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Monkeypox (Mpox): What You Need to Know

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What is mpox?

Mpox is a rare disease caused by the mpox virus. The risk of mpox to children and adolescents in the United States is very low. There have not been many infections in U.S. children and teens, and so far, they have been mild.

The virus causes a rash that can look like chickenpox (varicella); herpes simplex virus; allergic skin rashes; hand, foot, and mouth disease caused by enteroviruses; or molluscum.

Mpox previously was called "monkeypox." The disease got its name after it was discovered in colonies of monkeys kept for research in the 1950s. Mpox was first discovered in a person in 1970.

How does a person get mpox?

Anyone can get mpox. The most common way that people spread mpox to other people is through physical contact with the rash or with an object or material (e.g., blankets, furniture, clothes, etc.) that was in contact with the rash. It can also spread through large respiratory droplets from infected people from prolonged face-to-face contact. This is more of a risk for household members and close contacts of an infected person. Mpox is not spread through casual conversations with an infected person or walking past an infected person in a grocery store.

A person is contagious from the time symptoms develop until after scabs from the rash fall off and the skin has completely healed with a new layer of skin formed.

Anyone who has been in close contact, including sexual contact, with someone who has mpox can get the illness. Infections also can spread between people and their pets.

Symptoms of mpox

The telltale sign of mpox virus is how the rash looks and how the spots change over time. When the rash first appears, it looks like flat spots. Classically, all the spots change at the same time, becoming raised bumps and then fluid-filled blisters that become pus-filled white/yellow sores. However, in the current outbreak some patients have had skin lesions that did not follow the usual pattern, appearing in differing stages of development and resolution or on a single part of the body. Before the rash appears, or together with the appearance of the rash, early signs may include:

  • fever

  • swollen lymph nodes

  • headache

  • sore throat

  • cough

What if my child or teen has symptoms of mpox?

If a child or teen develops symptoms while at home, the parent should contact their pediatrician and the local health department. If they develop symptoms at school or child care, they should:

  • Be separated from other children or adolescents in a private space (such as an office).

  • Wear a well-fitting mask (if the child is at least 2 years old).

  • Be picked up by a caregiver so they can be examined by a pediatrician or other health care professional.

Anyone with symptoms of mpox should talk to their pediatrician or other health care clinician—even if they do not think they had contact with someone who has mpox. Your child may need to be tested for monkeypox if they have a suspicious rash and:

  • were in close, personal contact with someone with a confirmed or probable case, or

  • traveled somewhere that put them at risk of infection.

If your pediatrician suspects mpox based on the appearance of rash and your child's history, they will take a skin swab and do a lab test.

Is there any treatment for mpox for children?

Most people recover in two to four weeks even without medicines. Medicine for pain or itch relief may be needed. Your child may need treatment with a medicine against the virus if they have complications or severe disease or are at high risk for severe disease. Treatment may also be advised if they have lesions on certain parts of their body (for example, eyes, mouth, genitals or anus). Your pediatrician or health care provider will determine if such treatment is needed, sometimes in consultation with the health department.

Monkeypox remains contagious until the rash is completely gone—after all scabs have fallen off and new skin has formed. Parents and caregivers of children with mpox should:

  • Cover the child's skin rash.

  • Remind their child to avoid scratching or touching the rash or eyes.

  • Keep other people and pets away from the child. If possible, one person should provide all care for the child with mpox.

  • Have the child wear a well-fitting mask if they are 2 years old or older when others are taking care of them. The caregiver should wear a respirator or well-fitting mask and gloves when touching the child and handling bandages or clothing.

  • Keep the child isolated and home from school or other activities until they are no longer contagious.

Is there an mpox vaccine?

The Centers for Disease Control and Prevention recommends vaccination for some people who may have been exposed to someone with mpox, including children and teens. The vaccine also may be given to people who work in a laboratory with the virus or provide medical care to infected patients. At this time, there is no need for widespread vaccination of children or most adults. Anyone who has received the mpox vaccine (JYNNEOS) might consider waiting 4 weeks before they get an mRNA COVID vaccine, especially teen or young adult males who may be at higher risk of myocarditis.

Visit www.HealthyChildren.org and Centers for Disease Control and Prevention

www.cdc.gov/poxvirus/monkeypox for the latest updates.

Disclaimer

Adapted from the HealthyChildren.org article What Is Monkeypox (Mpox)? by David W. Kimberlin, MD, FAAP and Kristina A. Bryant, MD, FAAP (11/30/22). The American Academy of Pediatrics (AAP) is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists dedicated to the health, safety, and well-being of all infants, children, adolescents, and young adults.

In all aspects of its publishing program (writing, review, and production), the AAP is committed to promoting principles of equity, diversity, and inclusion.

Any websites, brand names, products, or manufacturers are mentioned for informational and identification purposes only and do not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication. The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

https://publications.aap.org/patiented/article-pdf/1346816/ppe_document264_sp.pdf

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