First confirmed death due to monkeypox: What parents need to know

The coronavirus aside, a different viral disease has parents everywhere on high alert. Earlier this summer, President Biden sounded the alarm about a spate of unusual cases of monkeypox, a rare virus similar to smallpox that, Biden stated, “if it were to spread it would be consequential.” 

Unfortunately, the virus is spreading, and today, the CDC and officials in Los Angeles confirmed the first death due to monkeypox. The LA County resident had been hospitalized and was “severely immunocompromised,” officials from the Los Angeles Department of Public Health said in a statement.

This is the first death to date confirmed to be due to complications from monkeypox, according to the CDC. An adult in Texas who died on Aug. 30 was also considered severely immunocompromised before being diagnosed with monkeypox, but the case is “under investigation to determine what role monkeypox played in the death,” the Texas Health Department said in a statement.

Related: For these parents, getting their 5- to 11-year-olds vaccinated is a huge relief

Given the rapid rate of increase of monkeypox infections—officials are now tracking more than 22,000 cases outside of the Western and Central African countries where it typically occurs—health officials are urging those who are immunocompromised to get vaccinated, as they’re considered high risk for complications from the virus.

According to the WHO, while anyone can become infected with the virus, the outbreak continues to primarily affect men who have sex with men who have a median age of 36 years.

Monkeypox in kids is rare

It’s concerning that a virus is on the rise in addition to Covid that could potentially have a negative impact on our more vulnerable populations, including children, pregnant women or those who are immunocompromised. 

But The American Academy of Pediatrics (AAP) stresses that monkeypox cases are rare in kids. As of late August, 17 cases of monkeypox in kids under 15 had been reported to the CDC.

Experts assure that monkeypox is different from Covid in terms of transmission method, and we have tools, like vaccines, to help alleviate the spread. We’re also better at detecting it. And we’re not dealing with the same virus.

Related: Mom begs people to take COVID seriously as her 9-year-old fights for her life

“Transmission is really happening from close physical contact, skin-to-skin contact. So it’s quite different from Covid in that sense,” said Dr. Maria Van Kerkhove, the World Health Organization’s (WHO) technical lead on Covid-19, in a live online Q&A. 

According to AAP, “The risk of children getting infected with monkeypox virus is low. Monkeypox can spread to anyone through close, personal, often skin-to-skin contact and not through casual contact (ie, in school, child care settings). Risk of infection is more likely for household members and other close contacts of an infected person.”

While researchers are actively working to learn more about monkeypox and how it is transmitted in humans, unlike the coronavirus, monkeypox is not a novel disease—which means we already know more about it. The other good news? A vaccine already exists that can potentially help with inoculation for those at higher risk. Here’s what else you need to know.

What is monkeypox?

Initially identified in laboratory monkeys, which is where it got its name, monkeypox is a rare viral disease similar to smallpox (though less severe) that typically occurs in Western and Central Africa. 

The current outbreak was first identified in the United Kingdom in early May, according to the WHO, and cases have now been reported in more than 100 countries around the world.

Related: Here’s what you need to know about BA.2, Omicron’s new variant

Monkeypox is a zoonotic disease, which means it primarily passes from animal to animal, and animal-to-human transmissions are considered rare, but can happen. 

However, human-to-human transmission can happen, too, and experts are concerned because there have been recent cases of monkeypox reported in people with no direct travel links to endemic areas where monkeypox usually occurs. This means that human-to-human transmission is happening among people in close physical contact with others who have symptomatic infection, says the WHO. 

What are the symptoms of monkeypox?

• Rash, which starts with flat red marks that become raised and filled with pus, and can be itchy and painful
• Fever
• Chills
• Body and muscle aches
• Body weakness
• Swollen lymph nodes
• Fatigue

The monkeypox rash may start on the face, inside of the mouth, hands, feet or genitals and can spread all over the body. If your child has these symptoms or is in contact with someone who is infected, call your pediatrician immediately, says Tanya Altmann, MD, FAAP, a pediatrician and founder of Calabasas Pediatrics.

Symptoms can appear anywhere from five to 21 days after initial exposure, but typically start between six and 13 days. Symptoms may last between two and four weeks, and can be severe in children, pregnant women or those with suppressed immune systems, notes the CDC.

The virus is considered self-limiting, as once the lesions scab over in two to four weeks, they are no longer infectious. 

Related: Croup is now a symptom of Covid in kids

How is monkeypox transmitted?

Monkeypox is primarily transmitted via close contact with someone who has symptoms of the disease, whether through lesions, bodily fluids, respiratory droplets from sneezing or coughing, or contaminated materials like utensils or bedding. It can also be transferred from mother to fetus via the placenta or as a result of close contact during or after birth.

But because the viral particles of monkeyvirus are larger and heavier than those of coronavirus, the respiratory droplets can’t travel as far (only a few feet), making it less likely you’ll get infected unless you’re in prolonged, very close contact with another person who is symptomatic. 

“One of the most challenging things about Covid has been that it can be spread asymptomatically or pre-symptomatically, by people who have no idea that they’re infected,” Dr. Rasmussen said, to the New York Times. “But with monkeypox it doesn’t appear that there is any pre-symptomatic transmission.” However, there are plenty of opportunities to transmit monkeypox in the first few days of an infection, when symptoms are non-specific, Dr. Rasmussen added.

Preventing monkeypox

While there is no as-of-yet proven treatment for monkeypox, antivirals developed for smallpox may be helpful, notes the CDC. As for inoculation, smallpox vaccines have been studied in lab and animal models in Western and Central African countries against monkeypox and found to be effective. 

Although smallpox was eradicated in 1980 as a result of widespread vaccination efforts, the WHO has stockpiles of smallpox vaccines should a new outbreak occur. Experts suggest you should get vaccinated if you have a close contact with a confirmed case of monkeypox, but vaccines are otherwise not currently recommended for the broader public.

What to do now

If you’re planning to travel, there’s currently no need to alter your plans, says Dr. Altmann, but keep an eye on travel advisories at your destination.

If you have recently traveled to a state or country where monkeypox cases have been reported, monitor yourself and your family for any symptoms, especially a monkeypox rash, and report any concerns to your pediatrician or primary care provider.

And finally, it’s a safe bet to continue to practice social distancing measures, as well as wearing a mask in public places and on public transportation to protect yourself and others from monkeypox—and Covid. 

A version of this story was originally published on May 24, 2022. It has been updated.