Is monkeypox worse in children? How severe is virus among kids, how many cases in UK, and symptoms explained

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Monkeypox cases in the UK are continuing to rise, with close contacts of confirmed cases advised to isolate for three weeks

As of 22 August 2022 there were 3,207 confirmed and 133 highly probable monkeypox cases in the UK. Of these, 78 were in Scotland, 27 were in Northern Ireland, 44 were in Wales and 3,191 were in England, the UK Health Security Agency (UKHSA) said.

From 8 June, monkeypox has been listed as a notifiable disease in law, which means all doctors in England are required to notify their local council or local Health Protection Team (HPT) if they suspect a patient has monkeypox.

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Laboratories must also notify the UKHSA if the monkeypox virus is identified in a laboratory sample.

A rash usually begins one to five days after the first monkeypox symptoms appearA rash usually begins one to five days after the first monkeypox symptoms appear
A rash usually begins one to five days after the first monkeypox symptoms appear | Mark Hall/National World

But is monkeypox worse in children than adults?

Here’s what you need to know.

What are the symptoms of monkeypox?

The illness begins with:

  • high temperature
  • headache
  • muscle aches
  • backache
  • swollen glands
  • chills
  • exhaustion

A rash then usually begins one to five days after the first symptoms appear. The spots often start on the face before spreading to other parts of the body.

During the illness, the rash then changes from raised red bumps, to spots filled with fluid, with the spots eventually forming scabs which later fall off.

Is monkeypox worse in children?

Martin Michaelis, professor of molecular medicine at the University of Kent, said monkeypox could present a greater risk to children as children are “particularly vulnerable to this disease and have not been vaccinated against smallpox”.

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This is echoed by Hussain Abdeh, clinical director and superintendent pharmacist at Medicine Direct, who said more severe cases of monkeypox often affect children.

However, he added that the severe cases in children are to do with how long they were exposed to the virus and how healthy the child was before catching it.

People with immune systems that are weaker than average are also at a higher risk.

He added that it has also been suggested people under the age of 40 might be more susceptible to this condition “due to having not been vaccinated against smallpox”, but this depends on the country.

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Mr Abdeh said that although the fatality rate of monkeypox was generally higher in children, it is important to bear in mind that the fatality rate of monkeypox is “generally low”, even in areas where the condition is more severe.

The fatality ratio has been around 3-6% in recent times.

However, Mr Abdeh added that in the UK, monkeypox is not normally a serious problem and will usually go away within a few weeks with treatment.

Researchers who have been looking into the current monkeypox outbreak, as well as past cases of the disease, have also said the virus is rare in children.

Dr David Porter, paediatric infectious diseases consultant, Alder Hey Children’s NHS Foundation Trust, said: “As a parent with a child that might develop a rash, I don’t think parents should be worried about this being…monkeypox at this stage, because we’re seeing a very low number of cases.

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“And in all the previous outbreaks that have occurred outside of Africa over the last few years, we’ve seen very rare numbers of cases in children, so it’s been predominantly in adults anyway.”

He added that if children have a rash and no contact history with someone who has had monkeypox, parents and carers should be reassured and follow what they normally do.

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