Student Well-Being

The Monkeypox Outbreak: What School Leaders Need to Know

By Evie Blad — August 05, 2022 4 min read
A visitor checks in at a pop-up monkeypox vaccination site at the West Hollywood Library on Wednesday, Aug. 3, 2022, in West Hollywood, Calif. The City of West Hollywood is working with public health officials at the Los Angeles County Department of Public Health in responding to the monkeypox outbreak.
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Though federal health officials have declared monkeypox a public health emergency, there’s no cause for panic among school and district leaders, epidemiologists told Education Week Friday.

The COVID-19 pandemic may have primed public expectations about such an emergency declaration, but the monkeypox outbreak remains smaller and—unlike COVID-19—unlikely to be spread through brief incidental contact or interactions, experts said.

Just five of the 7,000 confirmed cases of monkeypox in the United States were children, according to the latest data from the Centers for Disease Control and Prevention.

While there are likely to be additional pediatric cases as the country works to contain the outbreak, school leaders should be informed, not alarmed, said Wafaa El-Sadr, professor of epidemiology and medicine at Columbia University.

“It’s really important to distinguish that this is not COVID-19. I would allay that anxiety,” El-Sadr said. “Obviously, there is always a concern when there is an outbreak of any infectious disease, but at the same time, there is no cause for panic.”

Here’s what school leaders need to know about monkeypox and about the emergency declaration.

What is monkeypox? Can children get it?

Monkeypox is a rare disease that was first documented in humans in 1970 and has caused occasional outbreaks since, according to the CDC. Symptoms include a blister-like rash that lasts for two to four weeks, fatigue, fever, aches, nasal congestion, and cough. The virus is rarely fatal, the agency said in guidance to physicians.

The virus is spread primarily through direct, person-to-person contact or through contact with items like towels and bed linens that have touched an infected person’s rash, the CDC says.

Children who are at higher risk of severe illness include those 8-years-old and younger, children with compromised immune systems, and those with skin conditions like eczema or severe acne. Health officials expect they will identify additional cases in children as testing becomes more widely available.

Obviously, there is always a concern when there is an outbreak of any infectious disease, but at the same time, there is no cause for panic.

The current outbreak has spread to the United States and Europe, and the vast majority of documented cases have been in LGBTQ patients—specifically men who have sex with men, federal health officials said Thursday. The disease is not believed to be sexually transmitted, but it has spread through intimate, skin-to-skin contact, the CDC health guidance said.

The White House, in coordination with other federal agencies, is focusing much of its messaging efforts on that affected population while acknowledging that the virus can spread in the general population. Agencies have ramped up vaccinations and testing, and officials plan to work with LGBTQ advocates and community groups to spread messaging about risks and symptoms of monkeypox.

Could monkeypox spread in schools?

When Illinois officials announced that an adult worker at a Champaign child-care facility tested positive for monkeypox Friday, they stressed that the virus does not spread as easily as COVID-19. Children who attend the center will be screened for the illness, but none had tested positive Friday, they said.

The CDC and other federal agencies have not released any official guidance for school and district leaders about monkeypox as children have represented very few cases.

The pediatric cases documented in the United States have been transmitted between members of the children’s households at home, said El-Sadr, of Columbia.

“While COVID-19 is transmitted by casual contact and by people who have no symptoms at all … with monkeypox it’s quite different,” she said. “The main route of transmission requires prolonged skin-to-skin contact.”

Although it’s possible that contact could occur in school settings or through contact sports like wrestling, it’s still likely to be a relatively rare occurrence, El-Sadr said.

School and district leaders should listen to local health officials and encourage children with bumps, rashes, or lesions to consult a doctor, she said.

And, because transmission is largely through direct contact, it’s unnecessary for school leaders to prepare detailed contact tracing plans like they did for COVID-19, El-Sadr said.

Schools can play a role in combatting monkeypox stigma

Monkeypox “is not nearly as contagious as some other diseases children routinely pass from one person to another, but it has happened, and school administrators should be aware it could happen,” said Gigi Gronvall, a senior scholar at the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health.

Because the disease has largely been associated with LGBTQ people, a population that is subject to stereotype and discrimination, school leaders should be prepared to confront misinformation and stigma if parents become aware that student has contracted a case.

That may mean providing basic information about the illness, clarifying that it can be spread through non-sexual contact, and connecting families to resources from trusted sources, she said.

For example, in San Francisco, one of the cities that has seen rising cases of monkeypox, school district officials have shared information from the local health department on the school system’s website.

Why declare a public health emergency?

U.S. Health and Human Services Secretary Xavier Becerra declared a public health emergency Thursday.

Such a declaration will allow federal officials to more easily direct resources like vaccines and therapeutics and to collect and share state-level information about cases.

“We are applying lessons learned from the battles we’ve fought—from COVID response to wildfires to measles, and will tackle this outbreak with the urgency this moment demands,” he said in a statement.

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