Monkeypox

photo of a child with monkeypox in a piece about the monkeypox outbreak 2022 signs symptoms vaccines...
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Everything Parents Need To Know About Monkeypox

How it spreads, how to treat it, and when to call your doctor.

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As if parents didn’t have enough to worry about with the seemingly never-ending Covid-19 pandemic, another communicable disease has arrive on the scene. Since the beginning of May 2022, cases of Monkeypox have been popping up with increasing frequency, and on August 4, U.S. Health and Human Services Secretary Xavier Becerra declared the monkeypox outbreak a public health emergency. (Health officials in New York, California, and Illinois and at the World Health Organization have made similar announcements in recent weeks.)

Because of this recent outbreak, the Centers for Disease Control and Prevention (CDC) is urging health care providers to be on the lookout for signs and symptoms of the disease — especially the rash. Here’s what we know so far about monkeypox, and particularly monkeypox in children.

What is monkeypox?

The monkeypox virus is in the same family of viruses as smallpox, per the CDC website. Even though the symptoms are very similar to smallpox, a monkeypox infection is not as dire as a smallpox infection and most people who contract monkeypox recover. The infection can be extremely painfu,l however. While smallpox was eradicated in the ‘80s thanks to vaccines, “monkeypox continues to occur in countries of central and west Africa,” the WHO notes.

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How is monkeypox spread?

While the monkeypox virus is often to spread through sexual contact, it can also be spread from person-to-person through direct contact with the rash, which is a key indicator you’re infected.

Monkeypox is spread through prolonged (closer than six feet for at least three hours) person-to-person contact via:

  • direct contact with the infectious rash, scabs, or body fluids
  • "respiratory secretions" during face-to-face contact, kissing, cuddling, or sex
  • touching things that had been in contact with an infectious rash or body fluids

At the moment, the monkeypox outbreak appears to be largely occurring among men who have sex with men. About 6,600 cases of monkeypox have been confirmed in the United States since May 18, but experts believe that is a significant undercount. There have been about five official cases of monkeypox in children, who are believed to have gotten infected through household transmission.

Unfortunately, it does seem that an infected pregnant person can spread monkeypox to their fetus via the placenta. “While there have not been many cases, moms infected with monkeypox virus have been noted to have an increased risk of pregnancy loss either through miscarriage in the first trimester or through in utero fetal death (intrauterine fetal demise aka IUFD) during the second or third trimesters of pregnancy. In these cases, the fetus or embryo was noted to have the DNA from the virus and some are also noted to have actual monkeypox lesions,” says Dr. Idries Abdur-Rahman, OB-GYN.

If you believe you may have come into contact with someone who has monkeypox, contact your health care provider right away.

What are the symptoms of monkeypox?

The symptoms of monkeypox are very similar to the flu. They include:

  • fever
  • headache
  • muscle aches
  • backache
  • chills
  • exhaustion
  • swollen lymph nodes

The telltale sign that what you have is monkeypox and not the flu is a widespread rash. If you notice “pimples or blisters that appear on the face, inside the mouth, and on other parts of the body, like the hands, feet, chest, genitals, or anus,” your child may have monkeypox, according to the CDC. The rash is reportedly quite painful.

“The rash goes through different stages, starting with flat red spots, then bumps to fluid-filled blisters that ultimately dry out and then heal,” says Dr. Jen Trachtenberg, M.D., a board certified pediatrician and partner at Carnegie Hill Pediatrics.

Where is monkeypox in the U.S.?

While the outbreak is evolving day-by-day, you can keep tabs on how many cases of monkeypox have been reported in the U.S. thanks to this useful state-by-state map from the CDC.

How long does monkeypox last?

A case of monkeypox typically lasts two-to-four weeks. For some, the virus starts with the rash, and is followed by the other symptoms, while others only experience a rash. If you or anyone in your family is diagnosed with monkeypox, it is important to stay isolated for the duration of your infection.

Is monkeypox dangerous?

Monkeypox is milder than smallpox and “rarely fatal,” according to the CDC. That said, monkeypox prevention is key to controlling this outbreak, says Trachtenberg. “Prevention is through avoidance of those that are sick with it, wearing a mask, and hand-washing,” she says. While monkeypox is not as contagious as Covid-19, according to Trachtenberg, monkeypox is definitely contagious and to be avoided if possible.

What is the treatment for monkeypox?

While the CDC says that there’s no treatment available for the disease itself, antiviral drugs and vaccines may help treat and protect against monkeypox. If you or your child contracts monkeypox, you can definitely treat the symptoms, Trachtenberg says. As with any virus, offer plenty of fluids for hydration, and use a pain or fever reducer as needed.

“Antivirals, such as tecovirimat (TPOXX), may be recommended for people who are more likely to get severely ill, like patients with weakened immune systems,” the CDC notes.

Is there a monkeypox vaccine?

Yes. On June 28, 2022, the Biden administration rolled out their monkeypox outbreak response plan, which includes plans to roll out nearly 2 million doses of monkeypox vaccines over the coming months. The U.S. has been stockpile of pox vaccines, and has a robust supply of the smallpox vaccine ACAM2000, which can also be used against monkeypox. There is currently also a limited supply of JYNNEOS (also known as Imavune or Imvanex) — which is a newer vaccine with fewer side effects — and more doses are coming soon. The JYNNEOS vaccine, from bio-tech company Bavarian Nordic, is the one that children may receive if the CDC decides to offer monkeypox vaccines to kids, which it currently does not.

Those who are pregnant will have to wait to receive the vaccine. “Because the monkeypox vaccine is a live vaccine, pregnant women are not able to be vaccinated. The good news is that there are immunoglobulins that women, if they are infected, can be given to reduce their symptoms. Unfortunately their effectiveness when it comes to preventing transmission to the baby are not yet known,” says Abdur-Rahman.

If you believe you qualify for a monkeypox vaccine, contact your health care provider.

How worried should I be about monkeypox?

Try to breathe. While we should all consider the importance of mitigating the spread of this contagious virus, rest assured that for now cases in children are extremely rare and that while very uncomfortable, for most healthy people a case of monkeypox will mean a period of self-quarantine rather than a trip to the hospital. If you believe you are at risk for infection, be on the lookout for flu-like symptoms or a rash that looks like pimples, scabs, and ulcers that spread all over the body. If you notice any of these symptoms, or believe you may have been in contact with someone who has or had monkeypox, contact your health care provider about appropriate steps you can take to help end this outbreak.

Experts:

Dr. Jen Trachtenberg, M.D., board certified pediatrician, partner at Carnegie Hill Pediatrics and parenting expert.

Dr. Idries Abdur-Rahman, OB-GYN, author of Everything You Ever Wanted to Know About Pregnancy (But Were Too Afraid or Embarrassed to Ask, and one-half of the Twin Doctors from TwinDoctorsTV.

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