The Washington Post

U.S. sees first cases of monkeypox in children

- BY LENA H. SUN AND FENIT NIRAPPIL

The first two U.S. cases of monkeypox in children have been confirmed as part of a record outbreak of more than 2,800 infections nationwide, a top health official said Friday.

The pediatric cases, detected this week in an infant and a toddler, are likely the result of household transmissi­on, according to the Centers for Disease Control and Prevention. CDC Director Rochelle Walensky disclosed the developmen­t in a Washington Post Live interview Friday.

CDC and public health authoritie­s are still investigat­ing how the children became infected. The two cases are unrelated and in different jurisdicti­ons, the agency said in a statement. The toddler is in California; the infant’s case was confirmed while the family was traveling in Washington, D.C., but they are not residents of this country.

Walensky, in her interview, said the cases link back to individual­s who come from the menwho-have-sex-with-men community. But the investigat­ions are ongoing to “know or understand” the connection to that community, another CDC official said.

“While both children have monkeypox symptoms, they are in good health,” and receiving an antiviral treatment for the disease, the CDC said.

Since the outbreak began in May, the vast majority of monkeypox cases have occurred among men who are gay, bisexual, or who have sex with men. Officials emphasize that the pathogen can affect anyone who has close contact with people who have monkeypox, including children. However, they say they have not yet seen evidence of sustained transmissi­on outside of networks of men who have sex with men.

“I don’t think it’s surprising that we occasional­ly are going to see cases in individual­s that are not gay, bisexual or other men who have sex with men. … The social networks that we have as humans means we have contact with a lot of different people,” Jennifer Mcquiston, who leads CDC’S monkeypox response, told reporters Friday. “The primary drivers for this infection in the U.S. remain in the gay, bisexual and other men who have sex with men communitie­s right now. But we need to continue watching this and we stand ready to … respond.”

Monkeypox spreads through close skin-to-skin contact, which — in the case of children — could include holding, cuddling, feeding, as well as through shared items such as towels, bedding, cups, and utensils. Health officials say respirator­y spread is also possible, but usually over prolonged periods of time, such as when a person lives in the same home as an infected person.

The rapid spread of monkeypox in the United States and other countries where it is not endemic, including the United Kingdom, Portugal and the Netherland­s, has alarmed public health officials. The World Health Organizati­on, which stopped short of declaring the monkeypox outbreak a global emergency last month, has been reconsider­ing that decision and is scheduled to announce Saturday whether it would reverse course.

Efforts to track cases in the United States have been undercut by limited demographi­c data. Last week, CDC officials acknowledg­ed they had details such as gender and age for only about 700 patients — fewer than half of the confirmed cases at the time. Among cases with detailed informatio­n, 99 percent involved male-to-male sexual activity, officials said Friday. A handful of women and transgende­r men also tested positive.

The median patient age is around 36, with the oldest patient in their 70s, Mcquiston said Friday.

Walensky has said the agency expects cases to continue to climb through August as a result of a testing scale-up and greater awareness and outreach to clinicians.

In most cases, monkeypox symptoms disappear on their own within a few weeks. But for children, those who are pregnant and people with weak immune systems, the disease can lead to medical complicati­ons, including death, according to WHO.

During the current outbreak, a few countries have confirmed a handful of monkeypox cases in those under 18.

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