Person with blue medical gloves holding syringe and vial.

The World Health Organization (WHO) director general declared the current outbreak of monkeypox a Public Health Emergency of International Concern. Similarly, San Francisco declared a public health emergency due to the increase in monkeypox cases and the state of New York declared the spread of the virus an “imminent threat to public health.”

Monkeypox, formerly largely relegated to western and central Africa, has now infected approximately 16,000 people in seventy-five countries, according to the WHO. The origin of the current spread appears to be from those who have traveled to Europe and North America rather than Africa. This is coming at a time when many U.S. residents are traveling to Europe since travel restrictions from COVID-19 have largely been dropped and business travel has resumed for many. Employers may want to consider the necessity of business travel and how they will respond if an employee voices concern. Additionally, employers may wish to educate employees who are traveling rather than restricting personal travel.

The WHO takes the position that public health agencies should raise awareness and take the virus seriously but not be alarmed. If employers learned anything during COVID-19, it is that the first steps is likely to be understanding the problem and preparing for it as best they can. Because of the way the virus is spread, those with the greatest amount of risk in their workplaces are likely laboratory personnel (who might come into contact with infected material), rapid response teams, and health care workers, but employers in very diverse industries are expressing concerns. Both the U.S. Centers for Disease Control and Prevention (CDC) and the WHO have very good information on their websites related to symptoms and treatment. Employers may wish to either share these websites or make them known to their employees.

Symptoms include fever, chills, muscle aches, backache, swollen lymph nodes, exhaustion, and blisters on the skin. While the blisters have generally been on the face and upper body, in the current spread, they are often found on the genitals and lower body. Monkeypox has a low mortality rate but can cause complications if the eyelids or other places are affected. Because the current spread has been found to often emanate from intimate contact between men, there is some concern about groups being stigmatized unfairly. Just as employers needed to be concerned with xenophobia because of COVID-19, employers may wish to be cognizant of and warn against harassment in the workplace.

Monkeypox is a virus similar to smallpox (not chicken pox) and individuals who were vaccinated for smallpox will have some protection from monkeypox. Although those with compromised immune systems, young adults, and children are the most vulnerable. Because the smallpox vaccine eradicated smallpox approximately forty years ago, those vaccinated tend to be older. While there are two monkeypox vaccines, it is not yet known how effective they are against monkeypox. Employees who are infected may wish to discuss the vaccine with a physician.

Monkeypox has an incubation period of six to thirteen days, and it can take a matter of weeks for the skin blisters to clear. Employees who are eligible for leave under the Family and Medical Leave Act (FMLA) may be covered and employers may want to consider this on a case-by-case basis. Complications caused by monkeypox may rise to the level of a disability but this will also be determined on a case-by-case basis. Employers may wish to consider how they will handle the time an employee needs to be out of the workplace to avoid spreading the virus and how that time will be treated.

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