The True Story: Two Deaths in Two Days

In late July 2022, Spain reported its first mpox-linked death, and on 30 July 2022 it reported a second, at a time when Spain was one of the countries with the most cases in Europe.

Although most patients had mild illness, some needed hospital care and were transported by ambulance. Every transfer is a moment when staff are in close contact with the patient.

The Key Lesson: An Ambulance Is a Small Room Used by Patient After Patient

Rescue vehicles and ambulances in Thailand carry several patients a day. Points to watch are:

• Stretchers and mattresses in direct contact with patients' skin
• Blankets and stretcher sheets that must be changed every case
• Vital-signs equipment including blood-pressure cuffs, oxygen and monitors
• Handles, rails and control panels in the patient bay touched during the trip
• Staff uniforms that may be contaminated and taken back to base

How Mpox Spreads

According to the World Health Organization, mpox spreads mainly through close contact with an infected person's skin or sores, and can also spread through contaminated objects such as clothing, bedding and towels. Mpox is an enveloped virus, which suitable disinfectants can inactivate.

Risk Register for Ambulances and Rescue Units

1. Stretcher mattress not disinfected between cases: likelihood high / impact high / level critical. Mitigation: wipe and disinfect stretcher and mattress every case before the next patient. Owner: shift leader
2. Stretcher sheets and blankets reused: likelihood medium / impact high / level high. Mitigation: use single-use linen or change every case. Owner: vehicle crew
3. Crew unaware the patient has a suspicious rash: likelihood medium / impact high / level high. Mitigation: ask about rashes at dispatch and wear full PPE. Owner: dispatch centre
4. Vital-signs equipment not wiped: likelihood high / impact medium / level high. Mitigation: wipe cuffs and devices with an equipment-safe disinfectant. Owner: vehicle nurse
5. Patient bay never disinfected as a whole: likelihood medium / impact medium / level medium. Mitigation: fog the patient bay on a schedule and after suspected cases. Owner: base manager

Ways to Reduce Risk for Ambulances and Rescue Units

1. Ask about rash and fever at dispatch
2. Wear gloves, gown and mask for suspected cases
3. Change stretcher linen and blankets every case
4. Wipe stretcher, rails and handles before the next patient
5. Disinfect vital-signs equipment every time
6. Bag contaminated uniforms and linen separately before returning to base
7. Fog the whole patient bay on a schedule

How ULV Fogging Helps

The World Health Disinfection disinfection service uses ULV fogging machines that turn the disinfectant into a fine mist. It settles across the whole area, including corners, curtains, upholstery and surfaces that hand wiping cannot fully reach.

• Whole-area coverage without relying on wiping spot by spot
• Quick return to use, typically about 30 minutes after fogging
• The team wears full protective equipment, so owners and staff do not take the risk themselves
• Report and photos after the job to show customers, management or authorities
• Tax invoice with 3% withholding tax for companies and agencies
• More than 5 years of experience in hospitals, offices, hotels and public buildings

The Disinfectant We Use: Chemgene HLD4H

The team uses Chemgene HLD4H. According to WHD's product page, it meets the EN 14476 standard for virucidal activity, is used in NHS hospitals in England, and is endorsed by Mahidol University. We do not claim that Chemgene has been tested against mpox specifically. But mpox is an enveloped virus, which suitable disinfectants can inactivate when used at the manufacturer's stated concentration and contact time.

• No harsh bleach smell
• Works on many surfaces, from desks and counters to handles and equipment
• Can be bought for daily wiping of high-touch points

Before and After

Frequently Asked Questions

Q: When did Spain report its second death? A: On 30 July 2022, one day after reporting the first. Q: When can an ambulance be used after fogging? A: Usually about 30 minutes after fogging. Q: Does Chemgene HLD4H kill mpox? A: It is not claimed to be tested against mpox specifically, but it meets EN 14476 for viruses, and mpox is an enveloped virus. Q: Can rescue units or foundations get a tax invoice? A: Yes. Tax invoices are issued and 3% withholding tax is supported. Call 065-556-6294 or LINE @whd268.

Related Links and Sources

• World Health Disinfection disinfection service
• Chemgene HLD4H disinfectant and price
• Mpox information from Thailand's Department of Disease Control, hotline 1422
• WHO mpox fact sheet

Prevent It with a Disinfection Service and Chemgene HLD4H

The true story from Spain is a reminder that some mpox patients become seriously ill and need transport. Ambulances disinfected properly after every case protect both crews and the next patient. Prevent it with the World Health Disinfection disinfection service for ambulances, rescue vehicles and operating bases, and Chemgene HLD4H disinfectant for wiping stretchers, grab rails and vital-signs equipment.

Call 065-556-6294 | LINE: @whd268