Risk of Mpox Transmission to Child Household Contacts

Reviewed by Michael Payne, MD, Providence Health Care

This study was based in California and created a line list of all pediatric mpox household contacts aged <16 years reported through August 31, 2022. They identified 129 pediatric household contacts with median age of 7 years (range 0-15 years). Post-exposure prophylaxis (PEP) with the JYNNEOS vaccine, was recorded using the state vaccination database. Among 18 symptomatic contacts, 12 (66.7%) underwent mpox testing; 5 (41.2%) were confirmed cases, 6 (50%) were negative, and 1 (0.8%) had an indeterminate result. Six symptomatic children were not tested for mpox (33.3%). Overall, after clinical review, six mpox infected contacts were identified, resulting in a secondary attack rate of 4.7% (6/129). Among infected contacts, median age was 4.5 years (range 2-9 years) and three of six resided in the same household. Only 18 children (14%) reported receiving PEP and none of the children receiving PEP developed mpox. This study updates the risk of transmission through household, non-sexual pediatric contacts. Overall, the rate of transmission was low, however, the risk was greater for children under 10, suggesting increased direct contact/care, as a risk factor. PEP with vaccination was protective, however, underutilized in this study cohort.

Reference:The Journal of Infectious Diseases, Oct, 2023, jiad448, https://doi.org/10.1093/infdis/jiad448

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