The Centers for Disease Control and Prevention (CDC) has reported more than 14,000 cases of monkeypox in the United States and is increasing rapidly, with the vast majority among gay or bisexual men. As cases begin to appear outside this community, they will provide insight into alternative means that the virus can spread.
Close and frequent physical contact remains the primary carrier for transmission. However, recent cases in young children suggest that prolonged physical contact may not be as necessary as previously suspected. The extent to which the virus can be transmitted remains fine.
Given what epidemiologists and public health officials are watching and learning in real time, the virus is ripe for spreading to the general population if transmission can result from more casual physical contact. The most vulnerable subpopulations are the youngest members of society: children, school children and young adults in college. Young children and the immunosuppressed are most at risk of unpleasant consequences.
Young children have a natural tendency to play with and touch each other. If one such child is infected with monkeypox, they can cause local outbreaks with other children and their teachers. Many such children engage in physical contact such as sports wrestling. Such activities are innate. Attempting to limit or prevent such physical contact is not only futile, but it can also be detrimental to their development.
Older children also display a natural tendency for close physical contact. Team sports such as wrestling, football, basketball and rugby involve significant physical contact, creating an environment for transmission of the virus. Young people in this age group also begin to explore dating, providing even more potential opportunities for virus transmission.
College students are probably the most vulnerable. Interaction is plentiful both inside and outside the classroom. Packed classrooms, dormitories and accommodation, as well as sporting events all bring students closer to each other.
So, what are the drivers that can let monkeypox barrel through these populations?
First, there is an insufficient supply of vaccines available to all of these populations, even with doses being split five-to-one. Second, the expedited shipping and transportation of vaccines to essential locations would be a logistics nightmare. Third, and most critically, vaccinating such children and young adults, the so-called “last mile”, will be the most challenging.
Even if vaccine supply is significantly expanded and supply chain logistics streamlined, vaccine resistance and hesitancy will undoubtedly emerge and become issues.
In the absence of vaccines, schools must do what they do best: educate.
State public health departments need to create and enhance education campaigns that they can distribute to public schools. Such information can also be made available to private schools.
Without education, college students can be confused and confused by the information available in the media. Some may believe that it is a sexually transmitted disease confined to the gay and bisexual community. It’s not. It is a communicable disease that spreads when people live in physical proximity for a long time. Sexual contact may be enough to transmit the virus, but it is not necessary.
Parents of school children will be equally confused, which means education programs are important to them. Keeping students physically isolated is impractical and detrimental to their emotional development and well-being. Parents should be educated and alert for skin lesions or other symptoms in their children. School nurses should also be involved in this process, which includes testing.
Monkeypox is sure to cross over to the male gay and bisexual community. In fact, it is likely to already happen, but has not yet been widely recognized. With schools opening in the next two weeks, the time to take action has indeed passed, but action is imperative to be prepared for a wave of infections that must be contained.
Our country failed to stop the spread of COVID-19. It’s time to show that we are capable of doing this with monkeypox.
Sheldon H. Jacobson, Ph.D., computer science at the University of Illinois at Urbana-Champaign and Carle is a professor at the Illinois College of Medicine. A data scientist, he applies his expertise in data-driven risk-based decision-making to evaluate and inform public policy.
Janet A. Jocela, MD, MPH, is executive associate dean at Carle Illinois College of Medicine at the University of Illinois at Urbana-Champaign. He is an infectious disease and public health physician.
(This story has not been edited by seemayo staff and is published from a rss feed)