When should you be concerned?
What’s the latest on Monkeypox?
On July 23, 2022 WHO declared the monkeypox outbreak a Public Health Emergency of International Concern. On August 4th, The U.S. declared this a Public Health Emergency. THIS IS NOT A PANDEMIC. This is so all health agencies and governments can be aware, receive funding and aid their communities and each other.
The last two years made us hyper-aware of threats to our health and safety because of the pandemic. I recognize this. We have already been in a state of high alert and hearing about various infections (threats) doesn’t help anybody. The media coverage doesn’t help, either. Always remember mainstream media is meant to drive ratings so they will always use click-bait headlines and dramatic music to reel you in.
Here, I’m presenting the information in a non-scary and factual way so you can be informed. At the writing of this blog, there are currently 20,638 cases worldwide in 71 countries. As of now, there are five cases in U.S. children.
How do you get monkeypox?
Across the media and social media, many people have referred to this as a sexually transmitted infection (STI). It is not an STI. An STI is an infection that is only transmitted through sexual activity such as gonorrhea or chlamydia. Monkeypox has largely been transmitted through sexual activity, but this does not make it an STI. It’s the very close contact that makes it contagious. Monkeypox is not new to the human population as the first case in a person was diagnosed in 1970.
Monkeypox is transmitted the followings ways:
- Direct contact with the infectious rash, scabs, or bodily fluids (think a healthcare worker taking care of a patient with monkeypox with no precautions).
- Respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact (think sexual activity or prolonged kissing – this is why people are confusing this with an STI).
- Touching items such as clothing or linens that touched the infectious rash or body fluids. It is unknown the timeframe that the virus lives on these surfaces, but the recommendation would be if a person has monkeypox and is regularly sharing clothing and linens with someone who doesn’t have the infection.
- Pregnant people can spread the virus to their fetus through the placenta.
- A scratch or bite from an infected animal.
What are the symptoms of monkeypox?
The hallmark sign is a rash that usually comes after fever, body aches, headache, possible sore throat and cough, and swollen lymph nodes (in the neck, underarms, and/or groin area). Following the initial symptoms (prodrome) mentioned above, spots will appear in the mouth and on the body. Below are some images from the UK Health Security Agency.
- The lesions (spots) are painful until they become itchy and crust over.
- When the rash first appears, it looks like flat spots. Typically, all the spots change at the same time, becoming raised bumps and then fluid-filled blisters that become pus-filled white/yellow sores.
What is the duration of being contagious?
A person is contagious from the time symptoms develop until after scabs from the rash fall off and the skin has completely healed. This can take 1-2 weeks.
How is it diagnosed?
It is typically a clinical diagnosis (diagnosis is made based on history of symptoms and the rash). There are also skin swab and lab tests.
What is the prognosis if you get monkeypox?
Most people recover within 2-4 weeks without medicines. There are also antivirals available for certain populations.
What risk is this to children?
At the writing of this blog, there have been five cases in children. Their clinical course is unknown, but there were no deaths. For more on demographic data from WHO, click here. I advise parents not to panic as this is largely spread through very close contact with someone who is actively showing symptoms (especially of the rash). We are not concerned of any potential school transmission because kids are lower risk based on the way this transmits (prolonged very close contact). If your child has come in very close contact with an individual with monkeypox (sharing a bed, linens, etc), it is important to monitor for symptoms.
As a pediatrician, I KNOW that children get a lot of rashes so please don’t panic about every rash your child gets as there are other viral rashes MORE common in children. But, if your child was exposed to someone with monkeypox (again: think prolonged close contact AKA living with someone with it), it’s important to monitor for the fever and then this rash. If your child had no known exposure and you see a rash resembling the pictures above, it’s okay to discuss this with your child’s clinician. Right now, the threat to children is very, very low but it’s important to keep you informed so you know what to monitor.
I am not recommending cancelling any plans, but if that feels better for you during this outbreak—I support it. Monkeypox is something our family is aware of, but we are not changing how we live our lives.
For more information from the CDC about the current outbreak, click here. This link is also very useful as it relates to Pediatrics. As always, I will keep you updated via my newsletter (sign up below!) and this blog.