Monkeypox for Nurse Practitioners - Part 1

Aug 10

Listen

Watch

Show notes:

**ERROR UPDATE**‍ ‍:I mistakenly said that cotton swabs can be used but it's ONLY synthetic swabs for monkeypox testing!! Link for testing instructions here: https://www.cdc.gov/poxvirus/monkeypox/pdf/MPoxTestingPatients.pdf

Monkeypox was declared a global outbreak by the World Health Organization in May of 2022. Monkeypox has been confusing and scary for patients and providers alike, especially on the heels of the Covid pandemic that we’re still facing. The World Health Organization named it a public health emergency and global outbreak, as has the CDC, but that doesn’t necessarily mean it’s as scary as it sounds.

At the time of this episode, there have been about 7,000 cases in the United States, predominantly in patients who are cis-male and have sex with other cis-males (MSM), although this is a virus that can affect any patient. It’s not sexually transmitted, as has been reported in the news (misinformation).

Even though any person can be infected with monkeypox, we need to make sure that the most vulnerable populations are getting the access to care, education, and support they need-- at the current time means especially our patients who are men who have sex with men.

It’s extremely important to educate yourself and your patients about what monkeypox is and what it isn’t-- stigma about symptoms, testing and treatment are what contribute to the spread of outbreaks. Learn more about monkeypox in this week’s episode.

Monkeypox Overview for Nurse Practitioners

In this episode, we cover:

Key background information you need to know
Symptoms & Diagnosis
Transmission of Monkeypox & Infection control
Differential Diagnosis
Approach to testing
Overview of treatment

Next week’s episode will focus on the details of treatment so you feel more well informed, as well as a bonus episode that’s specifically for patient education.

Resources mentioned in this episode:

*Please note that the CDC links above are broken, but we have chosen to keep them posted in case they are restored in the future (July 2026)

If you liked this post, also check out:

WEBVTT
1
00:00:08.500 --> 00:00:16.560
Hey there, welcome to the Real World NP podcast. I'm Liz Rohr, family nurse practitioner, educator,
2
00:00:16.800 --> 00:00:22.740
and founder of Real World NP, an educational company for nurse practitioners in primary
3
00:00:22.740 --> 00:00:29.100
care. I'm on a mission to equip and guide new nurse practitioners so that they can
4
00:00:29.100 --> 00:00:34.800
feel confident, capable, and take the best care of their patients. If you're looking for clinical
5
00:00:34.800 --> 00:00:40.660
pearls and practice tips without the fluff, you're in the right place. Make sure you subscribe and
6
00:00:40.660 --> 00:00:45.760
leave a review so you won't miss an episode. Plus, you'll find links to all the episodes
7
00:00:45.760 --> 00:00:59.740
with extra goodies over at realworldnp.com slash podcast. So I first want to start by
8
00:00:59.740 --> 00:01:05.880
saying that monkeypox is a global outbreak, which sounds extremely scary and so many patients
9
00:01:05.880 --> 00:01:11.420
are worried about it. I just want to start by saying this is a mild self-limiting illness
10
00:01:11.420 --> 00:01:18.480
that does not require treatment in the vast majority of cases. And it is far, far, far,
11
00:01:18.480 --> 00:01:23.640
far, far less transmissible than coronavirus. So without further ado, let's hop in.
12
00:01:24.000 --> 00:01:29.660
So this week's episode is about monkeypox. And monkeypox is, I think, really concerning
13
00:01:29.660 --> 00:01:35.740
for a lot of patients, clinicians, and it can feel especially unnerving because we're
14
00:01:35.740 --> 00:01:41.440
still on the heels of the coronavirus pandemic, SARS-CoV-2. In this episode, though, I hope I
15
00:01:41.440 --> 00:01:45.780
can answer some questions. There's actually a lot of information, so I'm going to be
16
00:01:45.780 --> 00:01:53.240
recording two different episodes. The first one, which is today, right now, is about important
17
00:01:53.240 --> 00:01:59.020
background information about the virus, signs and symptoms and diagnosis, transmission,
18
00:01:59.020 --> 00:02:06.080
as well as an overview of treatments and some points about infection control and isolation,
19
00:02:06.100 --> 00:02:11.220
things like that. The next episode is going to focus more on the treatments, because there's
20
00:02:11.220 --> 00:02:17.520
just a lot to say in an episode. But yeah, that's how it's going to go. I actually am going
21
00:02:17.520 --> 00:02:22.240
to also do a third episode that is for patients specifically. And I want to post that
22
00:02:22.240 --> 00:02:26.560
to the YouTube channel specifically for patients to find. But I'm also going to share it on
23
00:02:26.560 --> 00:02:34.120
podcast for clinicians in case it is helpful for you to listen to how I would talk to a patient
24
00:02:34.600 --> 00:02:38.360
and have those conversations and answer those common questions that patients may have.
25
00:02:38.980 --> 00:02:43.260
First off, let's jump in with some really important background. What is monkeypox virus?
26
00:02:43.800 --> 00:02:50.540
It is a virus, of course by the name, in the orthopoxvirus family. The other virus that
27
00:02:50.540 --> 00:02:59.100
we are familiar with in that category is smallpox. It is a zoonotic virus, meaning that it originated
28
00:02:59.100 --> 00:03:04.540
in animals and has both animal to human transmission as well as human to human
29
00:03:04.540 --> 00:03:11.560
transmission. It was first detected in the 1950s in monkeys, and so hence the name of
30
00:03:11.560 --> 00:03:18.880
monkeypox. However, the original reservoir is unknown, and it's actually far more common in
31
00:03:18.880 --> 00:03:25.260
rodent animals. Rats and deer rats, I believe. I can't remember what they're called. But yeah,
32
00:03:25.260 --> 00:03:31.920
those are the original sources. So 1970s was the first time that it was detected in a human.
33
00:03:32.060 --> 00:03:37.060
So this is not a new virus. There's been a little bit of a change, but this is not a new
34
00:03:37.060 --> 00:03:44.180
virus. This is detected in humans in the 70s. Originally there were two strains. I believe
35
00:03:44.180 --> 00:03:50.220
the West African clade is one of them, and then the other one is Democratic Republic of Congo,
36
00:03:50.260 --> 00:03:56.820
I believe. Don't quote me on those names, but there are two strains, and they were found
37
00:03:58.140 --> 00:04:04.060
originally in a few countries in Africa and now have become endemic, meaning it is a virus
38
00:04:04.060 --> 00:04:10.080
that just kind of hangs out there. There are occasional outbreaks in other countries within
39
00:04:10.080 --> 00:04:17.740
the continent of Africa, and the most recent global outbreak that was declared by the World
40
00:04:17.740 --> 00:04:24.320
Health Organization around May of this year is because it is spread not just to the endemic
41
00:04:24.320 --> 00:04:30.860
area or to countries close by with smaller outbreaks. It's a much larger outbreak that's
42
00:04:30.860 --> 00:04:35.140
worldwide. So I'm going to give you some stats. Hopefully it'll help you and your
43
00:04:35.140 --> 00:04:39.600
patients feel more comfortable. So these are from, I believe, June, and so there may be
44
00:04:39.600 --> 00:04:45.000
more updated numbers, but these were the most recent ones that I could find. So there are
45
00:04:45.000 --> 00:04:52.160
about 18,000 cases worldwide in 78 countries as of May as June-ish. 70% of those cases
46
00:04:52.160 --> 00:04:58.660
were actually located in European countries, and then 25% were located in the Americas.
47
00:04:59.280 --> 00:05:03.980
Of those 18,000 people, five deaths were reported. So I just want to let that sink in.
48
00:05:03.980 --> 00:05:09.560
Hopefully those numbers can help you feel a little bit better. 10% of patients of those
49
00:05:09.560 --> 00:05:15.680
18,000 were admitted to the hospital. The reasons for hospitalization were complications,
50
00:05:15.920 --> 00:05:21.800
which we'll talk about, but also because of pain control. There were also a handful
51
00:05:21.800 --> 00:05:26.260
of patients that needed treatment because of immunocompromise, and then there also
52
00:05:26.260 --> 00:05:31.120
were patients that had infections on top of the lesions, like bacterial super infections,
53
00:05:31.120 --> 00:05:35.800
things like that. So, so far in terms of who's being affected, I just want to start by saying
54
00:05:35.800 --> 00:05:41.480
there is no virus that's going to specifically go for a type of person, regardless of any of
55
00:05:41.480 --> 00:05:46.400
their characteristics, really. I mean, I guess there's some caveats about specificity there,
56
00:05:46.400 --> 00:05:52.080
but anyway, the current outbreak, about 98% of them have been detected in men who have sex
57
00:05:52.080 --> 00:05:57.400
with men. And I want to say just on the record, there's no such thing as a gay disease,
58
00:05:58.190 --> 00:06:04.760
and this is, I want to dispel any myths there that number one, this is not sexually transmitted.
59
00:06:05.400 --> 00:06:10.940
Sexually transmitted means that it's like transmitted through the sexual fluids
60
00:06:10.940 --> 00:06:17.980
between partners. As we understand right now, it is not spread that way. There is an article
61
00:06:17.980 --> 00:06:25.760
that came out recently in the Lancet saying that there was monkeypox DNA detected in semen,
62
00:06:25.760 --> 00:06:30.880
but it is not thought that it actually is transmitting, which is a little bit of a
63
00:06:30.880 --> 00:06:34.740
complicated nuance there. But as we understand right now, it is not sexually transmitted,
64
00:06:35.260 --> 00:06:40.000
does not have an affinity for any specific type of person. The way that a lot of diseases
65
00:06:40.000 --> 00:06:45.600
spread, especially in outbreaks is by social clusters and patterns of behavior in close
66
00:06:45.600 --> 00:06:50.660
proximity. And so I think that's really important to stress to patients that this
67
00:06:50.660 --> 00:06:56.000
affect anybody. And if there's any stigma around testing diagnosis and treatment,
68
00:06:56.400 --> 00:07:01.820
it's going to make the outbreak worse and go on longer. So for example, another example
69
00:07:01.820 --> 00:07:05.460
we can talk about is if the original case was in somebody who was on a wrestling team,
70
00:07:06.080 --> 00:07:11.480
all of the wrestlers on the team would likely get exposed, right? And there is no virus
71
00:07:11.480 --> 00:07:14.700
that's going to go for a wrestler, right? Just it's a wrestler specific virus that doesn't
72
00:07:14.700 --> 00:07:18.580
exist, right? So hopefully that's a helpful example to share with your patients and to help
73
00:07:18.580 --> 00:07:23.560
understand yourself. So next I want to talk about symptoms as well as transmission.
74
00:07:24.240 --> 00:07:29.020
So let's talk about symptoms first. So you may have seen these pictures on the internet
75
00:07:29.020 --> 00:07:33.740
down below. I have some links. There were some requests for the different appearances
76
00:07:33.740 --> 00:07:38.520
of different types of lesions, especially in varying skin tones of patients and various body
77
00:07:38.520 --> 00:07:42.940
areas. So I have a link down below, so check that out. But basically what happens,
78
00:07:42.940 --> 00:07:49.600
the core of it is that there are these very extremely painful lesions, skin lesions. So
79
00:07:49.600 --> 00:07:54.900
the progression of these very painful lesions is that they are first a maculopapular rash.
80
00:07:56.680 --> 00:08:03.380
They're groups of or solitary maculopapular lesions, and they can be in what's called
81
00:08:03.380 --> 00:08:08.280
a centrifugal pattern, which I think is so cool, that terminology, not the rash,
82
00:08:08.280 --> 00:08:14.420
but it can start more on the outsides of the body than the central location. So it can be in the
83
00:08:14.420 --> 00:08:20.080
anogenital region. It can be in the mouth, the palms, the soles, more of like the distal
84
00:08:20.080 --> 00:08:25.280
extremities and less in the center. And so there can be a cluster of lesions that also
85
00:08:25.280 --> 00:08:29.560
can be a little bit more diffuse. Whereas maybe before it may have been like a lot more
86
00:08:29.560 --> 00:08:33.159
diffuse, but that's the presentation that we're seeing now. So there's a progression
87
00:08:33.159 --> 00:08:40.080
though. It's a maculopapular lesion in a cluster, quite painful. They're deep seated, meaning like
88
00:08:40.080 --> 00:08:44.020
chickenpox varicella, for example, is very superficial. This is a very deep,
89
00:08:44.059 --> 00:08:49.800
deep lesion underneath and it's rubbery and it's circular. They progress then to vesicles.
90
00:08:49.960 --> 00:08:55.640
And then after that, they become pustules. And then after that, they finally scab over.
91
00:08:56.420 --> 00:09:01.400
These are, like I said, they are quite painful. And what happens is it takes almost
92
00:09:01.400 --> 00:09:08.020
about six weeks from the original development of the lesion to the healed scabs to fall off
93
00:09:08.020 --> 00:09:12.500
and have new skin, which is important because we're talking about transmission in a second.
94
00:09:12.820 --> 00:09:16.780
So keep that in mind, six weeks to heal those lesions. So the lesions themselves
95
00:09:16.780 --> 00:09:23.880
are the contagious part. Hold that thought. Prodrome. The prodrome is that typically
96
00:09:23.880 --> 00:09:28.180
there's a classic case and then there's like a mild or non-existent case where patients can
97
00:09:28.180 --> 00:09:32.700
have headache and fatigue, like a pretty significant headache and fatigue to start.
98
00:09:33.100 --> 00:09:36.740
And then a couple of days later, I believe like up to three to five days later,
99
00:09:36.960 --> 00:09:40.680
they will start to get the lesions, like maybe one to five days. Don't quote me on that. But
100
00:09:40.680 --> 00:09:45.740
just a couple of days, they will get the lesions. The other thing that they can have
101
00:09:45.740 --> 00:09:51.020
is a fever and lymphadenopathy. So we're seeing a little bit more of that than previous
102
00:09:51.020 --> 00:09:56.480
monkeypox that has been seen globally was more of just like a headache and fatigue.
103
00:09:56.480 --> 00:10:00.800
And so an important note about that is that when patients come in with headache,
104
00:10:01.500 --> 00:10:07.560
fatigue, fever, and lymphadenopathy, that could be a whole bunch of stuff. So just something to
105
00:10:07.560 --> 00:10:11.860
keep in mind in your differentials before they have lesions. And then the other thing to keep
106
00:10:11.860 --> 00:10:15.840
in mind is that they're actually contagious once they start having symptoms. Let's talk
107
00:10:15.840 --> 00:10:19.960
about the whole life cycle though and transmission. So basically what happens is that
108
00:10:19.960 --> 00:10:25.380
the way that this is spread is through the lesions themselves. Even if they don't have
109
00:10:25.380 --> 00:10:31.920
visible pus, even if they're those deep-seated papules can still transmit. So anything touching
110
00:10:31.920 --> 00:10:37.120
a lesion can transmit. The caveat there is that it's not necessarily like one touch and then
111
00:10:37.120 --> 00:10:43.160
you have the virus yourself. What they're using for language is more prolonged contact. So
112
00:10:43.160 --> 00:10:48.900
physical intimate contact, whether it's again a wrestling match, if it's sexual intercourse with
113
00:10:48.900 --> 00:10:53.600
somebody, if it's somebody that lives in your house at close contacts, that's a possibility
114
00:10:53.600 --> 00:10:59.260
so someone just who's in close prolonged proximity and could be touching the lesions at any point.
115
00:11:00.000 --> 00:11:05.700
Another route is droplets. So respiratory droplets within three feet of another person
116
00:11:05.700 --> 00:11:11.280
with coughing, talking, sneezing for a prolonged period. So we don't have great numbers right
117
00:11:11.280 --> 00:11:18.560
now. I love specifics, but it's not nearly anywhere as contagious as say SARS-CoV-2 or
118
00:11:18.560 --> 00:11:25.200
COVID-19. So it's prolonged respiratory droplets, meaning like 15 minutes or more
119
00:11:25.740 --> 00:11:30.220
longer time. So that we don't have like hard facts and numbers about that, but just know
120
00:11:30.220 --> 00:11:35.460
that it's not like you touch it one time and then you get monkeypox. Someone is close to you
121
00:11:35.460 --> 00:11:39.160
for just a moment in the grocery store, you're going to get monkeypox. It's not like that.
122
00:11:39.540 --> 00:11:45.520
The last one I want to mention though is fomite transmission, which I love that word.
123
00:11:45.520 --> 00:11:51.080
It's the contact with objects. And so what we're talking about here is lesions that have come into
124
00:11:51.080 --> 00:12:00.480
contact with the clothing of an individual or bed sheets or towels. For example, patients who
125
00:12:00.480 --> 00:12:05.380
are admitted to the hospital, it was detected on a number of different surfaces in their
126
00:12:05.380 --> 00:12:10.920
bedroom. But again, just because it's there, a brief contact does not necessarily mean that
127
00:12:10.920 --> 00:12:17.100
there's enough virus in that single touch to cause an overall infection for that person, right?
128
00:12:17.380 --> 00:12:20.640
So the unfortunate part, so now we're talking a little bit more about transmission. The
129
00:12:20.640 --> 00:12:25.840
unfortunate part is that the life cycle is that when you get exposed to monkeypox
130
00:12:26.680 --> 00:12:34.060
and significant enough close intimate exposure, it takes about one to two weeks
131
00:12:34.060 --> 00:12:39.380
to get symptoms, to get the prodromal symptoms of that fever, headache, lymphadenopathy,
132
00:12:39.380 --> 00:12:44.960
fatigue. And so in that time period, it doesn't sound like people are infectious during that
133
00:12:44.960 --> 00:12:50.020
time period. However, the main way that we're going to be reducing this outbreak is through
134
00:12:50.020 --> 00:12:56.640
contact tracing. So that's like a real, real unfortunate part of this virus. So anyway,
135
00:12:56.760 --> 00:13:01.500
the life cycle is that those one to two weeks after exposure will develop symptoms. A couple
136
00:13:01.500 --> 00:13:10.280
of days will get to be the sequential rashes, right? Maculopapular to vesicles to pustules,
137
00:13:10.680 --> 00:13:14.780
which will then scab over and fall off and there's new skin. That unfortunately takes
138
00:13:14.780 --> 00:13:19.620
between two and six weeks. So that's a real unfortunate part of this illness. If people get
139
00:13:19.620 --> 00:13:25.320
it is because really you're supposed to be isolating until the scabs have fallen off and
140
00:13:25.320 --> 00:13:29.260
there are no more scabs. Because like I said, even if there's no pustules or like
141
00:13:29.260 --> 00:13:34.280
fluid coming out, you're still going to get virus shedding. One more thing I wanted to add about
142
00:13:34.280 --> 00:13:39.060
the lesions is that they can also have a central umbilication, which is just the most fun medical
143
00:13:39.060 --> 00:13:44.460
word, which can be kind of confusing with like molluscum. If you're familiar with that illness,
144
00:13:44.600 --> 00:13:49.200
that virus, but it can't have that little dot in the center of the pustule or the
145
00:13:49.200 --> 00:13:52.160
papule. Couple of differentials. Actually, I want to throw in there. I didn't say I was
146
00:13:52.160 --> 00:13:54.420
going to talk about them, but I do want to throw out some now that I've mentioned
147
00:13:55.400 --> 00:14:01.040
molluscum. So a couple of ones to keep in mind. Varicella, hand, foot, and mouth, right? Because
148
00:14:01.040 --> 00:14:07.920
you also have the oral lesions and you may have the extremities as well. Measles, scabies,
149
00:14:09.180 --> 00:14:15.460
molluscum, herpes, syphilis, allergic skin reactions, and drug eruptions as well.
150
00:14:15.820 --> 00:14:19.520
So those are the main things to keep in mind. But hopefully, I mean, hopefully you don't see
151
00:14:19.520 --> 00:14:23.820
this at all, but if you did see it, hopefully you would have kind of some precautions in place
152
00:14:24.320 --> 00:14:29.660
to prepare. So let's talk about diagnosis. So currently as it stands, the way it's gone in
153
00:14:29.660 --> 00:14:35.420
this outbreak so far is that it is handled by the Department of Public Health. This is not a
154
00:14:35.420 --> 00:14:39.740
routine infection that we send something to the lab for and then we test for it.
155
00:14:40.020 --> 00:14:43.600
So the majority of this, and again, check with your, actually I didn't say this yet,
156
00:14:43.700 --> 00:14:48.520
but check with your supervisor about testing and treatment and the protocols at your clinic.
157
00:14:48.520 --> 00:14:54.420
Hopefully your clinic has developed a protocol of how to prepare for these potential patients,
158
00:14:54.900 --> 00:14:59.280
protective equipment. Again, if it's a by touch transmission as well as droplet,
159
00:14:59.340 --> 00:15:03.180
we want to consider personal protective equipment that is both contact and droplet
160
00:15:03.180 --> 00:15:07.120
in the clinic setting. But yeah, when it comes to the testing and the treatment part,
161
00:15:07.280 --> 00:15:11.960
we do want to collaborate with our supervisors, the people running the clinic, as well as the
162
00:15:11.960 --> 00:15:15.360
Department of Public Health. The way that we're testing for it, if we have a suspected
163
00:15:15.360 --> 00:15:21.240
contact, step number one is let somebody know, let your supervisor know, let the
164
00:15:21.240 --> 00:15:26.000
Department of Public Health know. And actually down below this episode, I have a link to the
165
00:15:26.000 --> 00:15:30.020
contact information for every state for your Department of Public Health, phone number to
166
00:15:30.020 --> 00:15:36.780
call. And that is how you will arrange for testing as well as potential treatment. Not
167
00:15:36.780 --> 00:15:45.140
everybody gets treatment by the way. Okay. So the testing is a PCR swab test. It's
168
00:15:45.140 --> 00:15:50.580
to typically the Department of Public Health lab. I've heard that there are some commercial labs
169
00:15:50.580 --> 00:15:55.200
doing this test, but vast majority at the time of this recording, you're going to be working
170
00:15:55.200 --> 00:15:59.300
with your particular clinic, your particular state Department of Public Health. And how you
171
00:15:59.300 --> 00:16:04.180
collect the swab, according to CDC, is that it's actually, it's one of those cotton or
172
00:16:04.180 --> 00:16:10.400
Daychron or Rayon swabs, like a typical wound culture. Like anyway, talk to your supervisor,
173
00:16:10.480 --> 00:16:14.200
but that's typically what it looks like. And it's a, unfortunately it's like a vigorous
174
00:16:14.200 --> 00:16:20.840
rubbing of the lesion, even if it doesn't have visible discharge. And I say unfortunately,
175
00:16:21.000 --> 00:16:26.120
because apparently they are quite painful. So just do your very best to obtain those again,
176
00:16:26.180 --> 00:16:29.760
with guidance. You will likely have guidance if this is actually happening to you,
177
00:16:29.760 --> 00:16:34.760
but it's a vigorous swab of a lesion sent to that specific lab and it's a PCR test.
178
00:16:34.960 --> 00:16:40.800
And so because it's a PCR test, you shouldn't need to have too much sample for them to be
179
00:16:40.800 --> 00:16:46.440
able to run it. So I just want to briefly talk about approach to treatment. So this is a mild,
180
00:16:46.480 --> 00:16:51.500
I probably should have started with this comment, but it's a mild self-limiting illness
181
00:16:51.500 --> 00:16:56.540
for the vast majority of patients. The vast majority of patients will not need treatment
182
00:16:56.540 --> 00:17:01.140
of any kind and it will self-resolve, right? I said that at the beginning, but
183
00:17:01.820 --> 00:17:04.920
most patients are not going to get treatment. So there's basically two camps
184
00:17:04.920 --> 00:17:09.740
of management. If it gets to that point of treatment and you are not going to be doing
185
00:17:09.740 --> 00:17:12.920
this alone, you're going to be doing this with a supervisor and again, the department of public
186
00:17:12.920 --> 00:17:19.520
health. The brief overview is that there's two main options, two main categories. One is vaccine
187
00:17:19.520 --> 00:17:25.500
and then the second one is antivirals. So for vaccines, these are the smallpox vaccines
188
00:17:25.500 --> 00:17:31.940
and these are primarily for pre-exposure prophylaxis for certain healthcare workers, for
189
00:17:32.200 --> 00:17:36.300
certain lab, people who work in a lab processing these specimens. Please check
190
00:17:36.300 --> 00:17:41.680
the CDC recommendations about who should get that at this time, at the time you're watching
191
00:17:41.680 --> 00:17:47.840
this or listening to this. And so that can be for pre-exposure prophylaxis or post-exposure
192
00:17:47.840 --> 00:17:54.100
prophylaxis. So for patients who have a known exposure to monkeypox, those patients can get
193
00:17:55.300 --> 00:18:00.140
a smallpox vaccine, not a monkeypox vaccine, it's a smallpox vaccine. Again, I'll talk about
194
00:18:00.140 --> 00:18:05.900
that in the treatment episode, but it has this emergency use authorization to be used
195
00:18:05.900 --> 00:18:10.460
for monkeypox because they are in the same family of viruses. And then the people who
196
00:18:10.460 --> 00:18:16.000
require treatment are those who have severe symptoms. So people who should get treatment,
197
00:18:16.040 --> 00:18:19.660
again, this is in conjunction with your supervisor and the department of public health.
198
00:18:19.880 --> 00:18:24.500
This is not available at a commercial pharmacy. This is like specifically like obtained
199
00:18:25.180 --> 00:18:30.800
persons with severe disease. So hemorrhagic disease, many, many, many confluent lesions,
200
00:18:30.800 --> 00:18:36.380
people who have complications of sepsis or encephalitis, as well as other conditions
201
00:18:36.380 --> 00:18:40.340
requiring hospitalization, like if they had that super infection, if they were immunocompromised,
202
00:18:40.340 --> 00:18:47.220
things like that. So people who are at high risk for illness, for severe disease and are
203
00:18:47.220 --> 00:18:51.820
not hospitalized, those patients are immunocompromised patients with like things
204
00:18:51.820 --> 00:18:56.740
like HIV. Pediatric populations, especially those less than eight are at higher risk for
205
00:18:56.740 --> 00:19:04.000
severe illness. People who are pregnant or breastfeeding, people who have really extensive
206
00:19:04.000 --> 00:19:11.060
skin underlying conditions already. So if you had a severe atopic dermatitis or other
207
00:19:11.060 --> 00:19:15.320
exfoliative, active exfoliative, other skin conditions, those patients are at risk for
208
00:19:15.320 --> 00:19:20.640
being a lot worse. So again, I'm going to talk about the treatments in that episode,
209
00:19:20.640 --> 00:19:27.520
but I guess just as a quick take home, these are all available through emergency use
210
00:19:27.520 --> 00:19:33.140
authorization by the FDA. They're all FDA approved medications and vaccines, but they're
211
00:19:33.140 --> 00:19:39.240
all for other illnesses that are not monkeypox specifically. And so because of that, they are
212
00:19:40.000 --> 00:19:44.880
located in the US, all I can speak to is the US, unfortunately, they're located in the
213
00:19:44.880 --> 00:19:50.820
national stockpile of medications to be used in an outbreak. So there are special procedures
214
00:19:50.820 --> 00:19:54.480
to actually get those treatments. And so you're never going to make that decision
215
00:19:54.480 --> 00:19:58.120
yourself of like, do they need treatment or not? So hopefully this episode is helpful
216
00:19:58.120 --> 00:20:02.160
and helps answer a lot of questions that you might have. Please let us know what
217
00:20:02.160 --> 00:20:07.080
questions you have further and definitely check out the links down below about the
218
00:20:07.080 --> 00:20:12.220
contact number for the department of public health in your state, as well as some other
219
00:20:12.220 --> 00:20:16.540
recommendations and resources and images for diagnostic purposes.
220
00:20:21.090 --> 00:20:26.410
That's our episode for today. Thank you so much for listening. Make sure you subscribe,
221
00:20:26.630 --> 00:20:31.070
leave a review and tell all your NP friends. So together we can help as
222
00:20:31.070 --> 00:20:34.990
many nurse practitioners as possible give the best care to their patients.
223
00:20:35.410 --> 00:20:39.510
If you haven't gotten your copy of the ultimate resource guide for the new NP,
224
00:20:39.510 --> 00:20:45.390
head over to realworldnp.com slash guide. You'll get these episodes sent straight to
225
00:20:45.390 --> 00:20:50.110
your inbox every week with notes from me, patient stories and extra bonuses.
226
00:20:50.330 --> 00:20:54.210
I really just don't share anywhere else. Thank you so much again for listening.
227
00:20:54.430 --> 00:20:55.590
Take care and talk soon.

Podcast

Liz Rohr