With the American monkeypox outbreak in a state of uncontrolled spread, public health authorities are concerned that outdated science and bad faith scapegoating are combining forces to scare parents about the epidemic’s threat to their children. sons.
Epidemiologists, infectious disease specialists, and public health authorities almost universally agree that the current outbreak appears to pose a low risk to children at this time. But as far-right figures link the virus to unfounded panic about LGBT people “grooming” children, and as some media outlets and online influencers speculate monkeypox could flourish in school settings , those guarantees run the risk of being drowned.
“The few infected children have been close household contacts of cases,” said Dr. David Freedman, an emeritus professor of infectious diseases at the University of Alabama and an expert in tropical diseases. “I just don’t think silent transportation to a school setting is a huge risk unless the guidelines are completely ignored.”
The tangle of unintentional misinformation and intentional disinformation has grown in recent weeks as leading far-right conservative figures and conspiracy theorists have seized on a handful of pediatric cases as proof that gay men are abusing sexually of children on a large scale.
“Who is raping children in DC?” Laura Loomer, conspiracy activist and unsuccessful congressional candidate, wrote on Telegram last week, linking to an article confirming a case of monkeypox in a baby in the nation’s capital.
“Has any law enforcement agency investigated how those two children got monkeypox? Or just, like… right? Michael Knowles, a conservative commentator for The Daily Wire who accused teachers of “grooming” children if they do not disclose a child’s sexual orientation to the child’s family, tweeted in response to another pair of pediatric infections.
Those accusations – part troll, part continuation of a decades-long smear campaign against LGBT people – have been bolstered by other, more well-intentioned concerns voiced by parents and health activists who see the monkeypox outbreak as a successor to potential of COVID-19. pandemic.
Those activists and educators, like the geneticist-slash-podcaster Spencer Wells, who predicted “this is not going to be a fun school year” because of the risk of pediatric monkeypox, have seized on the longstanding medical belief that children—who face a higher risk of complications from monkeypox infection—spread the virus more easily, particularly in school settings. But scientific understanding of monkeypox contagion, methods of transmission and the risk to certain populations have changed dramatically in recent years, experts told The Daily Beast, and children may not face as much risk of infection. as previously thought.
“European countries that reported pediatric cases reported one or two cases, so the virus is not spreading among children,” said Dr. Kristina Bryant, a pediatric infectious disease specialist at the University of Louisville School of Medicine. . “I really don’t think we need to worry about the spread of this virus in schools or daycares.”
Part of the misunderstanding, said Dr. Abraar Karan, an infectious disease researcher at Stanford University, is rooted in outdated interpretation of nearly half-a-century-old data. The current outbreak, Karan said, has forced public health officials to unlearn decades of knowledge about the virus, including the earlier bias that monkeypox was largely confined to children.
“Children will be in close contact — they’ll touch a lot of surfaces, they won’t wash or clean their hands, they’ll be very exposed to fomites — whereas adults are probably more diligent about what they touch, what they put in their mouths, what they have in your hands, how often you wash your hands, that sort of thing,” Karan said, explaining the thinking behind a five-year study in the 1980s that found that nine out of 10 cases of the virus occurred in children under the age of fifteen years.
But recent reassessments of that and similar surveys, infectious disease experts told The Daily Beast, indicate those pediatric cases may not have been shown to be a unique monkeypox risk to children.
“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 been changing,” said Bryant, noting that the average age of monkeypox patients has slowly increased in recent decades. “In the seventies, the average age was four or five years old; more recently, they were late adolescents and young adults.”
Many epidemiologists are now concluding that the reason monkeypox first seemed to affect only children was the result of another global public health emergency: smallpox. At the time of the discovery of monkeypox, the world was finishing a global smallpox eradication campaign, in which almost every person on the planet was vaccinated against the deadly disease. Both smallpox and monkeypox are orthopox viruses, meaning that smallpox vaccines also prevent monkeypox, hence the use of the two-dose Jynneos vaccine to inoculate high-risk people against monkeypox .
“That may be another reason why the demographics skewed toward younger people, even in other outbreaks,” Karan said. “Basically, there was a vulnerable population as soon as we stopped widespread smallpox vaccination, so it was a matter of time before this happened.”
That apparent shift in the epidemiology of monkeypox, the experts suggested, means that public concern about the spread in day care centers or nurseries, whether spread by anti-gay conspiracy theorists or anxious parents that misunderstand the current science on the disease, could be exaggerated.
“There’s something we still don’t fully grasp or understand about this outbreak,” Karan said, noting that while most orthopox viruses, the family of viruses that includes smallpox and monkeypox, spread more easily among children than among adults, the current outbreak is not demonstrating that same trait.
“Orthopoxemia viruses don’t mutate as quickly as easily, and some studies have shown that some of the circulating strains have mutated much more than expected,” Karan said. “I think with regards to the epidemiology and transmission, we’re still learning a little bit about what’s going on.”
Infectious disease specialists know better than most the risks of making authoritative claims about unprecedented viral outbreaks, and they’re still waiting for the Centers for Disease Control and Prevention to issue science-based guidance on how to tackle cases in children. . But even without such guidance, Bryant said, parents and educators may actually be better positioned than most to identify early cases, because of monkeypox’s similarity to more common childhood illnesses.
“Children get a variety of infectious rashes that are much more common than monkeypox, so schools and day care centers have protocols to keep sick children home and away from other children,” Bryant said. “Those protocols work very well.”