Tackling a New and Emerging Threat in Commercial Laboratories: Monkeypox Virus

Understanding the Monkeypox Challenge 

A new and emerging viral threat has started to infiltrate countries around the globe. Monkeypox is a virus originating in the West and Central regions of Africa and is known for causing pox-like lesions on a person’s skin. Along with these lesions, a patient may also have a fever, muscle aches, swollen lymph nodes, and a headache (CDC 1). While this virus has been around for many years, it has begun to uncharacteristically spread to non-native areas throughout Europe, North America, and South America, infecting more than 2,103 individuals along the way (WHO 1). The virus can be transmitted through close contact with infected lesions, bodily fluids, and respiratory droplets. It can also be spread through contaminated materials and fomites. There are 2 main clades (a group of organisms that includes all descendants of one common ancestor) of the virus known as the West African clade and the Central African clade. Currently, the majority of individuals in the ongoing outbreak are being infected with the West African clade which is much less severe and holds only a 3% mortality rate (WHO 1). Diagnosis requires samples to be sent for PCR testing in a laboratory and careful attention to infection control measures are needed to prevent exposure.

Laboratory Involvement and Needs for Contamination Control in the Monkeypox Outbreak

A new move from public health officials will now allow commercial labs to begin processing and confirming Monkeypox cases throughout the United States. Dealing with this sensitive and pathogenic virus requires extra preventative measures to be taken to ensure the safety of staff and requires the use of either BSL-2 or BSL-3 precautions depending on smallpox vaccination status. Vaccination, Vaccine, Smallpox The smallpox vaccine is approximately 85% effective in preventing the development of Mokeypox and can be given up to 4 days after a person is exposed to the virus to halt symptoms from developing (CDC 1). Augmenting existing containment processes by implementing gaseous high-level decontamination helps reduce the risk of exposure and prevent cross-contamination when handling samples of Monkeypox and from patients under investigation. Furthermore, samples may contaminate commonly used equipment, such as biological safety cabinets (BSCs), centrifuge rotors, incubators, microscopes, and cups. Therefore, comprehensive decontamination is imperative.

  • BSCs are crucial when working with many pathogens, including Monkeypox, because they allow the staff to safely handle the sample by providing a barrier between the sample and person. According to the CDC, Class II BSCs are used most often when handling the Monkeypox virus. Inactivating the virus sample is also completed inside of the BSC to prevent accidental exposures.
  • Centrifuges are another important piece of equipment that is used frequently when conducting Monkeypox virus testing. The laboratory personnel use sample cups or sealed rotors as a safety precaution when dealing with the virus.

Understanding Current Methods for Laboratory Biodecontamination

Traditional biodecontamination of BSL-2 and BSL-3 laboratories often employ manual cleaning using caustic chemicals like quaternary ammonium compounds (QUATs) and sodium hypochlorite (bleach), or peracetic acid mixtures. Manual methods are of particular concern because certain areas of a workspace may be missed when wiping due to human error. Furthermore, QUATs have been linked to pathogen resistance of common laboratory pathogens and can generate sticky biofilm that can worsen this issue (Huff 1, Jia 1). Vaporous hydrogen peroxide (VHP) decontamination is also a popular option but high concentrations of VHP like 35%-59% solutions can be less desirable than lower concentrations. While highly efficacious, these chemicals can lead to degradation of expensive laboratory equipment and increase the risk of exposure to staff.

  • When used in high levels, VHP can cause degradation to metals and synthetic rubbers.
  • Higher concentrations of hydrogen peroxide may also require longer dissipation times.

A Safer Solution for Comprehensive and Effective Decontamination of Laboratory Spaces

CURIS System’s Hydrogen Peroxide Technology™ (HHP™) technology delivers a powerful combination of vaporous and micro-aerosolized hydrogen peroxide to each space for validated, repeatable results. HHP™ systems target even the highest level of pathogens,* including emerging viral pathogens like Monkeypox (a tier 1 enveloped virus) and can be found on the EPA’s Q list. CURIS automated disinfection offers remote portable systems which can be operated from outside of the laboratory space, providing a high-level safer mode of decontamination for staff.  Additionally, fixed systems for integration into facilities can improve contamination control efforts by offering on demand biodecontamination to virtually any lab space. CURIS devices can provide high-level decontamination of a commercial laboratory space and achieve a 6-log reduction, targeting and penetrating deep within the plenums of difficult equipment that is used in the handling of Monkeypox samples like BSCs, centrifuges, and incubators without having to use caustic chemicals or manual cleaning. These high-level biodecontamination treatments can be easily validated in real time using Geobacillus stearothermophilus biological indicators. CURIS is no stranger to the world of high-level laboratory decontamination and has worked closely with well-established and trusted BSC and isolator manufacturers to ensure compatibility and maximum efficacy. CURIS System devices can also save your facility time and money by allowing for the simultaneous decontamination of both BSCs and the laboratory space.

To learn more about how your commercial lab can implement CURIS System decontamination devices, read our study on the Decontamination of a Room, its Contents, and HEPA Filter.

*C. diff in a tripart soil load

 

References

World Health Organization. (2022, May 21). Multi-country monkeypox outbreak in non-endemic countries. World Health Organization. Retrieved July 19, 2022, from https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON385

Centers for Disease Control and Prevention. (2022, July 13). Frequently asked questions- Monkeypox. Centers for Disease Control and Prevention. Retrieved July 19, 2022, from https://www.cdc.gov/poxvirus/monkeypox/faq.html

Centers for Disease Control and Prevention. (2022, June 2). Monkeypox and smallpox vaccine guidance. Centers for Disease Control and Prevention. Retrieved July 27, 2022, from https://www.cdc.gov/poxvirus/monkeypox/clinicians/smallpox-vaccine.html 

World Health Organization. (2022, June 17). Multi-country Monkeypox Outbreak: Situation update. World Health Organization. Retrieved July 19, 2022, from https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON393

Citation: Huff, Jon. “The Problem With Quaternary Disinfectants.” EnvirOx, EnvirOx, 22 June 2020, www.enviroxclean.com/blog/the-problem-with-quaternary-disinfectants.

Jia, Y., Lu, H., & Zhu, L. (2022, April 6). Molecular mechanism of antibiotic resistance induced by mono- and twin-chained quaternary ammonium compounds. Science of The Total Environment. Retrieved May 12, 2022, from https://www.sciencedirect.com/science/article/pii/S0048969722021830