Monkeypox risk higher in children under 8: study

A review by Petra Zimmermann, MD, Ph.D., University of Friborg (Switzerland) and Nigel Curtis, Ph.D., University of Melbourne and Murdoch Children’s Research Institute, Australia, indicated that young children should be vaccinated against smallpox in the event of an extended outbreak. Key target groups for vaccination and other emergency measures.

They provide an expert perspective on “What Doctors Need to Know” about pediatric monkeypox.

Past outbreaks have raised concerns about the risk of monkeypox in young children. From her 47,000 in August 2022, approximately 77,000 laboratory-confirmed monkeypox cases have been reported worldwide.

Only 211 of them were children and adolescents under 18 years of age. Monkeypox virus appears to have been most widely transmitted in the current outbreak by close contact. It is not yet known how other transmission routes, such as droplets or contaminated surfaces or objects, are involved.

Both smallpox and monkeypox viruses are orthopoxviruses, and the epidemics reflect poor herd immunity as a result of low vaccination coverage for smallpox. The majority of monkeypox cases are “self-limiting” and disappear within 2 to 4 weeks after the rash develops. However, absence or mild symptoms can lead to missed diagnosis and possible future spread.

Despite the low incidence in children reported to date, there is particular concern about the complications and other serious consequences of monkeypox in children.

“Even in high-income countries, child hospitalization and mortality are reported to be on the rise,” write Drs. Zimmerman and Curtis.

Based primarily on data from low-income countries, children under the age of eight are at particularly high risk of complications, including the potential for serious bacterial infections. Young children may also be at higher risk of complications associated with scratching and spreading the infection to other parts of the body, such as the eyes.

With supportive care, most people with monkeypox recover. Severe cases and high-risk groups, such as children under 8 and people with underlying skin conditions, require more specialized care.

Pregnant people, immunocompromised people, people with eczema, and people with monkeypox rashes around the mouth, eyes, or genitals are additional risk groups.

Antiviral drugs such as tecovirimato, which is effective against orthopoxvirus, and vaccinia immunoglobulin (VIG), which is used to treat the side effects of smallpox vaccination, are treatment options in these high-risk settings. is.

However, “none of these treatments have proven effective against human monkeypox virus in clinical trials and are currently recommended only after consultation with national health authorities.” ‘ wrote the reviewer.

The smallpox vaccine is effective in preventing monkeypox, although the duration of protection is unknown. Many people are not vaccinated against smallpox because smallpox vaccination was discontinued when the smallpox outbreak in the United States was declared eradicated in 1972.

The FDA has approved a new vaccine (MVA-BN) to prevent monkeypox, but children are “not licensed or carefully studied” using this vaccine.

Again, there are “very limited data” supporting the use of drugs and vaccines to prevent monkeypox in children exposed to the virus. The reviewers also consider certain unique issues related to pregnant mothers, nursing mothers, and babies born to infected mothers.

Because monkeypox can be asymptomatic, outbreaks can get out of hand and affect vulnerable populations such as young children. will require “urgent action”.

Doctor. Zimmermann and Curtis conclude that smallpox vaccination provides protection against monkeypox. If the current outbreak spreads to young people, authorities should be ready to rapidly adopt immunizations for this age group.

Wolters Kluwer publishes the journal under the Lippincott imprint.

People with severely weakened immune systems, such as those infected with HIV, experience severe symptoms and may even die from monkeypox infection, according to a US study released Oct. 26, 2022. .

This study examined the cases of 57 American patients hospitalized with severe monkeypox complications. Nearly all (83%) had severely weakened immune systems, most often due to infection with the human immunodeficiency virus (HIV). Many of these patients had not been treated for the virus that causes AIDS.

More than 28,000 people in the United States have been infected with monkeypox since the outbreak began in May. decreased to

Deaths outside of Africa, where the virus is endemic, are rare, and deaths from clade IIb, the form of the virus currently circulating in the United States, are rare.

Overall, 47 of these individuals were found to be also infected with HIV, but only 4 were receiving antiretroviral therapy, a powerful drug that suppresses the virus. Most (95%) were male and 68% were black.

According to the analysis, 17 patients required intensive care and 12 died. Monkeypox was the contributing factor or confirmed cause of death in five of her deaths.

The researchers urged health care workers to test for HIV at the time of monkeypox testing for all sexually active patients with suspected monkeypox infection.

For patients with suspected monkeypox who are HIV-positive, CDC urges health care providers to begin treatment for monkeypox as soon as possible, even before monkeypox infection is confirmed. I was.

The agency also recommended that doctors start HIV treatment as soon as possible for anyone who tests positive for the virus.