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What Parents, Caregivers Should Know About Monkeypox

As of July 26, there were 231 cases reported by the Texas Department of Health and Human Services. The North Texas region accounted for almost half of the statewide total.

By Jean Yaeger

The global outbreak of monkeypox has raised concern now that at least two children in the United States have been diagnosed with the rare contagious disease.

Increasing cases of the rare monkeypox virus, which causes a rash and flu-like symptoms, prompted the World Health Organization on July 23 to declare monkeypox a public health emergency of international concern. Most reported cases are in males who have sexual contact with other males, according to the Centers for Disease Control and Prevention.

The monkeypox virus spreads when someone touches an infected person or items, including clothing, contaminated with the virus. Transmission primarily occurs through direct contact with lesions, scabs, or body fluids. Prolonged exposure to an infected person’s respiratory secretions can also transmit the virus. 

As of July 26, there were 231 cases reported by the Texas Department of Health and Human Services. The North Texas region accounted for almost half of the statewide total.

The CDC says that there have been 408 cases nationwide in the 16 to 20-year-old range, as of Oct. 5.  In Texas, there have been 16 cases in people under 18 years old.

“At this time, data suggest that gay, bisexual, and other men who have sex with men make up the majority of cases in the current monkeypox outbreak," the CDC said. "However, anyone, regardless of sexual orientation or gender identity, who has been in close, personal contact with someone who has monkeypox is at risk.”

However, young children are still at risk. The two known positive cases in children in the United States involve a toddler in California and an infant in Washington, D.C. Children under age 8 are among those most at risk for serious illness or death from monkeypox, according to the CDC. 

The CDC says monkeypox rash can be confused with other rash illnesses commonly considered in children, including chickenpox; hand, foot, and mouth disease; measles; scabies; allergy rashes; and adverse reactions to medication.

“Most cases of monkeypox resolve spontaneously and both adults and children can be safely quarantined at home," said Nicholas Rister, M.D., of the Cook Children's Infectious Disease team. "However, if you are concerned that your child may have come into contact with a monkeypox case or is developing symptoms, be sure to discuss this with your child’s provider to determine if additional testing or treatment is indicated.”

Frequently Asked Questions 

What is monkeypox?

Monkeypox is an infectious zoonotic disease caused by a virus related to smallpox. Symptoms are similar to smallpox symptoms, but usually milder and lasting two to four weeks.

How does it spread?

  • Direct contact with the infectious rash, scabs or body fluids
  • Contact with clothing, linens, eating utensils or items that previously touched the infectious rash
  • Respiratory secretions from prolonged up-close contact with an infected person
  • Eating the meat of an infected animal or being scratched or bitten
  • In pregnancy, to the fetus through the placenta 

What are the key symptoms?

Fever, malaise, headache, chills, sore throat and cough, and swelling of the lymph nodes are typical initial symptoms. A rash then appears inside the mouth or on the body. The lesions are painful and fill with fluid before eventually scabbing over.  Once all the scabs fall off, a person is no longer contagious. Go here to view CDC photos of the monkeypox rash.

What happens next in suspected cases?

Monkeypox should be considered as a possible diagnosis if doctors identify a rash in patients who recently traveled to central or west African countries or other areas reporting a monkeypox outbreak. Testing can confirm the diagnosis.

The patient should isolate at home to limit transmission. Treatment is rarely necessary.

For more information:

Monkeypox | Poxvirus | CDC

Prevention | Monkeypox | Poxvirus | CDC

Monkeypox | Home (

About Cook Children's

Cook Children’s Health Care System embraces an inspiring Promise – to improve the health of every child through the prevention and treatment of illness, disease and injury. Based in Fort Worth, Texas, we’re proud of our long and rich tradition of serving our community. Our not-for-profit organization is comprised of nine companies, including our Medical Center, Physician Network, Home Health company, Northeast Hospital, Pediatric Surgery Center, Health Plan, Health Services Inc., Child Study Center and Health Foundation. With more than 60 primary, specialty and urgent care locations throughout Texas, families can access our top-ranked specialty programs and network of services to meet the unique needs of their child. For 100 years, we’ve worked to improve the health of children from across our primary service area of Denton, Hood, Johnson, Parker, Tarrant and Wise counties. We combine the art of caring with leading technology and extraordinary collaboration to provide exceptional care for every child. This has earned Cook Children’s a strong, far-reaching reputation with patients traveling from around the country and the globe to receive life-saving pediatric care. For more information, visit