World Health Organization Alert! Introduction:
The WHO declared that the rise in mpox cases constitutes a public health emergency of international concern [PHEIC]. A PHEIC is the highest level of alarm under international health law. The current outbreak has already seen more than 15.600 cases – and resulted in more than 537 mortalities. The difference between the current outbreak and the one from 2022 is that we are now dealing with a variant of this virus that is known as clade 1b. And this variant has a higher risk of transfer and the mortality rate is much higher, when compared with the variant that was circulating in 2022.
Monkeypox and handling linen
The rash associated with monkeypox can be confused with other diseases that are encountered in clinical practise – such as secondary syphilis, herpes, chancroid, and varicella zoster. The implication for healthcare workers and laundry [sorting] staff is that handling infected linen should always be taken seriously. The CDC recommends to vaccinate those persons that are at risk for occupational exposure. This is particularly valid for healthcare workers.
The question has been raised if the virus could be airborne by handling infected linen. Before this question is answered we found that the CDC made a remark on transmission via the respiratory tract. CDC reported that the virus “may” spread through respiratory secretions when people have close face to face contacts. Translated this implies that the risk of getting infected via aerosol in the air – when handling / sorting infected linen – is very unlikely.
However, a report *** by an NHS team reported presence of the virus in the air and on healthcare staff uniforms after changing bed linen in occupied patient rooms. The conclusion of this medical team was that there is significant aerosolization of the MPX virus during specific activities.
The message of today is that there are no infection risks for the laundry staff PROVIDED that they stick to the existing hygiene guidelines.
How does this translate to the laundry? CONTEXT AND RECOMMENDATIONS
- The infected linen should be packed by the healthcare customer[s] in recognisable clearly colour coded bags .
- Face masks are recommended when sorting the linen and when loading the washing machines.
- Wearing gloves when working in the sorting department or when loading the washing machines – is essential in preventing infection with the virus. This vital recommendation is part of the EN 14065 RABC as well as CERCLEAN Quality Management System. Next to wearing face masks and protective work wear.
- Wearing gloves is crucial because transmission can take place when small lesions are present on the skin. Even when wounds are invisible with naked eye !
- For controlling the proces, practical tools are available.
See also the CDC website – monkeypox transmission.
Q : Are the laundry wash processes capable of killing all virus particles?
A : The Mpox virus is a so-called enveloped virus. And from the COVID19 pandemic we know that most enveloped viruses can be destroyed by thermal disinfection or chemo-thermal disinfection. On top of that these enveloped viruses are sensitive to high pH and surface-active agents. Both parameters being present in the pre wash of all healthcare wash processes. So, the Mpox virus de-activation already starts in the first minute of the dedicated wash process.
In short: the chance that this monkeypox virus will survive a well performing washing process for healthcare linen is very low.
*** Air and surface sampling for monkeypox virus in UK hospitals | medRxiv
