As children around the country head back to school for the third time since the Covid-19 pandemic began, a different infectious disease is now spreading globally: monkeypox. Almost every single state and territory in the United States has reported cases of monkeypox, with more than 11,000 confirmed cases nationwide. And news of a day care worker in Illinois testing positive earlier this month prompted some infectious disease specialists to warn there is potential for spread in group settings like schools and day cares.
But more than 98 percent of those infected with monkeypox are adult men who acquired the virus through intimate contact with other men — and so far, less than a dozen pediatric cases have been recorded in the U.S.
Monkeypox is not spread as easily as Covid-19 or common childhood illnesses, said Dr. Ibukun Kalu, a pediatric infectious diseases specialist at the Duke University School of Medicine. It typically requires direct contact with an infected person’s rash. According to the Centers for Disease Control and Prevention, monkeypox can also spread by touching objects, fabrics and surfaces that have been used by someone with monkeypox and haven’t been cleaned, or by respiratory droplets expelled by an infected person during close face-to-face contact.
However, new data suggests that indirect contact and environmental contamination is not a major source of transmission. If someone with monkeypox comes to shared spaces like offices or schools, scientists have found that they do not leave behind enough live virus that can replicate and infect others.
Additionally, there is a vaccine and a treatment for monkeypox. The vaccine is not publicly available, but an emergency use authorization now allows children under 18 to receive the vaccine if they have been exposed or are at high risk of getting monkeypox.
Parents who are concerned about the virus may also be relieved to know that many pandemic precautions and behaviors can be repurposed to protect children against monkeypox: wearing masks in crowded indoor areas, avoiding sharing personal use items, increasing the frequency of hand washing and isolating at home when you’re sick.
It’s important to pay attention to new rashes and other symptoms, Dr. Kalu said. “Get your child assessed by a doctor if the rash starts spreading or is something you’ve not really seen on your child before.”
What to look out for
A monkeypox rash starts off as red lesions that can become raised and filled with pus. It can appear anywhere on the body, including the face, hands, feet and genitals, and sometimes resembles chickenpox (which is caused by an unrelated virus) or hand, foot and mouth disease, a common childhood rash that tends to circulate during back-to-school season.
Monkeypox cases in adults can also look like acne or sexually transmitted diseases such as herpes or syphilis, particularly if the rash is limited to just a few pustules.
Other symptoms of monkeypox include a fever, headaches, muscle aches, swollen lymph nodes and rectal pain or bleeding. Symptoms can appear up to three weeks after an exposure and last two to four weeks.
How to think about transmission risks
Though monkeypox is unlikely to spread widely in schools and day cares, parents should expect to hear of more cases spilling over to these and other settings if the disease continues to proliferate.
What to Know About the Monkeypox Virus
What to Know About the Monkeypox Virus
What is monkeypox? Monkeypox is a virus similar to smallpox, but symptoms are less severe. It was discovered in 1958, after outbreaks occurred in monkeys kept for research. The virus was primarily found in parts of Central and West Africa, but recently it has spread to dozens of countries and infected tens of thousands of people, overwhelmingly men who have sex with men.
“There will absolutely be cases that will occur in women, in children and in people who are pregnant,” said Dr. Jay Varma, a physician and epidemiologist who specializes in infectious diseases at Weill Cornell Medical School in New York City.
However, for now, children are more likely to pick up monkeypox from people they come into contact with at home than at school, Dr. Varma said. Still, a child who lives with someone with monkeypox could potentially bring the virus to their day care or school.