Monkeypox in Children: Symptoms, Treatment, and Prevention

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Monkeypox in Children: Symptoms, Treatment, and Prevention
Is monkeypox a risk for children and adolescents? Photo by The National Library of Medicine / Unsplash

Monkeypox is a rare disease caused by the monkeypox virus. While it is not common for children and adolescents to contract monkeypox, there are certain groups of young people who may be at increased risk, such as those with immunocompromising conditions or skin conditions like eczema. In this blog post, we will explore the symptoms, treatment, and prevention of monkeypox in children and adolescents.

Symptoms of Monkeypox in Children and Adolescents

The most common symptom of monkeypox is a rash. This rash can look similar to other rashes, like chickenpox or hand, foot, and mouth disease. The rash starts as maculopapular lesions and then progresses to vesicles, pustules, and scabs. Other symptoms of monkeypox can include fever, lymphadenopathy, fatigue, and headache. However, these symptoms are not always present.

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How Monkeypox Spreads

Monkeypox is spread through close, personal, often skin-to-skin contact, including direct contact with the rash or scabs from a person with monkeypox. It can also be spread by touching objects, fabrics, and surfaces that have been used by someone with monkeypox. Unlike some other rashes, monkeypox remains contagious until the scabs fall off and new skin has formed.

Scientists are still studying whether the monkeypox virus can be spread in asymptomatic but infected individuals or through body fluids such as semen, vaginal fluids, urine, and feces. Monkeypox is not believed to spread through casual conversations with an infected individual but rather through close contact, which can include sexual encounters.

Testing for Monkeypox in Children and Adolescents

If a child or adolescent has a suspicious rash, pediatricians and other pediatric clinicians should test their patients, especially if there is a history of close, personal contact with someone who is a confirmed or probable case or travel that puts them at risk. Testing is available through state public health authorities and at some commercial labs. Requirements for specimen collection and shipping may differ by laboratory, and clinicians should confirm requirements before obtaining a sample from the skin lesions.

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Treatment for Monkeypox in Children and Adolescents

Treatment is available for monkeypox, particularly for those who have severe disease or are at risk for severe monkeypox disease. Tecovirimat is the first-line treatment and is being used under an investigational protocol. The CDC recently streamlined the process to obtain it. It is available in both oral and intravenous forms.

Monkeypox Prevention in Children and Adolescents

Monkeypox can be prevented through the following measures:

  • Good hand hygiene: Wash hands often with soap and water for at least 20 seconds, especially after being in contact with someone who has monkeypox or items that may have been contaminated with the virus.
  • Avoiding close contact: Do not touch or have close contact with someone who has monkeypox, including sexual contact.
  • Covering skin lesions: Individuals with monkeypox should cover their skin lesions.
  • Avoiding scratching: Parents/caregivers should encourage their children to avoid scratching their skin lesions and touching their eyes.
  • Avoiding contact with others: Individuals with monkeypox should avoid contact with other people and pets. If possible, one person should be the caregiver of a child with monkeypox and should avoid skin-to-skin contact with the rash.
  • Wearing a mask: Children who are at least 2 years of age who have monkeypox should wear a well-fitting mask when interacting with a caregiver, and the caregiver should wear a respirator or well-fitting mask and gloves when skin contact with the child may occur, and when handling bandages or clothing.
  • Isolation: Children and young adults can be kept isolated to reduce the chance of catching mpox (monkeypox).

In addition, the JYNNEOS vaccine can be given as post-exposure prophylaxis to individuals who have been exposed to mpox. It is important to discuss the use of the vaccine with the state or local health department.


Monkeypox is a rare disease that can affect children and adolescents. While the risk of infection is low, certain groups, such as infants, young children, those with eczema and other skin conditions, and those with immunocompromising conditions may be at increased risk for severe disease. Symptoms of mpox in children and adolescents can be similar to other rashes, but testing should be considered if there is a history of close contact with an infected individual or travel that puts them at risk.

There is treatment available for severe mpox disease, and a vaccine is available for post-exposure prophylaxis. However, the best way to prevent mpox is to practice good hygiene, avoid contact with infected individuals, and cover skin lesions to prevent spreading the disease.

Pediatricians and other pediatric clinicians play an important role in identifying and managing cases of mpox in children and adolescents. By following the appropriate precautions and recommendations, we can help prevent the spread of mpox and protect the health of our patients and communities.