Monkeypox: Nurse Tests Positive After Needlestick Incident

A nurse acquired a monkeypox infection after an incident with a needle, authorities reported. It is said to be the first such case in the U.S.

The Florida Health Department found out about the incident on July 12, the U.S. Centers for Disease Control and Prevention (CDC) noted in its Morbidity and Mortality Weekly Report (MMWR) on Monday.

During the incident, which had happened earlier that day, an emergency department nurse reportedly used a needle to "create an opening" in the lesion of a patient who was suspected to have monkeypox. This was being done in order to get direct contact with the fluids for the swabs.

However, the "needlestick" incident happened when the nurse was recapping the needle prior to disposal. The needle reportedly broke through the glove that the nurse was wearing, causing bleeding and a tear in the skin of the index finger.

Needlestick injury, also called sharps injury, is an incident wherein someone's skin is pierced or punctured by a needle used in medical procedures. It can also occur through other medical devices such as lancets and scalpels.

The wound was washed and drenched using a Betadine solution, and the incident was immediately reported to the hospital as well as the county health department. Later in the day, the swab tests collected from the patient turned out to be positive for Orthopoxvirus and, subsequently, for Clade II monkeypox virus in a duplicate test, the CDC revealed.

The nurse received the monkeypox vaccine within 15 hours of the incident as post-exposure prophylaxis, and continued working while asymptomatic "in accordance with CDC guidance."

During this time, the nurse used a surgical mask and reportedly wore medical gloves while with patients.

Ten days later, however, the nurse began self-isolation after a lesion formed at the injection site. Upon testing, the lesion also tested positive for monkeypox, but the nurse did not have any other lesions apart from the one at the puncture site. There were also no other symptoms.

"This report describes the first occupationally acquired MPVX infection in a U.S. health care worker during the 2022 monkeypox outbreak," the CDC noted.

It also noted some recommendations to prevent such incidents from occurring, like ensuring training for proper specimen collection and avoiding opening or "unroofing" monkeypox lesions and recapping the instrument because of the risk of injuries such as the one experienced by the nurse.

Swabbing the surface, the CDC said, "collects sufficient amounts of viral material without a need to unroof lesions."

"Overall, with routine adherence to standard infection control practices, among U.S. HCP (health care personnel) with nonpercutaneous exposure to monkeypox patients, the risk for acquiring monkeypox appears to be low," the agency said.

As of Oct. 12, the trajectory of monkeypox cases in the U.S. appears to be on a downward trend based on CDC data. By Monday, the 2022 U.S. map and case count has logged more than 27,400 confirmed monkeypox/orthopoxvirus cases, with places like California, New York, Texas and Florida each logging thousands of cases.