These FAQs are intended for medical providers and are current as of July 29, 2022. For additional information on monkeypox in the U.S., please see the Centers for Disease Control (CDC).
Please note: Consult with local and state health departments and the CDC before collecting any specimens. For more guidance, see the CDC’s Health Advisory Network updates, monkeypox infection control for health care settings, and pediatric clinical considerations and Red Book Online Outbreak: Monkeypox Virus Outbreak.
Human monkeypox cases are uncommon and are especially rare outside West and Central Africa. The CDC began monitoring this spring, when monkeypox infections were confirmed in countries that do not normally report monkeypox cases. An initial case of monkeypox in the U.S. was confirmed on May 17, 2022. The WHO declared the current monkeypox outbreak a global health emergency on July 23, 2022. Cases have risen sharply in the U.S. since May 2022; visit the CDC website for the latest case counts and trends. Clinicians should consider a diagnosis of monkeypox in people with an otherwise unexplained characteristic rash. Travel and sexual history are important additional information to obtain. For the latest information on case counts and guidance for health care providers, see the CDC’s Health Alert Network (HAN) and monkeypox resource collection.
Monkeypox is a rare disease that is caused by infection with monkeypox virus. Monkeypox virus belongs to the Orthopoxvirus genus also includes variola virus (which causes smallpox), vaccinia virus (used in the smallpox vaccine), and cowpox virus. See the CDC’s updated case definition for more details.
Monkeypox is similar to smallpox but produces milder effects. Monkeypox begins with fever, headache, muscle aches, and exhaustion. The main difference in symptoms of the two diseases is that monkeypox causes lymphadenopathy while smallpox does not. The incubation period (time from infection to symptoms) for monkeypox is usually 7–14 days but can range from 5–21 days.
Chickenpox skin lesions are superficial, erupt in crops, and evolve quickly with centripetal distribution. Monkeypox skin lesions (like smallpox) are deep-seated, and well-circumscribed at the same stage of development with centrifugal distribution.
Transmission of monkeypox virus occurs when a person comes into contact with the virus from an animal, human, or materials contaminated with the virus. The virus enters the body through broken skin (even if not visible), respiratory tract, or mucous membranes (eyes, nose, or mouth). Human-to-human transmission is thought to occur primarily through large respiratory droplets.
The characteristic rash and other manifestations of monkeypox infection would be expected to be similar in pediatric patients. Principles around infection prevention precautions for monkeypox are the same regardless of the patient’s age. The CDC reported the first pediatric cases of monkeypox associated with the current outbreak in the U.S. in July 2022. Young children, children with immunocompromising conditions, and children with eczema and other skin conditions may be at higher risk of severe disease. For more information about monkeypox in children and adolescents, see clinical considerations from the CDC.
Place the patient in airborne and contact isolation precautions immediately; generally, both smallpox and monkeypox should be ruled out. Contact your hospital or medical practice’s Infection Prevention and Control (IPC) department immediately if there is a suspected case of monkeypox. If the hospital or practice does not have an IPC department, contact the local public health department.
First, contact your local public health office. Public health officials may recommend JYNNEOS vaccine for contacts of monkeypox cases, especially for children deemed to be at high risk. The vaccine may be recommended for and given to children under 18 years old under a single patient expanded access investigational new drug (IND) protocol through the CDC.