5 Things Parents Need to Know About Monkeypox

Students are back in the classroom as yet another infectious disease spreads across the globe: monkeypox. Health experts, however, say there’s no reason to panic.

Currently, the majority of monkeypox cases have occurred in adults, and cases in children are rare. Monkeypox is not expected to have as wide of a reach as COVID-19 because it requires prolonged close contact for transmission.

David Wohl, MD, a UNC Health infectious diseases specialist, shares what you need to know about monkeypox and what it means for students who are back at school.

1. Monkeypox requires close contact with an infected person for transmission.

Unlike COVID-19, which spreads through small particles in the air, monkeypox spreads mostly through skin-to-skin contact.

Other less-common ways that monkeypox is thought to spread include breathing in droplets produced when an infected person sneezes or coughs; touching objects that are contaminated with the virus, including bedding, clothing or shared eating utensils; and, rarely, from an infected pregnant woman to her fetus.

To date, most cases of monkeypox in the United States have been in men who have sex with men. But we know that the virus is likely to be seen in other populations.

2. Children are not in a high-risk category for infection.

Although many parents might be concerned about transmission of monkeypox during close contact in schools, such as during sports, right now the virus has not spread to school-age children. A very small percentage of monkeypox cases in the United States have occurred in children.

“The risk of children getting infected with monkeypox infection remains very low,” Dr. Wohl says.

A handful of children have become infected through household transmission, meaning they caught it from someone living in their household.

If you have an adolescent or teenager who is sexually active, it’s important to make sure they know the signs of monkeypox (see No. 5). Encourage them to have an open conversation with any sexual partners to make sure they don’t have any lesions or other signs of the disease.

3. Many of the preventive measures for COVID-19 work against monkeypox.

Dr. Wohl says widespread outbreaks in schools and day care centers are unlikely, thanks in part to the protocols in place to combat COVID-19.

“If community transmission rises, it is possible more cases could start to appear in day cares and schools,” Dr. Wohl says. “However, parents should take comfort in the fact that many of the preventive measures that have been put into place for COVID-19, including masking in crowded areas, frequent hand-washing, disinfecting commonly touched surfaces and staying home while sick, will also work against monkeypox.”

Practicing those preventive measures at home helps, too.

If someone at your child’s school becomes infected with monkeypox, protocols should include thorough cleaning and isolation of any staff or children who were potentially exposed, Dr. Wohl says.

It’s reassuring to note that after a day care worker in Illinois tested positive for monkeypox, no other children or staff caught the virus. A vaccine was offered to anyone who had potentially been exposed.

4. There is a vaccine and treatment available for monkeypox.

According to the American Academy of Pediatrics, treatment is available for monkeypox, especially for those who have severe disease—lesions in the eyes, mouth, genitalia or anus or complications from the virus—or who are at risk for severe monkeypox disease.

People at risk for severe monkeypox disease include those who:

  • Are younger than 8 years old
  • Have an immunocompromising condition
  • Have a history of certain skin conditions, such as eczema

TPOXX (tecovirimat) is an antiviral medication that was approved for treatment of smallpox and, based on studies in animals, is expected to be effective in treating monkeypox. Most people don’t need this medicine, though, as the majority with monkeypox recover fully without treatment.

Children, however, may become sicker than adults if they get monkeypox, and TPOXX can be used in kids.

Vaccines that have been made to prevent smallpox also can work to prevent monkeypox. These vaccines can be given before to people at high risk of infection or after an exposure to someone with monkeypox.

5. Pay attention to any new skin changes.

The most common symptom of monkeypox is a skin blister or ulcer. Some might have only a few lesions—or even a single one—on the penis, anus, hands, feet, arms, legs or face. Sometimes blisters form on the palms or soles of the feet, which are unusual places to have a rash.

The blister usually starts with a bump that has fluid inside. The bump may then open and form an ulcer or crater in the skin that is painful. The ulcer eventually becomes dry and scabs. Some but not all of those diagnosed with monkeypox have felt sick with fever, headaches, tiredness or swollen glands. These symptoms may occur before any skin lesions appear.

Contact your doctor if you notice any unusual skin lesions, Dr. Wohl says, especially if they occur along with a fever.

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