Monkeypox may be on its way to a school near you

The U.S. Centers for Disease Control and Prevention (CDC) has reported more than 14,000 cases of monkeypox and is rapidly increasing, the vast majority of whom are gay or bisexual men. They will provide insights into alternative ways of spreading the virus as cases begin to emerge outside that community.

Close and continuous physical contact remains the primary vector of transmission. However, recent cases in young children suggest that prolonged physical contact may not be as necessary as initially suspected. The range of ways in which the virus spreads remains subtle.

Given that epidemiologists and public health officials are watching and learning in real time, the time is ripe for the virus to spread to the general population if it can be spread through more casual physical contact. The most vulnerable subpopulations are the youngest members of society: toddlers, school children and young adults in college. Young children and the immunosuppressed remain at the highest risk of adverse outcomes.

Young children have a natural tendency to play and touch each other. If one such child were to contract monkeypox, they could start a local outbreak along with other children and their teachers. Many of these children engage in physical contact, such as naughty wrestling. This activity is innate. Attempting to limit or prevent this physical contact is not only futile, but may be detrimental to their development.

Older children also show a natural tendency for close physical contact. Team sports such as wrestling, football, basketball and rugby all involve a lot of physical contact, creating an environment for the virus to spread. Young people in this age group are also beginning to explore dating, providing more potential opportunities for the virus to spread.

College students may be the most vulnerable. The interaction inside and outside the classroom is very rich. Crowded classrooms, dorms and residences, and sporting events have all brought students closer together.

So what are the likely drivers of monkeypox’s spread in these populations?

First, the vaccine available to all of these populations is in short supply, even if the doses are split five to one. Second, getting a vaccine quickly to where it’s needed would be a logistical nightmare. Third, and most critical, vaccinating these children and young adults, the so-called “last mile,” will be the most challenging.

Vaccine resistance and hesitancy will undoubtedly surface and become a problem, even if vaccine supplies are substantially expanded and supply chain logistics streamlined.

In the absence of a vaccine, schools need to do what they do best: educate.

State public health departments need to create and intensify educational campaigns that can be distributed to public schools. This information can also be provided to private schools.

Without education, college students may be confused and confused by information in the media. Some may think it’s a sexually transmitted disease limited to the gay and bisexual community. It is not. It is an infectious disease that spreads when people are in close contact for prolonged periods of time. Sexual contact may be enough to spread the virus, but it’s not required.

Parents of school-aged children can be equally confused, which means it’s critical to their educational plans. Keeping students physically separated is not feasible and is detrimental to their emotional development and well-being. Parents must be educated and alert for skin lesions or other symptoms in their children. School nurses must also be involved in the process, including testing.

Monkeypox is sure to cross the gay and bisexual community. In fact, it may already exist, but it has not been widely recognized. With schools reopening for the next two weeks, the time for action is practically over, but action must be taken to prepare for the wave of infections that must be contained.

Our country has failed to contain the spread of COVID-19. It’s time to prove we’re capable of dealing with monkeypox.

Sheldon H. Jacobson, Ph.D., is a professor of computer science at the University of Illinois at Urbana-Champaign and the Carl Illinois School of Medicine. As a data scientist, he applies his expertise in data-driven risk-based decision-making to evaluate and inform public policy.

Janet A. Jokela, MD, MPH, is the executive associate dean of the Carl Illinois School of Medicine at the University of Illinois at Urbana-Champaign. She is an infectious disease and public health physician.

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