Development and deployment of tools for rapid response notification of Monkeypox exposure, exposure risk assessment and stratification, and symptom monitoring

• Published in: Infection control and hospital epidemiology Vol. 43; no. 8; pp. 963 - 967
• Main Authors: Simpson, Lynn A., Macdonald, Kaitlin, Searle, Eileen F., Shearer, Jennifer A., Dimitrov, Dimitar, Foley, Daniel, Morales, Eduardo, Shenoy, Erica S.
• Format: Journal Article
• Language: English
• Published: New York, USA Cambridge University Press 01.08.2022
• Subjects: Call centers; Coronaviruses; Counseling; COVID-19 vaccines; Design; Disease control; Disease prevention; Electronic health records; Emergency preparedness; Exports; Exposure; Health facilities; Health services; Humans; Immunization; Infections; Infectious Disease Transmission, Patient-to-Professional - prevention & control; Monitoring; Mpox; Mpox (monkeypox) - diagnosis; Mpox (monkeypox) - epidemiology; Occupational Exposure - prevention & control; Occupational health; Original Article; Outbreaks; Pathogens; Post-Exposure Prophylaxis; Prophylaxis; Public health; Risk Assessment; Software; United States; Workforce planning; United States; United States > US; Massachusetts
• ISSN: 0899-823X; 1559-6834; 1559-6834
• DOI: 10.1017/ice.2022.167

Public health authorities recommend symptom monitoring of healthcare personnel (HCP) after defined exposures to monkeypox. We report on the rapid development and implementation of mobile responsive survey solutions for notification of possible exposure, exposure risk assessment and stratification, and symptom monitoring. An academic health center in Boston, Massachusetts, after admission of first diagnosed case of monkeypox in the United States during the current global outbreak. Research Electronic Data Capture (REDCap) design and programmers, infection control, occupational health, and emergency preparedness specialists, and HCP with possible exposure to monkeypox. Design and deployment of REDCap tools to identify HCP with possible exposure to monkeypox, to perform exposure risk assessment and stratification for postexposure prophylaxis (PEP), and to conduct symptom monitoring during the exposure window. Project enhancements included dashboards for HCP tracking and short message service (SMS text) reminders for symptom monitoring. Tools to support the contact tracing and exposure investigation were deployed within 24 hours of identification of a patient with suspected monkeypox, with the full suite in production within 4 days of confirmation of the monkeypox diagnosis. Clinical follow-up of HCP was integrated into the design, and real-time versioning allowed for improvements in HCP symptom monitoring compliance and enhanced tracking. During the current monkeypox outbreak, timely and comprehensive evaluation of potential HCP exposures is necessary but presents logistical challenges. Rapid development of monkeypox-specific solutions using REDCap facilitated flexibility in design and approach, and integration of targeted clinical support enhanced functionality.