Two children in the U.S. have been diagnosed with monkeypox infection, and health officials say they are streamlining the process to obtain antiviral treatment.
There have been 3,487 monkeypox cases among U.S. residents in 45 jurisdictions with the highest counts in New York, California, Illinois, Florida, Georgia and Texas, according to the Centers for Disease Control and Prevention (CDC). CDC Director Rochelle P. Walensky, M.D., M.P.H., confirmed the pediatric cases in a recent Washington Post event.
A CDC analysis that excluded the pediatric cases put the median age at 35 years. About 99% of the U.S. cases have been among people identified as male sex at birth. About 98% have reported male-to-male sexual contact. The most common symptoms have been rash (99%), malaise (70%), fever (64%) and lymphadenopathy (63%), the CDC said during a webinar Tuesday.
With the recent addition of commercial laboratories, testing capacity in the U.S is up to 80,000 tests per week. Labs are accepting swabs of lesion material from any part of the body.
Tecovirimat, an antiviral medication developed for smallpox, can be used via expanded access investigational new drug protocol to treat monkeypox in children and adults who are at risk for severe disease. Children under 8 years are among those who may be at increased risk.
The CDC has streamlined the process to obtain the drug, allowing health care visits to be conducted via telemedicine, making lab testing optional, requiring safety reporting only on serious adverse events, not requiring preregistration to begin treatment and allowing required forms to be returned after treatment begins. Information on obtaining tecovirimat is available at https://bit.ly/3ovsTWm.
The two-dose Jynneos vaccine is in limited supply, so the national vaccine strategy is to focus on post-exposure prophylaxis. Vaccination is recommended for people with a high degree of exposure and could be considered for people with an intermediate degree of exposure. The CDC recommends prioritizing doses for those at risk for severe disease. While the vaccine is licensed for use in adults, it can be given to children under a single patient expanded access investigational new drug protocol.
About 300,000 doses were made available in June and July. About 750,000 doses are expected to be available in the next phase of allocation. In total, health officials expect to have about 1.9 million doses this year and 2.2 million more in the first half of 2023.
CDC monkeypox guidance specific to children and teens is expected soon.