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Case Study Addressing mpox at a Frontline Community Health Center: Lessons for the Next Outbreak

A new case study published in Sage Journals explores the changes in clinical practices and programs implemented by Fenway Health during the mpox outbreak and discusses the valuable lessons that can inform strategies for future outbreaks. The 2022 mpox (formerly monkeypox) outbreak posed a significant public health challenge, with a particular impact on men who have sex with men (MSM). Fenway Health found itself at the forefront of this outbreak. The health center serves close to 10,000 MSM annually, which includes more than 2,400 MSM who are living with HIV and 3,320 MSM with active HIV preexposure prophylaxis (PrEP) prescriptions.  

Fenway Health was quick to act in response to the mpox outbreak. The health center diagnosed its first case in June 2022 and administered tecovirimat as treatment. The Massachusetts Department of Public Health (MDPH) designated Fenway Health as one of the first of four facilities to offer vaccinations to people exposed to mpox and at high risk of mpox infection. In early July, Fenway Health used its first dose of the Jynneos vaccine under the Emergency Use Authorization for protection against mpox. As of October 6, 2022, Fenway Health had diagnosed 69 individuals with mpox, with a major identifying factor as male and a significant proportion as gay or bisexual. 

Fenway Health implemented a range of programmatic changes during the mpox outbreak. These changes included staff training, diagnostic protocols, and vaccination strategies based on evolving CDC and MDPH recommendations. The health center’s approach to treating patients with mpox lesions and the rollout of the Jynneos vaccine evolved over time to adapt to the dynamic situation.  

Recognizing the importance of community engagement, Fenway Health initiated a comprehensive education campaign targeting MSM and other populations at risk. Trained nurses were available for questions through various communication channels, including social media, emails, text messages, and phone calls. To accommodate workload, Fenway Health drafted staff from other departments to assist with the vaccination efforts by reassigning occupational health staff to do clinic check-ins.  

Targeted efforts were made to engage racial and ethnic minority communities. Fenway partnered with the city and state public health departments and organized several community forums and webinars. Numerous social media and blog postings highlighted relevant information and Fenway staff reached out to people at high risk of mpox through emails, text messages, and telephone calls. 

The review of Fenway Health’s experience with the mpox outbreak was published in the most recent issue of Public Health Reports. The research team reviewed electronic medical records and other clinic data sources to describe the response to  mpox cases at Fenway Health. As of October 6, 2022, 69 cases had been diagnosed, and 6,376 doses of the Jynneos vaccine had been administered. The study noted that some individuals who reported prior Jynneos vaccination developed mpox, raising the question of whether boosting may be need in the future. The paper also highlighted the importance of community engagement and education to address emerging epidemic challenges. 

 Fenway Health’s experiences during the 2022 mpox outbreak revealed several key lessons for addressing infectious disease outbreaks. The main lessons learned include resource allocation, community engagement, and early intervention. Public health authorities play a vital role in determining the effectiveness and sustainability of frontline responses. Fenway Health’s proactive and adaptive response to the mpox outbreak demonstrates the importance of pandemic contingency plans to minimize disruptions in routine care during outbreaks. Collaboration between health centers and public health authorities is essential for an efficient response to emerging infectious diseases. 

You can read the case study “Addressing mpox at a Frontline Community Heath Center: Lessons for the Next Outbreak” online (Note: the full case study is behind a paywall). 

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