A global update of mpox (monkeypox) in children

Abstract

Purpose of reviewHuman mpox disease (formerly monkeypox) was first diagnosed in an infant in the Democratic Republic of the Congo in 1970. Mpox was rarely reported outside West and Central Africa until the global outbreak in May 2022. On 23 July 2022, the WHO declared mpox a public health emergency of international concern. These developments warrant a global update on pediatric mpox.Recent findingsMpox epidemiology in endemic African countries has changed from predominantly affecting children under 10 years to adults 20–40 years old. This shift also applies to the global outbreak, where 18–44-year-old adult men who have sex with men are disproportionately affected. Furthermore, the proportion of children affected in the global outbreak is less than 2%, while children under 18 years constitute nearly 40% of cases in African countries. The highest mortality rates remain among both children and adults in African countries.SummaryMpox epidemiology has shifted to adults and is affecting relatively few children in the current global outbreak. However, infants, immunocompromised children and African children are still at high risk of severe disease. Mpox vaccines and therapeutic interventions should be accessible to at-risk and affected children globally, especially to those living in endemic African countries.

Sustained Human Outbreak of a New MPXV Clade I Lineage in Eastern Democratic Republic of the Congo

“…However, limitations include the limited availability of comprehensive clinical and demographic patient information in this retrospective case series. Despite these constraints, our data suggest that transmission in this outbreak was primarily linked to sexual contact: first, most affected individuals were adolescents and young adults, contrasting with previous mpox outbreaks in the DRC, where children under 15 years were most affected; 18,19 20 Given the recent history of mpox outbreaks in DRC, we advocate for swift action by endemic countries and the international community to avert another global mpox outbreak.…”

School‐based interventions on Mpox: A scoping review

“…7 Children and adults also account for the highest mortality rates in Africa. 9 While there is a strong need for multisectoral intervention, one significant way of reaching a wider population is a school-based approach. 10,11 A school-based intervention depicts measures implemented in classrooms or in schools to improve health and wellbeing and reducing risk or problem behavior of the students.…”

“…The global prevalence among children is less than 2% but up to 40% among children in Africa 7 . Children and adults also account for the highest mortality rates in Africa 9 …”

“…Globally, there is a low prevalence of mpox among school‐aged children 8 , 9 but intense and possibly prolonged physical contact among the school‐aged in schools and during activities such as sports and plays constitute a significant concern for any infectious diseases including mpox and COVID‐19 among others. Sam‐Agudu et al 9 reported an mpox epidemiological transition, initially with high prevalence among children (under 10 years old) but now more prevalent among adults and sexual minorities. The global prevalence among children is less than 2% but up to 40% among children in Africa.…”

Editorial: Emerging and reemerging global pediatric infectious diseases amidst vanishing pediatric infectious diseases workforce

“…Morello et al [10] described prevalence and possible etiological causes of Long-COVID in children. Sam-Agudu et al [11] described the evolution of Mpox being a predominantly infection of children in endemic regions to now infecting adults in nonendemic regions. In the Current Opinion in Pediatrics Issue #3 in 2023, Tomatis Souverbielle et al [12] provided a comprehensive review of the epidemiology, clinical manifestations, and treatment strategies of nonpolio enterovirus (EV) and parechovirus (PeV) infections in the United States.…”