Monkeypox in Children: Everything You Need to Know

Want to know all about monkeypox in children? We'll tell you about its symptoms, transmission, and treatment. Keep reading!
Monkeypox in Children: Everything You Need to Know

Last update: 30 May, 2022

In early May 2022, the World Health Organization (WHO) was notified of an outbreak of monkeypox in non-endemic countries. Since then, this disease has been the focus of attention of both the media and health agencies. Therefore, today we’re going to tell you everything you need to know about this illness.

Certainly, when parents think of monkeypox in children, it’s inevitable that they associate it with the smallpox virus and other similar and potentially dangerous viruses. We would like to convey words of encouragement that this variant of the virus is less lethal than the one that was eradicated in the mid-1980s.

What is monkeypox?

Monkeypox is an infection caused by an Orthopoxvirus belonging to the Poxviridae family. This virus was first discovered in 1958 in monkeys sent from Singapore to a research center in Denmark. However, the first case of human infection was reported only in 1970 in the Democratic Republic of Congo.

As experts point out, the immunity granted by the smallpox virus vaccine (vaccinia) managed to keep the outbreak of monkeypox under control at that time. However, the lack of boosters and the neglect of vaccination campaigns in areas where this virus is endemic paved the way for the disease in question to transcend beyond borders.

Most cases of monkeypox occur in rural areas of Africa and it is considered an endemic infection in the following nations :

  • Democratic Republic of the Congo (DRC).
  • Cameroon.
  • The Central African Republic.
  • Gabon.
  • Ivory Coast.
  • Liberia.
  • Sierra Leone.
  • South Sudan.
  • Nigeria. This country has been the focus of infection the last few years and from 2017 to April 2020 a total of 558 cases had been reported.

This kind of smallpox is a zoonotic disease, which means it’s characteristic of animals but can eventually affect humans. Thus, it is most common for a person to become infected through an animal reservoir, but in the context of an outbreak, there is also the possibility of inter-human transmission.

It should be noted that although they belong to the same family, the monkeypox virus is much milder than the already eradicated smallpox virus. Thus, the mortality rates associated with the disease that is now in the world’s spotlight are very low.

Monkeypox in children.
The characteristic lesions of the virus that causes monkeypox are polymorphic. That is, they follow a certain sequence from the time they appear until they completely resolve.

What are the symptoms of monkeypox in children?

The symptoms of monkeypox in children are similar to the symptoms of common smallpox but much milder. It should be noted that they don’t appear immediately after contact with the virus, but that the incubation period averages 14 days. In fact, it ranges from 5 to 21 days.

According to the official website of the U.S. Centers for Disease Control and Prevention (CDC), the most common manifestations of the disease are as follows:

  • Fever
  • Headache
  • Muscle aches
  • Chills
  • Exhaustion and fatigue
  • Back pain
  • Skin rashes

Skin rashes tend to develop about 3 to 5 days after onset and have a characteristic evolution, both in their distribution and their appearance. First, they start in the center of the body and then spread to the limbs. Secondly, the shape of the lesions changes as the days go by. They start as spots, then become raised, after a while, they transform into fluid blisters, which break and leave crusts.

As for fever, it usually doesn’t last more than 5 days, and after this time, it’s accompanied by skin lesions and swollen lymph nodes. This last sign is common in infantile cases and is one of the features that differentiates simian smallpox from common smallpox.

Although the disease has typical manifestations, its intensity varies from one person to another. This depends mainly on the underlying condition of each child.

It’s worth noting that people infected with monkeypox virus can infect their cohabitants or close contacts as long as they have active signs or symptoms of the disease.

How monkeypox is transmitted

As explained above, the natural reservoir of the virus is animals. In addition to monkeys, it has also been detected in rodents, such as rats, squirrels, and dormice.

According to WHO, the virus is transmitted to humans through direct contact with the blood, body fluids, or mucous membranes of infected animals. Also, the ingestion of undercooked meats and other animal products of questionable origin is also believed to be a possible route of transmission.

As for human-to-human transmission, this phenomenon usually occurs in the context of an outbreak. To contract the virus from an infected human, coming into contact with their respiratory secretions, skin, or objects recently handled by them is sufficient.

Transmission by respiratory droplets requires close and prolonged contact, as the contagiousness rate of this virus is quite low.

In the specific case of monkeypox, babies can contract the virus through the placenta or shortly after birth, due to close contact with their infected mother. In the first case, it’s referred to as congenital monkeypox.

A child with a skin rash holding up a vaccine.
Vaccination against monkeypox hasn’t yet been approved as a universal prevention strategy in the context of the current outbreak. It’s reserved for specific cases.

Treatment options for monkeypox in children

There’s currently no curative treatment for monkeypox. However, most of the time, the condition resolves spontaneously within a few days.

Smallpox vaccination, antivirals, and immunoglobulins are used as a method of prevention, but these strategies are reserved for those who travel to endemic countries or are in a high-risk group.

The main goal of monkeypox therapies in children is to alleviate symptoms. As well as avoiding complications and preventing long-term sequelae.

Most patients recover satisfactorily, so there’s no cause for alarm at this time. As of today, international health organizations define the problem as an outbreak and not a pandemic.

Most of the reported cases are adults and, as we’ve said, the risk of infection is low compared to the eradicated smallpox virus. However, if in doubt or if there are compatible symptoms, the best thing to do is to consult your family doctor to find out what to do.

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