What parents should know about the risks of monkeypox for kids

Since the monkeypox outbreak in the U.S. began in May, more than 7,500 Americans have contracted the virus, according to the latest data by the Centers for Disease Control and Prevention. At least five children in the U.S. have been diagnosed with the disease so far, including two in California, two in Indiana and an infant who was traveling through Washington, D.C.

On Friday, health officials in Illinois said they were screening children and others who were potentially exposed to monkeypox at a day care center after one of its employees tested positive.

Though the Biden administration declared monkeypox a public health emergency on Thursday, the number of pediatric cases so far has been small. Many parents, however, have started to become concerned about monkeypox, especially as children have begun returning to school.

To help offer guidance on monkeypox and how it may affect children, Yahoo News spoke to Dr. Charles Mitchell, a pediatric infectious disease specialist at the University of Miami Health System, and Dr. Monica Gandhi, an infectious disease doctor and professor of medicine at the University of California, San Francisco.

How worried should parents be about monkeypox?

Children, Gandhi said, are at very low risk from monkeypox, which is rarely fatal. To date, no deaths have been reported in the U.S. since the outbreak began.

“There have been five cases in children, but that's actually an extremely rare event,” she said.

The majority of cases, some 98.3% of them, Gandhi said, have been among men who have sex with men. The virus has been spreading primarily through close skin-to-skin contact among this segment of the population, health experts have said.

In addition, Mitchell told Yahoo News that while the number of monkeypox cases in the U.S. is increasing, the virus is not going to “have the impact, especially in children, that COVID-19 has had,” adding that “it is nowhere near in terms of degree of contagiousness as COVID-19.”

“I don't think I would be unduly alarmed,” Mitchell said.

What are the symptoms?

Symptoms of monkeypox can include fever, severe headaches, muscle aches, back pain, exhaustion, swollen lymph nodes and skin rashes or lesions. The virus can cause painful and debilitating symptoms, but around 90% of people usually survive it on their own without any complications, according to health experts.

The skin lesions from monkeypox are very infectious, but most people resolve them within two to four weeks. Someone is considered infectious until their lesions have crusted and the scabs have fallen off, according to the CDC.

Young children under the age of 8, particularly those with eczema and other skin conditions, and children with immunocompromising conditions may be at increased risk of severe disease, according to the agency.

Mitchell said that because their immune systems are not fully developed, children may be more vulnerable to developing severe disease from monkeypox than adults.

How can monkeypox spread to children?

Monkeypox spreads through physical contact with an infected person, particularly if one comes in direct contact with another's skin lesions or body fluids. It can also spread through respiratory droplets or aerosols produced by sneezing or coughing, but experts have said this would require very close and prolonged contact in close quarters with an infected person.

In addition, monkeypox can spread by sharing items like towels, clothes or bedsheets used by someone with a monkeypox lesion.

Gandhi said that the five cases of monkeypox in children reported in the U.S. are likely the result of household transmission via parents.

“This was likely very close person-to-person contact between a child and their parent who had an active monkeypox lesion, probably a gay male parent,” Gandhi said.

The best way to protect children right now, Mitchell said, is to make sure they are not exposed to anyone with the disease. “If, in fact, there is somebody who is a friend, a family member, who appears to have the lesion, I would restrict contact with the individual,” he said.

Another way to protect children from monkeypox, Gandhi explained, is for parents to protect themselves and get vaccinated if they are at high risk for contracting the disease.

“I think the most important thing is to protect the adults that are around the children,” she said.

According to the CDC, those who are more likely to get monkeypox are people whose sexual partners have been diagnosed with monkeypox in the past two weeks, and individuals who had multiple sexual partners in the past two weeks and live in an area where transmission is currently high.

Others at risk include people whose jobs may expose them to monkeypox, such as some laboratory workers conducting testing for orthopoxviruses and “some designated health care or public health workers,” the agency said.

“If you're up for vaccination as a gay male, please get vaccinated because then you won't get the infection at all,” Gandhi said.

What about wiping down surfaces? Should parents avoid taking children to shared public spaces such as playgrounds?

At the moment, children are not likely to get monkeypox through contact in public spaces such as schools and playgrounds, Gandhi said, since the virus is mainly spreading through very close and prolonged skin-to-skin contact. Parents should not be concerned about disinfecting surfaces or taking their children to public places for fear of contracting monkeypox.

“Casual contacts — sitting on a plane, sitting next to someone is not how you get this virus,” she said. “In fact, we would have many more cases — I mean, in the probably million range or more, if this was spread as readily as COVID-19.”

Are there any monkeypox treatments or vaccines for children?

There is currently a vaccine for monkeypox called Jynneos that is only available to adults ages 18 and older. However, the shot can be given to children who have a known exposure on a case-by-case basis, with a special authorization from the Food and Drug Administration that according to the CDC can be acquired in coordination with state and local health departments and their agencies.

The CDC says on its website that Jynneos has “been administered to some children in the United States during the current outbreak without any adverse events to date.”

Gandhi said an antiviral medication called tecovirimat, or Tpoxx, can also be given to children and adolescents who may develop severe disease or have underlying medical conditions that put them at risk for severe disease from monkeypox.