Monkey pox in a daycare center was ‘just a matter of time’, expert says. Then: swimming pools, sports, schools

‘It was only a matter of time’ before monkeypox reached gathering places, says pediatric infectious disease specialist Fortuneafter Illinois state officials announced on Friday that a daycare worker had been diagnosed with the virus linked to smallpox.

“There is definitely the potential for the spread of monkeypox” in daycares, schools, college campuses, prisons and other similar settings, said Dr. Alexandra Brugler Yonts, infectious disease specialist at Children’s National. Washington Hospital, DC. She participated in the FDA review. of Jynneos, one of two smallpox vaccines licensed for the treatment of monkeypox, and by far the safer of the two.

“Anywhere there is close, skin-to-skin physical contact, especially among people who are in various stages of undressing, there is a risk,” she said.

All children and adults at the unidentified Champaign County, Illinois daycare center have been screened and no additional cases have been identified, state health officials said Friday, adding that the governor JB Pritzker had been in contact with the White House regarding the situation. .

But schools and congregate living spaces aren’t the only places for the spread, Brugler Yonts said. Also on his list of places where transmission could occur: swimming pools and water parks – “not by water, but by bumping into someone with active lesions – especially in the summer, given the heat and the tendency to minimize clothing”.

Contact sports like football and wrestling could also prove problematic, she added.

“Hopefully outbreaks can be contained more locally, but as people continue to travel, be part of the [aforementioned] activities, then with the next school year…. I think it will spread. There have already been cases in almost every state in the United States”

As of Friday, 7,510 cases had been identified in the United States, with the majority of cases in New York, California and Florida, according to data from the United States Centers for Disease Control and Prevention. All states except Wyoming and Montana had identified cases.

More than 28,000 cases have been reported worldwide since January, virtually all in countries where monkeypox is not considered endemic, according to the CDC. The United States now leads the world in identified cases, followed by Spain, Germany, the United Kingdom, France and Brazil. Only 345 cases have been identified since January in African countries where the virus is considered endemic. Eighty-one children had been infected by the end of July, according to the World Health Organization.

Illinois health officials said Friday that the U.S. Food and Drug Administration has cleared the use of Jynneos, licensed for use in adults 18 and older, for potentially affected children at the center. , “without jumping through normal hoops”. Mobile screening and vaccination services were on site, they added.

An FDA spokesperson told Fortune via email on Friday that the vaccine was approved for those children through an “expanded single-patient access investigational new drug application” submitted for each. Applications are processed “as expeditiously as possible” and approved “when no comparable or satisfactory alternative option is available and requested by the treating medical officers, who determine whether the benefits outweigh the likely benefits.” [sic] risk.”

The spokesperson would not comment further on the possibility of general approval for the use of Jynneos in children.

Because Jynneos is licensed, not just authorized under emergency use authorization as the original COVID vaccines were, it can be used ‘off-label’ – for example, given to children who have been exposed, Brugler Yonts said.

Researchers “will definitely want to collect data on the safety and, if possible, immunogenicity of these children and follow them closely, as there are no pre-existing data to use in the pediatric population,” she said. . “But Jynneos is safe, and if it can prevent a larger outbreak in the pediatric population – and of course the adults who care for them and live with them – that’s very important.”

The decision to provide the vaccine to children is “worth the potential risk”, she added.

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