Monkeypox: info for parents
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I think for many of us, the idea of another contagious viral illness making the rounds fills us with dread. So before you google “monkeypox in children” or “should I get a monkeypox vaccine for my child”, let me reassure you:
there is no need to panic at this time.
But for those of you who want to learn more, here is an overview.
What is monkeypox?
Monkeypox is a zoonotic disease caused by the monkeypox virus (which is endemic in certain parts of Africa). It is related to smallpox (which has been eradicated).
The World Health Organization has declared Monkeypox a Public Health Emergency of International Concern, which has understandably made many of us worried. But I want to be clear: this designation is specifically made to allow for global cooperation, sharing information and collaborating to try to stem the spread.
Should parents be concerned about monkeypox?
There have been only 5 pediatric cases in the US during this outbreak so far. During the last outbreak in 2003, children were more likely to be admitted than adults, but everyone recovered.
Although anyone can be infected, the majority of infections are being seen in men/transgender women who have sex with men. Because prolonged close contact is required for spread, it could spread within a household if a family member was infected, though, so it is important to be vigilant in situations of close contact.
Is it serious?
The vast majority of people who are infected recover fully. As with many other infections, the clinical course can be more serious in people who are immune compromised. However, the rash can be painful and cause scarring.
What are the symptoms?
The typical progression is flu-like symptoms followed by a rash 1-3 days later. However, it is possible to get the rash at the same time as the other symptoms, or to get only the rash.
Fever & chills
Body aches
Headaches
Swollen lymph nodes (this differentiates it from smallpox)
Other flu-like symptoms: sore throat, congestion, cough, fatigue
A classic painful rash that usually develops 1-3 days after the fever begins
Red flat spots that can occur all over the body, but particularly around the genital area or on the face, hands, feet, or chest.
The red spots become bumps and then turn into fluid-filled lesions. These eventually crust over, but it can take 2-4 weeks to get to this point.
How is monkeypox spread?
A person without symptoms will not spread the infection, but a symptomatic person will be contagious until the rash has fully healed (ie all the scabs have healed and fallen off with new healthy skin underneath). This can take several weeks.
Monkeypox can be spread via:
Direct contact with infected skin lesions or body fluids
Shared surfaces such as bedding, towels, utensils
Prolonged exposure (several hours) to respiratory droplets, ie. prolonged face-to-face contact
Placental transmission during pregnancy
Scratches or bites from infected animals
Incubation period
Typically after exposure, a person will develop symptoms within 1-3 weeks.
Preventing transmission
Avoid close (skin-to-skin) contact with people who have a suspicious rash.
Wash hands often with soap and water
Minimize contact with sick people
If you suspect you have been exposed, reach out to your healthcare provider
If you cannot avoid contact with an infected person, follow the latest CDC recommendations to minimize transmission
What about the vaccine?
Because of similarities between smallpox and monkeypox, the existing smallpox vaccines can be used.
There are 2 vaccines licensed by the FDA for this purpose (Jynneos, ACAM2000), but for now they are only recommended for those who have been exposed or are at higher risk of contracting the infection.
There is no reason to give it to children routinely at this time.
How is monkeypox treated?
Like many other viruses, treatment focused on supportive care and managing complications and discomfort (such as ensuring hydration and minimizing pain, and treating secondary infections).
For people at high risk for more severe infections, antiviral medications such as tecovirimat (which are used for smallpox) can be used as well.
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