Abstract
Dear Editor,
Monkeypox is a zoonotic disease caused by the monkeypox virus, and symptoms include fever, muscle pain, headache, fatigue, swollen lymph nodes, and the appearance of pustules and wounds on different parts of the body [[1]]. Transmission is through direct contact with infected animals or people, or through contact with fluids such as respiratory droplets [[2]].
During the coronavirus disease 2019 pandemic, there was an increase in the number of patients presenting to various rehabilitation services [[3]]. Physical rehabilitation services at health facilities must interact with patients to provide adequate care, treatment and follow-up. Additionally, there is a need to use instruments and accessories such as stretchers, mats, sheets and towels, among others.
Considering the transmission mechanisms of monkeypox, these instruments/accessories can act as fomites [[4]]. This poses high risk for both health personnel and patients, and also the population, as inappropriate use, containment and sterilization of these instruments/accessories would promote spread of the virus, turning physical rehabilitation centres into infectious hotspots.
To date, the World Health Organization has not issued guidelines focused on these high-exposure health establishments. This makes it impossible to adopt standardised measures to minimise the spread of the disease. However, practices such as adoption of single-use, disposable instruments/accessories for patients, and disposal in biosafety containers for subsequent sterilization should prevail. This should be evaluated based on practicalities at establishments, as these practices are particularly difficult to implement in countries with limited resources and budgets. Another solution could be the implementation of telerehabilitation, which has generated an adequate contribution for various types of patients [[5]], avoiding the saturation of services and reducing the possibility of contagion.
Health personnel must wear regulatory personal protective equipment at all times, with adequate changes, particularly the gloves. There is a need to train health personnel in identification of the signs of monkeypox through workshops and training. In this way, epidemiological surveillance can be carried out at the primary care level.
In summary, physical therapy healthcare facilities and services are at particular risk of exposure in the context of the monkeypox emergency. Guidelines to ensure the biosafety of healthcare personnel and patients should be issued as soon as possible by the relevant global and local entities.