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Child infected with monkeypox in Orange County, health officials report

A nurse holds a vial of monkeypox vaccine.
Luis Garcia, a registered nurse, prepares a monkeypox vaccine at St. John’s Well Child and Family Center in Los Angeles.
(Irfan Khan / Los Angeles Times)
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Orange County health officials this week confirmed the county’s first case of monkeypox in a child, a rare circumstance even as the virus continues to spread statewide.

“Please remember that monkeypox is very uncommon in children,” said Dr. Regina Chinsio-Kwong, Orange County’s health officer. “It is important to note that many childhood illnesses can cause rashes. If you or your children have a new or unusual rash, please follow preventive guidance and seek medical attention from a qualified healthcare professional for further recommendations.”

For the record:

10:08 p.m. Aug. 25, 2022A previous version of this article said youth illnesses made up about 2% of California’s total monkeypox cases. Juvenile cases are about 0.2% of the total.

There have been at least five other juvenile monkeypox cases in California. Still, the youth illnesses make up less than a quarter of a percent of the state’s total cases of monkeypox, which have now surpassed 3,000, state data show. In Orange County, officials had confirmed 126 cases as of Wednesday.

The majority of cases across California and globally continue to be in men or transgender people who have sex with men. The virus spreads primarily through intimate, skin-to-skin contact, such as intercourse. However, monkeypox also can be spread through items that have come in contact with infectious lesions, such as bedding or towels, and through respiratory droplets during close face-to-face contact, such as kissing.

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A city spokesperson confirmed the child’s infection was linked to household members but declined to disclose further information.

No one has died of monkeypox in the U.S., and most people recover without treatment, but the skin lesions that can develop can be extremely painful. A small percentage of infected people have ended up in the hospital for additional care, the California Department of Public Health has reported.

The first two cases of someone younger than 18 becoming infected with monkeypox were reported by the Centers for Disease Control and Prevention in late July, and included a toddler in California. At the time, CDC officials said that the two youth cases were linked to household members who were infected and that the children had received the investigational Tpoxx treatment drug, which has shown promise for lessening the severity of monkeypox symptoms.

The first pediatric monkeypox case in Los Angeles County also was linked to household members, Long Beach health officials said when that case was reported earlier this month. That child has since recovered.

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At least 2 cases of monkeypox are confirmed in L.A. County children, but health officials say the risk for kids remains low, including in school.

Chinsio-Kwong, with the Orange County Health Care Agency, declined to comment on specifics of the county’s first pediatric case, citing privacy. But she said the child “has been receiving appropriate care from their health provider and is improving.”

“It is very important for all potential cases to seek medical attention for appropriate assessment and treatment,” Chinsio-Kwong said. She said a full contact investigation is underway.

In a statement, the Orange County Health Care Agency said vaccines are being offered to those who may have been exposed to the child.

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Vaccines for monkeypox are still in limited supply, so widespread vaccination is not being recommended. The two-dose series is being offered to those most at risk, primarily men or transgender people who have sex with men and meet certain health or risk factors.

Orange County residents can check their eligibility and sign up for shots online or by calling the Health Care Agency’s referral line at (800) 564-9448 from 8 a.m. to 5 p.m. Monday through Friday.

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