, April to May 2022. Euro Surveill. 2022;27:2200422. DOIPubMedGoogle Scholar
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  4. World Health Organization. 2022–23 Mpox (monkeypox) outbreak: global trends [cited 2022 Dec 27]. https://worldhealthorg.shinyapps.io/mpx_global
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  6. Carvalho  LB, Casadio  LVB, Polly  M, Nastri  AC, Turdo  AC, de Araujo Eliodoro  RH, et al. Monkeypox virus transmission to healthcare worker through needlestick injury, Brazil. Emerg Infect Dis. 2022;28:2334–6. DOIPubMedGoogle Scholar
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  10. Alarcón  J, Kim  M, Balanji  N, Davis  A, Mata  F, Karan  A, et al. Occupational monkeypox virus transmission to healthcare worker, California, USA, 2022. Emerg Infect Dis. 2023;29:435–7. DOIPubMedGoogle Scholar
  11. Jang  YR, Lee  M, Shin  H, Kim  JW, Choi  MM, Kim  YM, et al. The first case of monkeypox in the Republic of Korea. J Korean Med Sci. 2022;37:e224. DOIPubMedGoogle Scholar
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  14. Centers for Disease Control and Prevention. Guidelines for collecting and handling specimens for mpox testing [cited 2022 Dec 27]. https://www.cdc.gov/poxvirus/monkeypox/clinicians/prep-collection-specimens.html

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Page created: February 22, 2023
Page updated: April 19, 2023
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