The Centers for Disease Control and Prevention (CDC) has issued interim guidance advising states that persons investigating monkeypox outbreaks and involved in caring for infected individuals or animals should receive a smallpox vaccination to protect against the possibility of contracting monkeypox. CDC is also recommending that persons who have had close or intimate contact with individuals or animals confirmed to have monkeypox should also be vaccinated. They can be vaccinated up to 14 days post-exposure. Since the smallpox vaccine is not an approved vaccine for monkeypox, the smallpox vaccine for this CDC recommended use is being distributed under FDA special procedures to allow such emergency use in association with individual patient informed consent and approval by an institutional review board (ethics committee).
CDC is not recommending smallpox vaccination for veterinarians, veterinary staff or animal control officers who have not been exposed. However, the public health agency does encourage such personnel to use standard infection control measures to prevent contact or airborne transmission of the virus if they are involved in investigation or treatment of ill animals.
“This outbreak demonstrates the importance of preparedness for the unexpected,” said Tommy G. Thompson, Secretary of the Department of Health and Human Services. “State health departments have been actively involved in planning and preparing for the possibility of a bioterrorist event. We are now seeing that this level of preparation can also assist in unexpected, natural outbreaks.”
“Monkeypox can be a serious illness, and it has not been previously seen in humans in this hemisphere. CDC, FDA and a team of expert advisors carefully weighed the risk of smallpox vaccination against the risks posed by exposure to monkeypox infection in arriving at this important decision,” said Dr. Julie Gerberding, CDC Director. “We must do everything we can to protect persons who are exposed to monkeypox in the course of investigating or responding to this outbreak.”
CDC also issued a case definition for human cases of monkeypox. The agency cautioned that it is important to confirm suspected cases of monkeypox before recommending vaccination in instances where there is close or intimate contact between persons with rash illness and persons who have contraindications for smallpox vaccination, such as pregnancy or eczema.
CDC has also issued interim guidance for veterinarians and pet owners who may be in contact with ill prairie dogs or exotic rodents from Africa. CDC strongly cautions pet owners not to release these animals to the wild and not to destroy the animals themselves and dispose of them in landfills, but to contact their state health departments for guidance if there is any concern about the health of an exotic rodent or prairie dog acquired as a pet after April 15 of this year.
Persons who should be alert to their health status are those who have been exposed to an exotic rodent or a prairie dog that is exhibiting signs of illness, such as conjunctivitis, respiratory symptoms and/or rash, or an animal that itself has been in contact with a case of monkeypox in either a pet or a human. Exposure includes living in a household, petting, handling or visiting a pet holding facility – such as a pet store, veterinary clinic or pet distributor – where ill animals have been identified.