Metrex Products and Monkeypox in the Environment of Care
Metrex Research and Development staff have, like you, noted the outbreak of Monkeypox infections outside of endemic countries normally associated with this viral disease1,2. This communication addresses applicability of Metrex Research products as infection prevention tools in the environment of care when a risk of monkeypox to patients, staff and others is determined.
Background of Monkeypox Virus:
The Monkeypox virus is a member of the poxviridae family and classified in the orthopoxvirus genus, which includes Vaccinia (cowpox) and Variola (smallpox) virus. Orthopoxvirus particles are large, enveloped double stranded DNA viruses. They are most commonly transmitted by human-animal contact and human-to-human contact. Current evidence suggests that the mucosal membranes are particularly susceptible points of entry for the monkeypox virus to infect the host. Transmission via contaminated objects (fomites) is also suspected1,2.
Monkeypox Virus Outside the Host (Environment):
A study on Vaccinia virus, also a member of the genus orthopoxvirus, indicated survival of the virus, measured as infectivity, on common environmental surfaces up to 56 days in low temperatures and relative humidity3 . The same study also found that no Vaccinia virus was detectable on the same surfaces at room temperatures and higher humidity at seven days with substantial drops at three days3 . Monkeypox virus is also not thought to survive for long periods on hard, dry surfaces due to its envelope which is needed for infection and its relatively large size: thought to be similar to vaccinia virus studied.
Although hard surface (fomite) transmission is not the most common route of Monkeypox virus transmission, there is evidence that close contact with shared bedclothes and shared use eating utensils (e.g. not washed between uses during a meal) have transmitted the virus between humans4,5. Hard surface disinfection of surfaces which may directly or indirectly contact mucosa is recommended to reduce Monkeypox transmission, a practice aligned with current environmental hygiene practices in most environments of care.
Metrex Hard Surface Disinfectants with Effectiveness Against Monkeypox Virus
Different public health advisories are employed in different regions internationally. Metrex Research wants to assure healthcare professionals use the infection prevention tools we offer in a manner aligned with the regulations and availability in your region. The following table lists Metrex disinfectant options, aligned with current recommendations from public health sources, when a risk of monkeypox transmission exists in your facility. Please consult local public health authorities for the latest information regarding outbreaks in your area and follow precautions, including use of personal protective equipment, indicated if you have a suspected monkeypox case in your facility.
^: United States Environmental Protection Agency, ^^: Ready To Use, No Dilution, ^^^: Disinfection Contact Time When Monkeypox is a Risk. * These products are not available in the European Union
CaviCide and CaviWipes are indicated for use in the EU and areas which accept EU directives for use on non-invasive medical devices. In the U.S., the above listed products (as applicable) have demonstrated effectiveness against viruses similar to the Monkeypox virus on hard, non-porous surfaces. Therefore, the above listed products can be used against the Monkeypox virus when used in accordance with the directions for use against the viruses cited above (listed on product label) on hard, non-porous surfaces. Refer to the CDC website7 for additional information. If no public health directive is active in your region, then the use of all of the products in the table above, subject to availability, are suitable for use when risk of Monkeypox is present.
- Johns Hopkins Bloomberg School of Public Health, Health Security. Factsheet: Monkeypox. Link: https://www.centerforhealthsecurity.org/our-work/pubs_archive/pubs-pdfs/fact_sheets/monkeypox.pdf
- World Health Organization, Multi-country monkeypox outbreak in non-endemic countries. May 21, 2022 Link: https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON385
- J.P. Wood, Y.W. Choi, M.Q. Wendling, J.V. Rogers and D.J. Chappie, Environmental persistence of vaccinia virus on materials. Letters in Applied Microbiology 57, 399--404 Published 2013 (United States Environmental Protection Agency, National Homeland Security Research Center, Research Triangle Park, NC, USA and Battelle Memorial Institute, Columbus, OH.)
- Li Brown K, Leggat PA. Human Monkeypox: Current State of Knowledge and Implications for the Future. Trop Med Infect Dis. 2016;1(1):8. Published 2016 Dec 20. (doi:10.3390/tropicalmed1010008)
- Nolen, Leisha Diane et al. Introduction of Monkeypox into a Community and Household: Risk Factors and Zoonotic Reservoirs in the Democratic Republic of the Congo. The American journal of tropical medicine and hygiene vol. 93,2 (2015): 410-5. ( doi:10.4269/ajtmh.15-0168 )
- List Link: https://www.epa.gov/pesticide-registration/disinfectants-emerging-viral-pathogens-evps-list-q
- U.S. CDC link to monkeypox response: https://www.cdc.gov/poxvirus/monkeypox/response/2022/index.html U.S. CDC general Link: https://www.cdc.gov/