Top 5 Takeaways

1. Prevalence and Demographics: Monkeypox virus (MPXV) infections in children and adolescents aged <18 years constituted only 0.3% of all U.S. cases during the study period, with no critical illnesses or deaths reported. The majority of these cases were among non-Hispanic Black or African American and Hispanic or Latino children and adolescents.
2. Transmission Modes: Younger children typically acquired MPXV through skin-to-skin contact with infected caregivers, while adolescents were more frequently exposed through male-to-male sexual contact.
3. Clinical Features and Treatment: Most cases in children and adolescents were not severe, and the majority did not require hospitalization. Common symptoms included lesions on the trunk, and some received antiviral treatments.
4. Prevention and Public Health Implications: The study underscores the importance of prevention measures, such as vaccination and education about monkeypox transmission, particularly in household settings and among sexually active adolescents.
5. Equity in Health Care Access: The findings highlight the need for equitable access to monkeypox vaccination, testing, and treatment, particularly among Black and Hispanic communities.

Note:

This MMWR Article was created prior to the conventional renaming of Monkeypox to its more standard and appropriate name, Mpox. To avoid confusion, Monkeypox is retained when writing this article, but all future works should use Mpox.

Original Article Author and Citation

Corresponding Author

Ian Hennessee, ihennessee@cdc.gov.

Suggested Citation

Hennessee I, Shelus V, McArdle CE, et al. Epidemiologic and Clinical Features of Children and Adolescents Aged <18 Years with Monkeypox — United States, May 17–September 24, 2022. MMWR Morb Mortal Wkly Rep 2022;71:1407–1411. DOI: http://dx.doi.org/10.15585/mmwr.mm7144a4.

Summary

The study analyzed MPXV infections in children and adolescents aged <18 years in the U.S. from May 17 to September 24, 2022. A total of 83 cases were identified, accounting for a small fraction (0.3%) of the overall U.S. cases. The majority were male, particularly among adolescents. Infections in younger children were mostly acquired through household transmission, while adolescents contracted the virus predominantly through sexual contact.

Methods

This analysis involved identifying children and adolescents who tested positive for MPXV or related viruses through PCR testing. Data on demographics, exposure characteristics, clinical features, and treatment were collected and analyzed, stratified by age group.

Discussion

The study revealed differing modes of transmission between younger children and adolescents and highlighted the role of household and sexual contact in the spread of MPXV. It also emphasized the disparity in infections among Black and Hispanic children and adolescents, reflecting broader societal inequities.

Conclusion

While MPXV infections in children and adolescents during this period were rare and generally not severe, the findings stress the importance of preventive measures, particularly in household settings and among sexually active adolescents. Ensuring equitable access to healthcare resources, including vaccination and treatment, is crucial.

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