monkeypox

Boston Doctors on Whether to Worry About Monkeypox in Children, Schools

Schools should not be closing due to monkeypox, experts said, and people should not be isolating or quarantining after exposure

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After two-and-a-half years of the coronavirus pandemic and all its educational disruption, many parents are now worried that monkeypox could pose problems for their children.

The good news is that the rising tide of monkeypox cases has been declining in Massachusetts over the last two weeks. Health officials announced 37 more cases on Thursday, bringing the state's total case count to 280, fewer than previous weeks. While monkeypox does not spread as through the air, as COVID-19 does, and is rarely fatal, it can be painful and require long periods in isolation, and has prompted concerns as school gets back in session.

Tufts Medical Center's Dr. Shira Doron and Boston Medical Center's Dr. Benjamin Linas explained how common monkeypox is in children, what symptoms to look out for and whether or not it will be an issue for schools during NBC10 Boston's latest "COVID Q&A" discussion.

Monkeypox in Children

While there have been some monkeypox cases among children, they are few and far between. As of Tuesday, more than 18,000 people in the U.S. have had confirmed or probable monkeypox infections, and almost all are adults. Children make up less than 1% of cases, Doron said, and those cases largely have involved known exposure to somebody who had monkeypox.

"At this point, it's uncommon for kids to have monkeypox," Linas said. "There have been some cases, but they are not random transmission because someone went to an amusement park and got monkeypox, or went to school and got monkeypox. It's because it's a child who lives in close proximity to someone who had monkeypox developed it through risk."

Doron said, "This is not something that is at all likely to pop up in your child out of the blue."

As monkeypox cases continue to spread, colleges are issuing guidance and protocols for students.

The virus is transmitted through close skin-to-skin contact, which can occur through sexual transmission or by sharing personal items like sheets, clothes or towels. Due to the nature of college life and the close proximity of dorms, experts have warned college students to take precautions, but Boston doctors don't think it poses a major risk for grade school children.

"We've got a lot of things to talk about with schools and monkeypox shouldn't be very high on that list," Linas said.

Are schools closing due to monkeypox?

Schools should not be closing due to monkeypox, experts said. And, further, people should not be going into quarantine after exposure.

"This is not COVID-19. It's not as transmissible," Doron said. "We have lessons to learn from COVID-19 in schools, especially that fear mongering and fear-based decision making is harmful to children and their education."

If you have a rash of unknown etiology, if you have risk factors or if you've been exposed to somebody who has a rash that looks like monkeypox, then you need to be seen by a health care provider and get tested, Doron said. But schools should not be closing for deep cleaning if a case happens to arise, like they have for COVID-19 outbreaks.

Monkeypox is now a public health emergency nationwide which allows the federal government to open up additional funding for testing and vaccines to fight the virus as the US beefs up its approach.

Monkeypox symptoms in kids

Human symptoms of monkeypox are similar to but milder than the symptoms of smallpox, the CDC says. It presents itself as a flu-like illness accompanied by lymph-node swelling and rash on the face and body.

"The hard thing is, other than the rash, the symptoms are very nonspecific," Linas said. "I want to be reassuring that I would not run to the pediatrician to get a monkeypox test if your child has a fever in September or October. Quite honestly, I'd go get a COVID test."

Monkeypox often starts off with fever, headache, muscle aches, and exhaustion. Monkeypox also causes lymph nodes to swell, something that smallpox does not. The incubation period is usually 7 to 14 days but can range from 5 to 21 days.

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