By David W. Kimberlin, Ph.D., Member, American Academy of Pediatrics & Kristina A. Bryant, Ph.D., Member, American Academy of Pediatrics
Monkeypox (Mpox) – The rash caused by this virus can look like chickenpox, herpes simplex virus, allergic rash, hand, foot and mouth disease caused by enterovirus, or molluscum. The name "monkeypox" comes from the fact that it was discovered in the 50s of the 20th century in a group of monkeys used for research. In 1970, monkeypox was first detected in humans.
The United States has designated the current monkeypox outbreak as a public health emergency. More than 81,225 cases have been reported globally. In the United States, there have been nearly 30,000 confirmed cases of monkeypox and 15 deaths. At least 59 U.S. cases involve children and adolescents aged 15 years and younger, and a further 641 cases have been reported in young people between the ages of 16 and 20.
How do people get monkeypox?
Anyone can get monkeypox. The most common mode of transmission is through physical contact with the rash, or through items or materials that have been in contact with the rash (e.g., blankets, furniture, clothing, etc.). It can also be spread through large amounts of respiratory droplets from an infected person, especially during prolonged face-to-face contact. This is more of a risk for household contacts and close contacts. Monkeypox does not spread through casual conversations with an infected person or walking past an infected person in a supermarket.
A person is contagious from the onset of symptoms until the scabs of the rash fall off and the skin heals completely, forming a new layer of skin.
Anyone who has had close contact with someone with monkeypox, including sexual contact, can contract the disease. The infection can also spread between people and their pets.
Should you be concerned about monkeypox in schools or childcare?
The risk of monkeypox infection in children and adolescents is very low. There aren't many infections among children and adolescents in the United States, and so far, the symptoms have been mild.
According to the U.S. Centers for Disease Control and Prevention, most of the time, children or staff exposed to monkeypox do not need to be excluded from school or child care. However, if contact tracing is not possible, and there is a high level of exposure that increases the risk of infection, the health department may limit a person's activity participation. Health departments also take into account the individual's age and ability to recognize or communicate symptoms, as well as risks to others.
Young people may need treatment if the symptoms are severe or there is a risk of serious disease. Infants and toddlers under 1 year of age; Children with eczema, specific skin conditions, or other immune conditions; and people who are pregnant and breastfeeding may be at higher risk of more severe disease.
The U.S. Centers for Disease Control and Prevention recommends that babies infected with monkeypox live in a separate room and avoid direct contact with infected parents or caregivers. Breastfeeding should be delayed during the infection period and expressed breast milk should be discarded.
If your child or adolescent has had close personal contact with a known or probable case of monkeypox, your child should be monitored for symptoms for 21 days. Steps may include:
- Check your child's temperature every day.
- A daily full-body skin exam is done to look for new rashes.
- Check your child's mouth for sores or sores.
- Help older children or teens examine their mouth and hard-to-see areas of skin (such as the back of the neck, arms, and legs).
- Alert older children or teens to any rashes or pains in areas covered by clothing, including genitals.
- They should check these areas for a rash and let you know if they notice any changes in the skin or feel any pain in those areas.
Symptoms of monkeypox
The telltale signs of the monkeypox virus are the appearance of the rash and how the spots change over time. When the rash first appears, it looks like flat spots. Typically, all the spots change at the same time, turning into raised papules, then into fluid-filled blisters, into pus-filled white/yellow ulcers. However, in the current pandemic, some patients' skin lesions do not follow the usual pattern, appear at different stages of development and resolution, or appear only in one part of the body. Before or with the rash, early signs may include:
- fever
- Swollen lymph nodes
- headache
- Sore throat
- cough
What if my child or teen has symptoms of monkeypox?
If a child or teen develops symptoms at home, parents should contact their pediatrician and local health department. If they develop symptoms at school or in child care, they should:
- Isolated in a private space (e.g., office) separate from other children or teens
- If your child is at least 2 years old, wear a well-fitting mask
- Be picked up by a caregiver for examination by a pediatrician or other health professional
Does my child need to be tested for monkeypox?
Anyone with symptoms of monkeypox should speak to their pediatrician or other health clinician – even if they don't think they have been in contact with someone with monkeypox.
Your child may need to be tested for monkeypox if they have a suspicious rash and have close, personal contact with a confirmed or probable case, or have been to a place where they may be infected. If the pediatrician suspects monkeypox based on the appearance of the rash and the child's medical history, they will perform a skin swab test and perform a lab test.
Is there a cure for monkeypox?
Most people recover within two to four weeks even without medication. Medications to relieve pain or itching may be needed. If your child has complications or serious illness, or is at risk of severe illness, antiviral therapy may be needed. Treatment may also be recommended if they have lesions in certain parts of their body (e.g., eyes, mouth, genitals, or anus). Your pediatrician or health care provider will decide if this treatment is needed, sometimes in consultation with the health department.
Monkeypox remains contagious until the rash is completely gone – after all the scabs have fallen off and new skin has formed. Parents and carers of children with monkeypox should:
- Cover the child's skin with a rash.
- Remind your child to avoid scratching or touching the rash or eyes.
- Keep other people and pets away from children.
- If possible, all care should be provided for children with monkeypox.
- If your child is 2 years old or older, have your child wear a well-fitting mask while others are caring for them.
- Caregivers should wear a respirator or a well-fitting mask and gloves when touching children and handling bandages or clothing.
- Have your child isolate and stay home, away from school or other activities, until they are no longer contagious.
Is there a monkeypox vaccine?
The U.S. Centers for Disease Control and Prevention recommends vaccination for some people who may have been exposed to someone with monkeypox, including children and adolescents. The vaccine may also be given to people who work in laboratories or provide medical care to infected patients. Currently, most children or adults do not need to be widely vaccinated. Anyone who has been vaccinated against monkeypox (JYNNEOS) may want to consider waiting 4 weeks before getting the mRNA COVID vaccine, especially adolescents or young adult men, who may be at higher risk of myocarditis.
When can someone with monkeypox return to school or nursery?
The CDC recommends that anyone with monkeypox should isolate until all the scabs of the rash have fallen off and a fresh, healthy layer of skin has formed. This can take up to 4 weeks after the symptoms first appear. Caregivers should follow the advice of doctors and health departments regarding returning to an educational setting.
Should my family be worried about monkeypox?
Monkeypox sounds scary, but it's harder to spread or get than COVID. It's good to always be aware of the health risks. If someone in your family develops monkeypox rarely, share this information with your pediatrician and discuss what you can do to protect your child from infection.
信源：What Is Monkeypox (Mpox)?https://www.healthychildren.org/English/health-issues/vaccine-preventable-diseases/Pages/what-is-monkeypox.aspx