States Build on COVID Lessons for Monkeypox Tracking

State governments have been busy handling public health emergencies since the outbreak of COVID-19, and the spread of monkeypox infections has brought back statewide dashboards to track case information. 

In developing monkeypox dashboards, which record case numbers, vaccinations and demographic data just as many COVID-19 dashboards did, some agencies have drawn on lessons learned from previous dashboards to guide their efforts. 

The Ohio Department of Health (ODH) was able to create its monkeypox dashboard by building on processes used to track COVID-19 and the Ohio Disease Reporting System, public information officer Ken Gordon said. The ODRS is the state’s electronic disease surveillance system that follows reportable conditions across Ohio. 

“Using existing pathways and processes did make it easier to set up the monkeypox dashboard,” Gordon said. “It is important to note that with monkeypox, we are using the same processes for disease investigation and reporting that we have had in place for a long time.” 

The ODH is collecting data on cases, hospitalizations and any other elements required by the Centers for Disease Control and Prevention or are pertinent to the state’s investigation, Gordon said.

At first, ODH did not share details when case numbers were low to avoid identifying patients or violating medical privacy laws. Since the dashboard’s release in late August, however, Gordon said “case numbers now are at a point where we have been able to report locations on a county level on our dashboard.”

The Colorado Department of Public Health and Environment also leaned on its experience with COVID-19 tracking to build its monkeypox site, which was deployed in August. CDPHE is “taking advantage of many of the same workflows and visualization tools that we used to create and expand our COVID visualizations,” said Paul Galloway, marketing and communications manager.

Like Ohio, CDPHE limits exposure of identifiable information by not publicly reporting small case numbers in counties, unless they exceed three. The state only releases aggregated case and vaccine data as well as state-level demographic information such as sex and age ranges “to help us focus our response and resources to where and who has the greatest need,” Galloway said. 

The CDPHE relies on case interviews, vaccine clinics, patient health care providers, local public health agencies and labs that offer monkeypox testing to compile data on case numbers, age, county, gender identity, race and ethnicity, vaccine administration and distribution and whether individuals were hospitalized. 

Labs must alert the department of positive cases and vaccine providers submit immunization and vaccination data through the online Colorado Immunization Information System. 

The District of Columbia Department of Health also launched a monkeypox website last month. While it is “completely new,” the department learned from its successful COVID-19 system to ensure “data integrity and a timely weekly cadence.” 

Data is provided by commercial labs, hospitals and public health centers that submit vaccine, hospitalization and case information through “a secure disease surveillance and management system,” the department said. The reports are then analyzed by the epidemiology team.

Information is obtained from case interviews and electronic health records, according to the District's monkeypox data guide. Similar to Colorado, the district tracks monkeypox across age, gender identity, race and ethnicity, sexual orientation and ward. 

If there are fewer than five individuals reported, the dashboard will indicate that without providing specific figures in order to shield patient confidentiality. 

The CDC has watched and recorded monkeypox numbers since the start of the U.S. outbreak in Boston in May. The U.S. is recognized as having the highest recorded case numbers at more than 20,000 across all 50 states.