Top 5 Takeaways

  1. Among 313 Health Care Personnel (HCP) in Colorado exposed to monkeypox patients, only 23% wore all recommended Personal Protective Equipment (PPE).
  2. HCP were actively monitored for 21 days; none developed monkeypox, indicating a very low risk of transmission in healthcare settings.
  3. PPE use varied by facility, with highest adherence in sexually transmitted infection clinics and community health centers.
  4. Only 48% of HCP eligible for postexposure prophylaxis (PEP) with the JYNNEOS vaccine received it.
  5. The study underscores the need for improved infection prevention education and training, especially in primary and urgent care settings.


This MMWR Article was created prior to the conventional renaming of Monkeypox to its more standard and appropriate name, Mpox. To avoid confusion, Monkeypox is retained when writing this article, but all future works should use Mpox.

Original Article Author and Citation

Corresponding Author

Kristen E. Marshall,

Suggested Citation

Marshall KE, Barton M, Nichols J, et al. Health Care Personnel Exposures to Subsequently Laboratory-Confirmed Monkeypox Patients — Colorado, 2022. MMWR Morb Mortal Wkly Rep 2022;71:1216–1219. DOI:


The report investigates 313 HCP exposures to monkeypox patients in Colorado between May 1 and July 31, 2022. Despite the low adherence to recommended PPE (only 23% wore all recommended PPE), there were no cases of monkeypox transmission to HCP. This suggests a low risk of transmission in healthcare settings.


Data were collected on clinical and nonclinical HCP who treated, were in close proximity to, or handled linens from patients subsequently diagnosed with monkeypox. The Colorado Department of Public Health and Environment conducted interviews, reviewed medical records, and assigned risk levels using CDC criteria. HCP with high or intermediate risk exposures were offered PEP and actively monitored for symptoms.


The study revealed significant variations in PPE use across different healthcare settings. STI clinics and community health centers reported higher adherence compared to primary and urgent care settings. The findings highlight the importance of infection prevention training and awareness among frontline HCP, especially considering the lower adherence to PPE recommendations in certain settings.


The study emphasizes the very low risk of monkeypox transmission to HCP, despite incomplete adherence to PPE guidelines and lower receipt of PEP among eligible HCP. It also underscores the need for improved public health outreach, infection prevention education, and training, particularly in primary and urgent care settings.


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