Children are highly unlikely to contract monkeypox—but the risk is not entirely zero. In recent weeks, the outbreak has spread widely enough for the World Health Organization (WHO) to declare it a public health emergency of international concern. The Centers for Disease Control and Prevention (CDC) reported over 5,000 cases in the United States and more than 22,000 worldwide.

Two U.S. cities have declared public health emergencies, and the Biden Administration is considering a federal declaration. Notably, two cases have been reported in children: one toddler in California and one infant visiting from the United Kingdom. Both cases are believed to be due to household transmission.

While this news may be alarming for parents, experts suggest the overall risk to children remains very low. Here's what you need to know.

How Monkeypox Spreads to Children

Although children can contract monkeypox, they represent a very small percentage of total cases. The virus primarily spreads through close skin-to-skin contact, with the current outbreak mainly affecting men who have sex with men. In the U.S., over 95% of cases have occurred within this group.

In the rare pediatric cases reported, the virus was most likely transmitted within the household—possibly through cuddling or contact with contaminated items like linens or clothing.

While monkeypox can also spread through respiratory droplets or shared items such as bedding or furniture, this form of transmission is much less common. Most infections happen through direct contact with the monkeypox rash.

Importantly, there’s no significant evidence that children are contracting monkeypox in public places like pools, schools, or changing rooms. Experts say that intimate, prolonged contact is typically required for the virus to spread.

Symptoms and Severity in Children

Children under 8 years old are considered more vulnerable to severe symptoms. However, most cases in this outbreak—including the two pediatric cases—have been mild.

Monkeypox symptoms typically include:

• A pimple-like rash, often on the face, hands, or other body parts

• Fever

• Headache

• Muscle and back aches

• Swollen lymph nodes

• Chills and fatigue

• Possible respiratory symptoms (sore throat, nasal congestion, or cough)

Infants and newborns are especially at risk due to underdeveloped immune systems. So far, no deaths have been reported in children in the U.S., although there have been a few deaths in other countries.

Vaccination and Treatment for Children

The two children diagnosed with monkeypox are recovering and receiving treatment with TPOXX, an antiviral medication approved for smallpox. Though not specifically developed for monkeypox, TPOXX has been shown to be safe with minimal side effects. Because children under 8 are at higher risk, the CDC recommends this treatment for them.

For children exposed to monkeypox, a vaccine called JYNNEOS is available under expanded use guidelines. The vaccine is FDA-approved for monkeypox and smallpox, but current vaccination efforts prioritize adults in high-risk groups, such as men who have sex with men.

What Parents Should Do (and Not Do)

If your child shows symptoms consistent with monkeypox or has been exposed to someone infected, contact their pediatrician immediately. The doctor can arrange for testing and report the case to public health authorities.

Until a diagnosis is confirmed or ruled out, it’s best to isolate your child to prevent potential spread.

To stay informed, parents should regularly check updates on the CDC, WHO, or Vaccine Education Center websites. These platforms offer the most current guidance on monkeypox and vaccination options.

While there's no need to drastically change routines, it’s still wise to encourage children to:

• Wash hands frequently

• Avoid touching their faces

• Practice good hygiene

• Wear masks in crowded indoor settings, if appropriate

Currently, children are much more likely to get COVID-19 than monkeypox, according to health experts.

Final Thought: Don’t Panic

Although monkeypox is a virus that warrants attention, there’s no reason for excessive worry—especially when it comes to children. Taking basic precautions and staying informed are the best ways to protect your family.

As one expert summarized: "Monkeypox is something we should all be aware of, but parents should not panic about their children getting infected."