On August 4, 2022, U.S. Department of Health and Human Services Secretary Xavier Becerra declared the monkeypox outbreak a public health emergency in recognition of the continued rapid transmission of the disease.

The public health emergency declaration strengthens and accelerates the federal government’s response to the monkeypox outbreak, including data collection and sharing, vaccine production and distribution, access to funding, etc.

How does monkeypox spread?

According to the Centers for Disease Control and Prevention (CDC), monkeypox is spread through close, personal, often skin-to-skin contact. This includes direct contact with monkeypox rash, scabs, or bodily fluids (including respiratory secretions, though it is not considered airborne like COVID-19) from a person or animal infected with monkeypox. It also includes contact with objects, fabrics, and surfaces that have come in contact with someone who has monkeypox. Since intimate contact often involves much of the above, many cases have been attributed to such contact. Additionally, a pregnant person can spread monkeypox to the fetus through the placenta.

Monkeypox can be spread from the onset of symptoms until the rash has healed, all scabs have fallen off, and a fresh layer of skin has formed.

What are the symptoms of monkeypox?

The most obvious symptom is the rash that is usually located near the genitals, but have been common on the face with this outbreak. The rash can initially look like pimples or blisters and may be painful or itchy.

Other symptoms include:

• Fever
• Chills
• Swollen lymph nodes
• Exhaustion
• Muscle and back aches
• Headaches
• Respiratory symptoms (e.g., sore throat, nasal congestion, cough)

The progression of symptoms can vary from person to person, and the illness usually lasts 2-4 weeks.

What should employers do?

Employers have a general duty to provide a safe work environment, which may include taking appropriate action to prevent the spread of contagious diseases in the workplace.

Employers should consider developing a policy to address protocols for contagious diseases. Topics may include, but are not limited to:

• Encouraging (and providing resources) for employees to stay home if they are sick;
• Designating a point person to be responsible for monitoring infectious disease outbreaks;
• Protocols for determining and notifying close contacts;
• Reminder of anti-discrimination and anti-harassment policies; and
• Work from home provisions (if possible).

The CDC recommends that infected individuals remain isolated for the duration of the illness. However, the CDC also recognizes that such isolation may not be possible in all situations, and offered further guidance if an individual is not able to isolate such as avoiding others unless absolutely necessary, covering the rash, wearing a mask, and avoiding sharing items. (Note that the CDC offers additional guidance for healthcare settings and other congregate settings.)

Employees with monkeypox may qualify for job-protected leave under the Family Medical Leave Act or Americans with Disabilities Act. Employers should examine their sick or other leave policies to help employees understand their leave options if they are infected and need to isolate.

Considering reports of higher transmission rates among gay or bisexual males, employers may also consider reviewing their anti-discrimination and harassment policies to try to prevent stigma.

For more information regarding monkeypox, visit https://www.cdc.gov/poxvirus/monkeypox/index.html.