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Stony Brook’s top children’s doctor says monkeypox outbreaks in schools are unlikely

Elise Amendola

Children under 8-years-old may be at an increased risk for severe illness from monkeypox if they develop the disease, according to the U.S. Centers for Disease Control and Prevention. The federal guidance shows this is likely due to a less developed immune system.

  • Monkeypox cases are on the rise globally. 
  • New York has the highest number of cases in the U.S. 
  • Outside of New York City, Suffolk County, home to Stony Brook University Hospital, tops the list. 

WSHU's J.D. Allen spoke with Dr. Sharon Nachman, chief of the division of pediatric infectious diseases at Stony Brook Children’s Hospital, about the questions parents have about monkeypox for the upcoming school year.

WSHU: What are the symptoms? How is it spread? And who is most vulnerable today?

SN: So monkeypox is spread by very close contact. So, the idea that you're going to walk into a grocery store and handle a shopping cart? No, that is not how you're going to get monkeypox. It really requires very, very close skin-to-skin contact. Therefore, we don't expect that it will get good penetration into the general population, unlike COVID has done.

WSHU: Anyone can become infected with monkeypox.

SN: Absolutely anyone can, but how likely they are to be infected is quite different.

WSHU: We learned from COVID-19 that congregate settings like schools can lead to viral outbreaks. Should we expect more monkeypox cases as kids return to school?

SN: I suspect that we will not see monkeypox transmitted through school. The amount of close contact that's happening in school is not the type of close contact that we're seeing in the population that is getting monkeypox now.

WSHU: So who is most vulnerable? Who is getting monkeypox today?

SN: It's those adults that have close ongoing skin-to-skin contact, not just shaking someone's hands or giving someone a high five in the hallway.

WSHU: What should parents know about what the CDC is outlining about the possibility of severe illness from monkeypox for children under 8?

SN: If your child is not well, speak to your child's pediatrician. If they have a rash, and you're not sure what it is, take a picture of the rash. Take a picture in the morning and in the afternoon. Let's see how the rash evolves. But certainly connecting with your child's doctor — and saying, “hey, they're sick. This is a rash. What do you think it is?” — is really important. If they have a rash, please don't send them to school. We really don't want, even if it's not monkeypox, whatever that virus is being passed in a school situation.

WSHU: There's a concern with COVID-19 and monkeypox that there will be disruptions to the academic year coming up. Should schools be preparing differently?

SN: I don't think the schools need to do anything different than what they are already doing. I think the likelihood that we will see any kind of transmission in school is quite low. So I don't think that's a concern for monkeypox.

On the other hand, as in the past, schools have lots of children and lots of children have lots of respiratory pathogens. So I think reminding families that if your child is sick, please don't send them to school. And if you're not sure what's going on with them, please have them see their local care providers so we can test them and decide if it is this respiratory virus.

Is it some other respiratory virus or is it in fact strep throat? The treatment for all of those is going to be quite different. And that will also help us get them back to school safely.

WSHU: This is not something where parents will likely need to get another vaccine for their child before the upcoming school year. Who is eligible for doses of the monkeypox vaccine? Do you anticipate any changes for kids?

SN: The monkeypox vaccine is absolutely not indicated for children going to school at this point. The second issue is that we don't have an unlimited supply of the vaccine. So we're really targeting those populations that are at highest risk.

The same populations that are getting disease at this time and children, for the most part, are not part of that group.

A native Long Islander, J.D. is WSHU's managing editor. He also hosts the climate podcast Higher Ground. J.D. reports for public radio stations across the Northeast, is a journalism educator and proud SPJ member.