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Monkeypox Virus Transmission to Healthcare Worker through Needlestick Injury, Brazil - CDC

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  • Monkeypox Virus Transmission to Healthcare Worker through Needlestick Injury, Brazil - CDC

    Early Release
    Volume 28, Number 11—November 2022



    Laína Bubach Carvalho , Luciana V.B. Casadio, Matheus Polly, Ana Catharina Nastri, Anna Cláudia Turdo, Raissa H. de Araujo Eliodoro, Ester Cerdeira Sabino, Anna Sara Levin, Adriana Coracini Tonacio de Proença, and Hermes Ryoiti Higashin

    Abstract

    We describe monkeypox virus (MPXV) transmission from a patient to a healthcare worker through needlestick injury. A lesion appeared at the inoculation site 5 days after injury. Blood tested MPXV-positive by PCR before symptoms worsened; blood remained MPXV-positive at discharge 19 days after symptom onset. Postexposure prophylaxis could prevent potential MPXV bloodborne transmission.

    ... On July 9, 2022, a female nurse in her 20s sustained a needlestick injury to her thumb from supplies used to collect cutaneous lesion samples from a monkeypox patient. The nurse was wearing personal protective equipment, including gown, gloves, goggles, and mask, and was gathering materials to discard in a sharps container when a needle perforated her glove; the puncture site was visible immediately. After 5 days, a nodule developed at the injury site (day 0 of symptoms); it later evolved into a painful vesicle (Figure). The nurse lived alone, denied recent travel, and reported having protected sexual intercourse only with her male partner. She had no other potential exposures.

    The source patient, a man in his 20s who reported having sex with men, had mild monkeypox that started 2 weeks before the needlestick incident. He had sore throat, cervical lymphadenopathy, and sparse lesions on his face, torso, and groin. The patient and nurse provided written consent for this report.

    Overall, the nurse had 7 lesions: 1 each on the thumb (inoculation site) and palm of the right hand, dorsal left hand, and left thigh, and 3 on her face (Appendix Figures 1–3). Magnetic resonance imaging of the injury site on day 15 showed a neurovascular bundle and subcutaneous inflammation.

    During the nurse’s follow-up, blood and skin lesion samples tested MPXV-positive ...




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