Not many pediatric cases of monkeypox have been reported worldwide outside of endemic areas like Nigeria and Congo.

But as the virus outbreak continues to expand, public health experts warn that no one is immune, and both pregnant women and children could catch the virus. The virus in children, as well as unborn children, can be severe, even deadly.

As Bloomberg reported, “Though the number of pediatric cases in this outbreak is, at the moment, very low, (World Health Organization) Director-General Tedros Adhanom Ghebreyesus said he’s worried that sustained transmission suggests the virus is ‘establishing itself’ and could move into high-risk groups such as immunocompromised and pregnant people.”

The article added, “In the US, experts have warned the stingy approach to testing could be missing more community spread of the virus.”

The Centers for Disease Control and Prevention said more than 2,300 confirmed cases of monkeypox have been found in the United States as of July 20.

Risk of monkeypox to kids

The World Health Organization said that “monkeypox is usually a self-limited disease with the symptoms lasting from 2 to 4 weeks. Severe cases occur more commonly among children and are related to the extent of virus exposure, patient health status and nature of complications.”

The international public health agency notes that the overall case fatality rates have been higher among young children than in the general population, and children with medical issues or compromised immune systems are at particular risk if they get the highly contagious virus.

In late June, U.S. public health officials started preparing to expand the monkeypox vaccine program to children. As Time magazine reported, “The U.S. Centers for Disease Control and Prevention is developing a protocol aimed at allowing use of Bavarian Nordic A/S’s Jynneos vaccine in children, if needed.”

The article said the vaccine is approved for adult use and is believed to be safer and have fewer side effects than Emergent BioSulution’s ACAM2000 smallpox vaccine, which is also deemed effective against monkeypox.

What to do if your child has monkeypox

India has had some experience with monkeypox in children and Hindustan Times offers tips. They note that monkeypox in children is typically mild, but not always.

“Usually, affected children may feel better within two to four weeks. But sometimes the virus can make them severely ill,” says Dr. Amitoj Singh Chhina, consultant in pediatrics and neonatology at Cloudnine Group of Hospitals in Bengaluru.

“Complications can include secondary infections, bronchopneumonia, sepsis, encephalitis, and infection of the cornea with ensuing loss of vision,” Chhina said.

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Logically, children may be more prone to scarring and even spreading the virus because it’s harder to keep children — especially young children — from scratching the lesions, which can be painful or itchy. That increases the risk of infection spread since the virus can be transmitted by contact with surfaces, linens and clothing that have been contaminated, as well as through broken skin, mucous membranes, respiratory drops and direct contact.

Keeping lesions covered with bandages or clothing can help, Chhina said.

The rash can be washed with sterilized water, while antiseptic and saltwater rinses are helpful with lesions in the mouth. Warm baths with baking soda and Epsom salts can help, the Hindustan Times reported. The tub should be disinfected well afterward.

News18.com in New Delhi said the first step is keeping children away from people who are infected. The article said they should be taught to avoid sick animals and encouraged to use good hand-washing hygiene. With children, it said, use alcohol-based sanitizers.

With children, as well as with adults, treatment focuses on managing symptoms like fever, cough, headaches and swollen lymph nodes. Lesions need to be kept clean and dry. Hygiene is crucial.

The National Health Service in the United Kingdom said to consult a family doctor or pediatrician if a child who has a rash with blisters has been near someone who might have monkeypox within the past three weeks or has traveled to western or central Africa within that time period.

“They should stay at home and avoid close contact with other people, including sharing towels or bedding, until you’ve been told what to do,” those experts added.