The monkeypox outbreak in the United States continues to spread, infecting more than 3,500 people to date, according to the Centers for Disease Control and Prevention. Now, cases have also appeared in children.
Last Friday, the agency announced two cases of young children stateside: a toddler in California and an infant in the U.K. whose family was traveling through Washington SAR. The CDC said both infections were likely the result of household transmission.
“We’ve now seen two cases in children,” CDC Director Rochelle Walensky, MD, said in an interview with Washington post. “Those kids are doing great.”
The current outbreak is largely driven by a strain of the virus known as the West African clade. According to the CDC, it has so far been mainly spread among men who have sex with men (MSM). Currently, 99% of cases in the United States occur in the MSM population.
Vandana Madhavan, MD, MPH, Clinical Director of Pediatric Infectious Diseases at Massachusetts General Hospital in Boston, said that while it is important for MSM parents and clinicians to understand the risk of monkeypox in children , seeing a small number of cases in children is not a major problem at this time. Prevention will be key, she added, encouraging families to continue sharing information about symptoms observed at home to avoid potential transmission.
“I want the caregivers of children to be aware of these considerations,” she said, but stressed that COVID remains a more prevalent risk to children right now.
There are still many unknowns about how the current monkeypox outbreak will affect children. Although some experts say monkeypox may be more severe in younger patients, pediatric infections remain rare during outbreaks, and more information on current strains is needed to determine risk.
As more cases spread globally, providers may continue to find cases in children and other populations outside the MSM community, experts warn.
Karen Acker, MD, assistant professor of clinical pediatrics at Weill Cornell Medical Center in New York City, told MedPage Today , it is not surprising to see some cases of monkeypox in children, as “contagious infections are not usually contained in the community in which they start.”
Based on current understanding of how monkeypox spreads — through close physical contact with someone with lesions or through respiratory droplets — and how quickly the virus has spread, “it’s only a matter of time before we see cases in children,” Acker added.
Pediatric monkeypox cases have been reported in Spain and the Netherlands. Dutch researchers recently documented a case report of a 10-year-old boy who presented to the emergency room in June with 20 skin lesions all over his body, including his shoulders, forearms and cheeks. There were no signs of a rash on his mouth or genital area. The researchers determined that the source of the infection was unknown.
“Through this case description, we hope to raise clinicians’ awareness that [monkeypox] can develop in children and be present in the general population,” the researchers wrote. They recommend immediate diagnostic testing to stop the spread of the virus in the community and to vaccinate those at risk.
Aaron Glatt, MD, a spokesman for the Infectious Diseases Society of America, said pediatric infections can result from children hugging their parents or coming into close contact with an infected person. Contaminated towels or bedding can also spread the virus. But Glatter warned that other routes of transmission were unlikely. In a camp or something like that,” added Glatt, chair of the South Nassau Department of Medicine at Mount Sinai. According to Madhavan, the risk of complications from monkeypox is higher. But whether these findings can be extrapolated to the U.S. population and current strains of the virus, It’s hard to say, she points out.
“In general, monkeypox causes mild or moderate infections, but can lead to more severe disease in immunosuppressed individuals,” Aker explained, And added that children may be at risk for more severe disease, but their susceptibility to severe disease during the current outbreak is unclear.
More is needed about how Using data from current vaccines and treatments. The Jynneos vaccine, which is FDA-approved for the prevention of smallpox and monkeypox in adults, has not been tested in children, although the CDC says it is available for use in children under a special extended access protocol.
As Madhavan said, for treatment, treatment for children may be considered on a case-by-case basis. Tecovirimat (Tpoxx) is an FDA-approved drug for the treatment of smallpox in adults and children under CDC protocols Monkeypox therapy. The agency states that all monkeypox patients, especially children under the age of 8, should consider tecovirimat.
Sallie Permar, MD, chair of the Department of Pediatrics at Weill Cornell Medicine, said the tecovirimat “Mainly recommended for severe cases or people at risk of serious illness, such as young children or those with exfoliative skin or immunocompromised individuals. “
Amanda D’Ambrosio is a reporter for MedPage Today’s corporate and investigative teams. She covers maternity Section and other clinical news, and write feature stories about the U.S. healthcare system. Follow