Federal health officials are providing guidance to schools on preventing the spread of monkeypox, while stressing the risk to children and adolescents is low.
Most cases in the current outbreak have been among men who have sex with men, but children can be infected if they have close contact (such as skin-to-skin) with an infected person. They also can become infected by touching contaminated objects like toys, utensils, clothing, towels, bedding and surfaces, although this is less common.
In its new guidance, the Centers for Disease Control and Prevention (CDC) recommends students, staff and volunteers follow typical infection-prevention measures, including washing their hands regularly and staying home when sick. Schools should maintain routine cleaning and disinfecting and have personal protective equipment on hand for staff who may need to care for infected students.
Children with fever and rash but no known monkeypox exposure should be evaluated by a medical professional and follow standard illness policies.
Children and staff who are exposed to monkeypox but do not have symptoms typically can remain in school, although the local health department may limit their participation in certain activities. Health officials may recommend vaccination for those who are exposed or at increased risk of infection. Parents or caregivers should monitor their child for symptoms for 21 days, including daily temperature checks and full-body skin checks for new rash. They also should inspect their child’s mouth for sores or ulcers.
Children and staff who have been exposed and develop symptoms should stay home and contact their health care provider for an assessment, according to the CDC guidance. Testing for monkeypox can be done only if the person has a rash.
If a child exposed to monkeypox develops symptoms while in school or a similar setting, he or she should be separated from other children, wear a well-fitting mask (ages 2 and older) and be picked up by a caregiver for a medical assessment. Staff caring for the child should avoid close contact except necessary care like diaper changes. They should wear a respirator (preferable) or a well-fitting mask, cover the child’s rash with clothing and avoid touching it. Gowns and gloves should be used if close contact is required. Staff should wash their hands after having contact with the child and change, launder or throw away soiled clothing, gloves and gowns.
If there is a case of monkeypox in a school, the classroom where the infected person spent time should be cleaned and disinfected, focusing on items and surfaces the person may have touched. Schools also should help health departments identify people who have been exposed and communicate to staff, students and parents without introducing stigma.
People with monkeypox should isolate until all their scabs have fallen off and a fresh layer of healthy skin has formed, which could take up to four weeks.
The CDC also provides guidance for parents/caregivers who have monkeypox. In these situations, another adult should serve as the caregiver if possible. If the child cannot avoid the infected adult, the parent/caregiver should cover the rash and wear a well-fitting mask. Children 2 years and older should wear a well-fitting mask or respirator. Families should disinfect surfaces, floors and shared items. They also should discuss possible vaccination of exposed children with the health department.
Resources
- CDC monkeypox guidance for schools
- CDC Clinical Considerations for Monkeypox in Children and Adolescents
- AAP News story “AAP experts answer pediatricians’ questions on monkeypox”
- Red Book Online Outbreak: Monkeypox Virus Outbreak
- Information for parents from HealthyChildren.org on monkeypox
