Isolation and Infection Control At Home

Overview

Healthcare providers can help prevent community transmission of monkeypox by discussing infection prevention and control principles in the home setting ; encourage patients and families to adopt these principles to the extent possible.

Implementing isolation and infection control measures in a home setting varies depending on the following factors:

• Additional people or pets in the home
• People in the home who may be at increased risk for severe outcomes from monkeypox disease, including people who are immunocompromised; children under 1 year of age; or people who are pregnant orhave a history of atopic dermatitis or eczema;
• Whether the person with monkeypox and other people in the home are likely to adhere to recommended precautions

Isolation and infection control measures

Until monkeypox infection has resolved

• Avoid contact with unaffected individuals until the rash has resolved, the scabs have fallen off, and a fresh layer of intact skin has formed. This often takes 2-4 weeks.
• Friends, family or others without an essential need to be in the home should not visit.
• Avoid close contact with others.
• Avoid close contact with pets in the home and other animals.
• Do not engage in sexual activity that involves direct physical contact.
• Do not share potentially contaminated items, such as bed linens, clothing, towels, wash cloths, drinking glasses, or eating utensils.
• Limit use of spaces and food shared with other household members.
• Routinely clean and disinfect commonly touched surfaces and items, such as counters or light switches, using an EPA-registered disinfectant (such as List Q) in accordance with the manufacturer's instructions.
• Wear well-fitting source control (e.g., medical mask) when in close contact with others at home.
• Avoid use of contact lenses to prevent inadvertent infection of the eye.
• Avoid shaving rash-covered areas of the body as this can lead to spread of the virus.
• Avoid contaminating upholstered furniture and other porous materials that cannot be laundered by placing coversheets, waterproof mattress covers, blankets, or tarps over these surfaces.

Bathroom usage

• If possible, use a separate bathroom if there are others who live in the same household.
• If there is not a separate bathroom in the home, the patient should clean and disinfect surfaces such as counters, toilet seats, faucets, using an EPA-registered disinfectant (such as List Q) after using a shared space. This may include during activities like showering, using the toilet, or changing bandages that cover the rash. Consider disposable glove use while cleaning if rash is present on the hands.

If there are animals in the home

In general, any mammal may become infected with monkeypox. It is not thought that other animals such as reptiles, fish or birds can be infected. Therefore:

• Avoid contact with animals (specifically mammals), including pets.
  • If possible, friends or family members should care for healthy animals until the owner has fully recovered.
  • Keep any potentially infectious bandages, textiles (such as clothes, bedding) and other items away from pets, other domestic animals, and wildlife.
• If you notice an animal that had contact with an infected person appears sick (such as lethargy, lack of appetite, coughing, bloating, nasal or eye secretions or crust, fever, rash) contact the owner's veterinarian, state public health veterinarian, or state animal health official.

Hand hygiene, source control, and personal protective equipment

• Wash hands with an alcohol-based hand rub or soap and water after touching rash material or clothing, linens, or environmental surfaces that may have had contact with rash material.
• Cover all skin rashes to the extent possible by wearing long sleeves or long pants.
• Consider gloves to cover rash on the hands when they're not in isolation, such as when they're receiving medical care.
• Use well-fitting source control (e.g., medical mask), if they can't avoid close contact with others, such as when receiving medical care.
• Other household members should wear a respirator or a well-fitting mask when in close contact (e.g., within 6 feet) with the person with monkeypox for more than a brief encounter.
• When possible, the person with monkeypox should change their own bandages and handle contaminated linens while wearing disposable gloves, followed by immediate handwashing after removing gloves.
  • Immediately launder any clothing that contacts the rash during bandage changes.
• As a last resort, if they need assistance with these activities, caregivers should avoid extensive contact and wear disposable medical gloves and a well-fitting mask or respirator at a minimum.
• Contain and dispose of contaminated waste, such as dressings, bandages, or disposable gloves.

For close contacts: risk assessment and monitoring

Anyone with an exposure to monkeypox at home or in the community should monitor their health for signs or symptoms for 21 days after their last exposure. Monitoring includes assessing the person monkeypox risk and signs and symptoms, then taking action if symptoms develop.