As cases of monkeypox continue to rise in Texas, child care providers and school districts are cautiously monitoring the situation.
The good news, according to infectious disease experts and the Centers for Disease Control and Prevention, which released guidance for schools and child care settings last week, is that the risk to children is extremely low.
“It is possible for anyone to catch monkeypox if they have close, personal contact with an infected person,” the CDC said. “However, at this time, the risk in schools and early childhood settings is low.”
Fort Worth schools leaders are in touch with local officials as the situation progresses, according to a statement shared with the Star-Telegram.
“The Fort Worth ISD is in regular communication with Tarrant County Public Health and monitoring community cases as we would any communicable disease, following public health guidance,” the district said in a statement. “(We) encourage anyone with symptoms or concerns to consult their healthcare provider.”
There have been 87 cases reported in Tarrant County, according to the Tarrant County Public Health website.
Here are five key questions answered in the latest guidance from the CDC.
My child has a rash. Do they need to get tested?
Symptoms of monkeypox include fever and a rash.
So if you or your child shows those signs, do you need to get tested?
You should consult your doctor and particularly keep an eye on those symptoms if you know you or your child was exposed to someone with monkeypox.
According to the CDC, several illnesses can cause a rash and fever in children, such as hand-foot-mouth disease and chickenpox.
A healthcare provider can determine what treatment or testing the child needs, the CDC said.
Some symptoms in young children may also be difficult to recognize promptly, the CDC warns.
When monitoring a child for illness following exposure to monkeypox, parents and caregivers should check the child’s temperature daily and also perform daily full-body skin checks for a new rash, according to the guidelines. Parents should also inspect the inside of the mouth for any sores or ulcers on young children, according to the CDC.
The guidance suggests that for older children and adolescents, parents can help with inspection of the mouth and exposed skin areas that may be difficult for the child or adolescent to see, such as the back of neck, arms and legs.
You can also remind your child or adolescent to be aware of any rash or pain in areas covered by clothing, including the genitals and to inspect those areas for rash and let the parent know if they notice any changes in their skin or feel any pain in those areas, according to the guidance.
If a child or adolescent develops symptoms while at home, the parent or caregiver should contact the local health department and their healthcare provider. If symptoms develop, your child should not return to school or day care until they see a doctor.
Adults with symptoms of monkeypox should avoid close contact, including having sex with anyone, until they have been checked out by a healthcare provider or at a public health clinic.
Do teachers, students need the monkeypox vaccine?
There are vaccines available for monkeypox for children as young as 5 months old. But the CDC only recommends vaccination for three groups of people who are at high risk for contracting the disease:
“At this time, there is no need for widespread vaccination for monkeypox among children or staff at K-12 schools or early childhood settings,” according to the CDC.
If you get monkeypox, how long should you isolate?
Isolation and quarantine practices have been commonplace at schools and day cares due to COVID-19. So if you are exposed to monkeypox, or test positive for the disease, how long do you need to stay out of school?
According to the CDC, monkeypox causes a rash with lesions that eventually scab over.
People who are confirmed to have the disease should prioritize isolation and prevention practices until all scabs have fallen off and a fresh layer of healthy skin has formed. That process could take as long as 4 weeks, according to the guidance.
Caregivers should work with a healthcare provider and the department of health to decide when the child or adolescent can return to the educational setting, according to the CDC’s FAQ.
Staff or volunteers who have monkeypox should isolate and be restricted from the workplace. The CDC suggests that employers should provide flexible, non-punitive sick leave policies for staff members.
The Texas Education Agency has not released any guidance for schools on whether teachers or students would be able to take time off or work remotely in the event they test positive. They did not respond to questions by press time Monday.
What about exposure?
The four-week isolation guidance is only for confirmed cases. Students exposed to the virus “can attend school and other school-related activities even if they have had close contact with someone with monkeypox.”
The health department will provide specific guidance should an exposure occur, the CDC says.
How do schools, day care centers need to prepare?
Child care centers, schools and other settings that work with children have enhanced precautions to slow the spread of infectious diseases over the last two years due to the COVID-19 pandemic.
Existing precautions like washing hands regularly, sneezing and coughing into your elbow, and staying home when sick were reiterated. Those same precautions protect against the spread of monkeypox, according to the CDC.
In addition, organizations should identify “private spaces for assessment of an ill child away from others and provide personal protective equipment (PPE) for staff who care for students with infectious diseases.”
In the event of a monkeypox exposure, the department of health will help in considering “appropriate actions to prevent the spread of the virus.”
In the event of infection in a classroom or child care center, the area will be cleaned and disinfected before continued use.
This includes disinfecting surfaces, floors and shared items such as toys, learning materials, sports equipment, or uniforms used by the person with monkeypox. Linens or towels that the person with monkeypox used will be laundered, according to the guidance, and items that cannot be cleaned, disinfected, or laundered will be thrown away.
Schools and care facilities will also work with the health department to track those exposed to the virus so they can be notified and watch for symptoms. The guidance suggests children should be monitored for 21 days after being exposed.
I have monkeypox and can’t isolate from my child. What should I do?
If you contract monkeypox and are the sole caregiver for your child, you can continue to care for your child with some precautions.
“If a child cannot be completely separated from the parent or caregiver with monkeypox, the parent or caregiver should continue to care for the child in an age-appropriate manner including regular interaction based on the physical and emotional needs of the child,” the CDC states in their FAQ.
The parent or caregiver should, however, cover their rash with clothing, gloves, or bandages and wear a well-fitting mask.
While skin-to-skin contact with an infected person is one of the most common methods of transmission, the disease can also spread by small water droplets from the mouth. Therefore, the CDC recommends that the child or adolescent, if 2 years of age or older, should wear a well-fitting mask or respirator during interactions with the parent or caregiver.
Similar to a classroom, anything the infected person comes into contact with including surfaces, floors and shared items should be cleaned or discarded.
The parent should work with their doctor and their health department for further guidance on the child’s activities outside the home, the CDC suggests — adding that in cases such as these, vaccination may be appropriate for the exposed child.
“It is also important to discuss vaccination for exposed children with the health department,” the CDC said. “A vaccine is available that can help prevent monkeypox in people who have been exposed if it is given soon after exposure.”
While the guidance reiterated existing precautionary measures, the CDC continues to underline the rarity of monkeypox in children.
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