The CDC issued a Health Alert Network Health Update to announce updated case-finding guidance for monkeypox. Since May 2022, the CDC said monkeypox cases, which have historically been rare in the United States, have been identified in 18 states and territories among persons returning from international travel and their close contacts domestically.

During a recent call between the CDC, the CAP, and laboratory groups, agency officials noted there is sufficient testing capacity for monkeypox across the United States. However, the officials cited specimen collection as a concern.

In updated case-finding guidance, the CDC expanded its case definition to encourage testing for monkeypox among persons who present for care with relevant history, signs, and symptoms. In people with epidemiologic risk factors, rashes initially considered characteristic of more common infections (eg, varicella zoster, herpes, syphilis) should be carefully evaluated for concurrent characteristic monkeypox rash and considered for testing.

Please review the Health Alert Network Health Update in detail for more information.

Agencies Update Guidance for Monkeypox Virus Disposal

Interagency partners at the Transportation, Labor, and Defense departments, the Environmental Protection Agency, Centers for Disease Control & Prevention (CDC) updated planning guidance for handling category A solid waste, which includes the transportation and disposal of material suspected to contain monkeypox virus. Read the updated guidance document.

All currently known monkeypox cases in the United States are of the West African clade. If clinical teams can reasonably determine that it holds true for the specific patient, then materials known or suspected to contain only West African clade monkeypox virus can be classified at lower levels (ie, below Category A) under the Hazardous Materials Regulations (HMR). Waste can be packed, transported, treated/inactivated, and disposed of as United Nations (UN) 3291, Regulated Medical Waste (RMW) under the HMR and any applicable state, tribal, local, or territorial regulations—the same way other waste from health care facilities is routinely managed.

Laboratory specimens can be packed and shipped as Category B infectious substances (UN 3373, Biological Substance, Category B). Specimens suspected to contain only West African clade monkeypox virus do not require a Department of Transportation special permit.