The following is the summary of “Contact Tracing and Exposure Investigation in Response to the First Case of Monkeypox Virus Infection in the United States During the 2022 Global Monkeypox Outbreak” published in the December 2022 issue of Internal medicine by Shenoy, et al.


The United States reported its first case of monkeypox virus (MPXV) infection during the ongoing global outbreak in May 2022. An examination into possible exposures and subsequent contacts was conducted as part of the public health and medical facility response. The goal of this study is to provide details about how contacts of the index patient were tracked down, what exposures they had been exposed to, what their risk levels were, whether or not they were given postexposure prophylaxis (PEP), and how long they were monitored after their exposure. Exposure and contact tracing inquiry. A variety of Massachusetts hospitals and clinics, and community centers. People who are known to be in contact with the index patient are the participants. Notification, risk assessment, symptom monitoring for contacts; PEP administration for some.

Outcomes are evaluated based on epidemiologic and clinical data obtained using routine surveillance methods at each site and then examined in the aggregate. About 4 contacts were found to be at high risk, 49 were at intermediate risk, and 113 were at low or uncertain risk, out of 37 community contacts and 129 healthcare contacts. In the course of the observation period, 15 healthcare workers experienced the onset of symptoms. Three were able to be tested for MPXV, however all three tested negative. Two people they knew in the community got sick. Neither patient had a clinical course suggestive of monkeypox, nor did they meet the requirements for MPXV testing. Three out of four people with high-risk exposures who were offered PEP took it up on it. 

PEP was offered as part of the informed clinical choice making to 10 HCP with intermediate-risk exposures, and 2 of them chose to receive PEP. Although the index patient was diagnosed with monkeypox 21 days after the onset of the monitoring period, no more transmissions were found during that time. Risk stratification is impacted by recollection bias in exposure descriptions.No secondary cases of monkeypox were found after an investigation into 166 community and health care contacts of a patient with the disease.

Source: acpjournals.org/doi/10.7326/M22-2721