Monkeypox and kids: How at risk are they?

As if one global pandemic isn’t enough to worry about, the Biden administration officially declared monkeypox a national health emergency on Thursday. To date, there are 7,102 confirmed monkeypox cases in the U.S., according to the Centers for Disease Control and Prevention. What does this mean for parents? Well, there’s no need to panic just yet. We talked to a doctor to learn more.

“Compared to COVID 19 and other childhood viruses, like the flu and RSV [respiratory syncytial virus], monkeypox does not transmit between people very easily,” says Dr. Larry Kociolek, medical director of infection, prevention and control and attending physician in infectious diseases at Ann & Robert H. Lurie Children’s Hospital of Chicago. “Currently, there are 10 pediatric cases across the globe and two reported cases in the U.S.”

What is monkeypox and what are the symptoms in kids?

Monkeypox is a rare disease caused by the monkeypox virus. In general, monkeypox presents similarly in adults as in children—with fever, swollen lymph nodes, and skin lesions throughout the body. Rashes are the most common symptom for monkeypox and can look similar to other rashes commonly found in children.

Symptoms typically start within three weeks of exposure and illness usually lasts two to four weeks. Most cases are mild and do not require hospitalization, but severe cases can occur in people with weakened immune systems.

How is monkeypox transmitted?

The easiest way to transmit monkeypox is through direct contact with skin lesions. “It’s not transmitted through casual contact,” says Kociolek, adding the disease is not easily shared by touching common household items, such as door knobs and handles. “You’re not going to get monkeypox with brief face-to-face interactions with people who have monkeypox, you’re going to get it from really prolonged direct close contact with somebody who’s been affected.”

If I catch monkeypox, how can I prevent passing it on to my child?

Preventative measures for monkeypox are similar to the same actions you would take for other common infections: staying home when you’re sick, avoiding contact with other sick people and frequently washing your hands with soap and water for 20 seconds, especially before eating.

If you suspect you may have monkeypox, it’s important to contact your doctor immediately. 

“Testing is much more readily available now than it was even a month ago,” says Kociolek. “If you do suspect, or have been told you have monkeypox, the most important way to prevent spreading it is by keeping skin lesions covered and not sharing items that have had contact with skin lesions with other people, such as bed linens, towels and clothing.”

While it’s believed that monkeypox is more difficult to spread through a respiratory route like COVID-19, it is possible, so if you do become infected it’s important to wear a mask and socially distance yourself from other individuals in a household. That being said, the suggested isolation for monkeypox is much longer than other viruses.

“You can transmit monkeypox for as long as the skin lesions are present, which can be as long as four weeks,” Kociolek explains.

What is the risk for my kids? 

“The likelihood of anyone’s child getting monkeypox right now is exceedingly low,” says Kociolek. “So the vast majority of rashes in children are going to be from other infectious or noninfectious causes.”

However, if you have reason to believe your child has been exposed, or is developing a rash that’s consistent with monkeypox, then you’ll want to contact your pediatrician for further guidance and take measures to avoid spreading the disease to other people.

Are some children at a higher risk?

According to the American Academy of Pediatrics (AAP), some children, including infants, children under 8 and those with skin conditions, such as eczema, and those who are immunocompromised, may be at an increased risk of serious illness if they were to contract monkeypox.

Is there treatment or vaccine available?

Yes, for children who have a severe case of monkeypox, or those who are at risk for severe disease, a treatment is available. “Tecovirimat is the first-line treatment and is being used under an investigational protocol,” according to the AAP. “The CDC recently streamlined the process to obtain it. It is available in both oral and intravenous forms.”

While there is currently not a monkeypox vaccine available to all children, the JYNNEOS vaccine may be recommended for children under 18 who have been exposed to monkeypox. 

How concerned should I be about my child getting monkeypox?

“Right now, the concern is exponentially higher than the risk,” says Kociolek. “People have a lot of vigilance right now for emerging diseases coming out of this COVID pandemic and there’s a lot of media attention around monkeypox as well. But in reality, the risk to a child is exceedingly low.”

For comparison, there are 10 known cases of monkeypox in children worldwide, whereas hand, foot, and mouth disease, which is common in children under 5, is caused by enterovirus, of which there are roughly 15 million reported cases in the U.S. each year. 

“And that’s only one cause of the hundreds of causes of rashes in childhood,” says Kociolek. “Just to put it into perspective.”