Doctors call for calm as the right lies about children and monkeypox

With the U.S. monkeypox outbreak spiraling out of control, public health authorities fear that outdated science and bad faith scapegoats are combining forces to scare parents about the outbreak’s threat to their children. .

Epidemiologists, infectious disease specialists and public health authorities agree that the current outbreak appears to pose a low risk to children at this time. But with far-right figures associating the virus with unfounded panic over LGBT people ‘caregating’ children, and some media outlets and online influencers speculating that monkey pox could be thriving amid school, these assurances risk being drowned.

“The few infected children were close household contacts of cases,” said Dr. David Freedman, a professor emeritus of infectious diseases at the University of Alabama and an expert in tropical diseases. “I just don’t think silent carrying in a school setting is a big risk unless the guidelines are completely ignored.”

The tangle of unintentional misinformation and deliberate misinformation has grown in recent weeks as far-right conservative figures and conspiracy theorists have latched onto a handful of pediatric cases as evidence that gay people sexually abuse children at home. large scale.

“Who rapes children in DC?” Last week, Laura Loomer, conspiracy activist and failed congressional candidate, wrote on Telegram, linking to an article confirming a case of monkeypox in an infant in the nation’s capital.

“Did a law enforcement agency investigate how these two children got monkeypox? Or just, like… right? Michael Knowles, a conservative Daily Wire commentator who accused teachers of “grooming” children if they did not disclose a child’s sexual orientation to their family, tweeted in response to another pair of pediatric infections.

These accusations — part troll, part continuation of a decades-long smear campaign against LGBT people — have been bolstered by other, more well-meaning concerns expressed by parents and health activists who see the epidemic of monkeypox as a potential successor to the COVID-19 pandemic.

These activists and educators, like geneticist-slash-podcaster Spencer Wells, who predicted “it’s not going to be a fun school year” because of the risk of pediatric monkeypox, have taken hold of the long-held medical belief that which children… who face a higher risk of complications from monkeypox infection – spread the virus more easily, especially in school settings. But scientific understanding of monkeypox contagiousness, transmission methods and risks for certain populations has changed dramatically in recent years, experts told The Daily Beast, and children may not be at as much risk of infection as they are. we thought so before.

“European countries that have reported pediatric cases have reported one or two cases, and therefore the virus is not spreading among children,” said Dr. Kristina Bryant, a pediatric infectious disease specialist at the School of Medicine. University of Louisville. “I really don’t think we need to worry about this virus spreading to schools or daycares.”

Part of the misunderstanding, said Stanford University infectious disease researcher Dr. Abraar Karan, is rooted in an outdated interpretation of data nearly half a century old. The current outbreak, Karan said, has forced public health officials to unlearn decades of knowledge about the virus, including the previous prejudice that monkeypox was largely limited to children.

“Children will have close contact – they’ll touch a lot of surfaces, they won’t wash and clean their hands, they’ll be exposed to fomites a lot – whereas adults are probably more diligent about what they touch, which they put in their mouth, what they have on their hands, how often they wash their hands, that sort of thing,” Karan said, explaining the thinking behind a five-year study in the 1980s that revealed that nine out of ten cases of the virus occur in children under the age of fifteen.

But recent reassessments of this and similar investigations, infectious disease experts told The Daily Beast, indicate that these pediatric cases may not have proven a unique risk of monkeypox for children at all.

“It is true that in countries where the virus was endemic, cases occurred in young children, and we know that children under the age of eight were at higher risk of severe disease. But even in endemic countries, the epidemiology of monkeypox has changed,” said Bryant, who noted that the average age of monkeypox patients has slowly increased over the past few decades. “In the 1970s, the average age was four or five – more recently it’s been late teens and young adults.”

Many epidemiologists are now coming to the conclusion that the reason monkeypox first appeared to affect only children was the result of another global public health emergency: smallpox. At the time of the discovery of monkeypox, the world had just completed a global smallpox eradication campaign, which saw nearly every person on the planet vaccinated against the deadly disease. Smallpox and monkeypox are orthopox viruses, which means that smallpox vaccines also prevent monkeypox, hence the use of the two-dose Jynneos vaccine to inoculate high-risk people against the latter. .

“This may be another reason why demographics are skewed towards younger people, even in other epidemics,” Karan said. “There was basically a vulnerable population as soon as we stopped widespread smallpox vaccination, so it was only a matter of time before that happened.”

This apparent change in the epidemiology of monkeypox, experts have suggested, means that public concern about the spread in daycares or daycare centers – whether propagated by anti-gay conspiracy theorists or anxious parents who misinterpret current science on the disease – could be overstated.

“There’s something we don’t yet understand or fully understand about this outbreak,” said Karan, who noted that while most orthopox viruses, the family of viruses that includes smallpox and monkeypox , spread more easily in children than in adults, the current epidemic does not demonstrate this same trait.

“Orthopox viruses don’t mutate as quickly, and some studies have shown that some of the circulating strains have mutated much more than expected,” Karan said. “”I think in terms of epidemiology and transmission, we’re still learning a bit about what’s going on. “

Infectious disease specialists know better than most the risks of making authoritative statements about unprecedented viral outbreaks and are still waiting for the Centers for Disease Control and Prevention to release scientific advice on how to treat cases in children. But even without that guidance, Bryant said, parents and caregivers may actually be in a better position than most to identify early cases, due to monkeypox’s similarity to more common childhood illnesses.

“Children have a variety of infectious rashes that are much more common than monkeypox, so schools and daycares have protocols to keep sick children home and away from other children,” Bryant said. “These protocols work very well.”

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