School is in session. Should you worry about your kid catching monkeypox?

Dr. Lena Wayne: Monkeypox is primarily spread through prolonged, direct, skin-to-skin contact with someone who is actively shedding the virus. It is associated with intimate sexual activity, but can be spread by other close contact such as kissing and hugging. The most commonly affected groups are gay, bisexual and other men who have sex with men. A recently published study by the CDC found that 99% of cases occurred in men, of whom 94% reported recent male-to-male sexual or close intimate contact.

CNN: Let’s talk about some examples of common scenarios in a school setting. Can monkeypox be spread by sitting next to someone in class or riding a bus?

Wayne: This is extremely unlikely. Monkeypox is not spread just by sitting next to a person. Again, this is not COVID-19 – this virus is almost non-contagious.

CNN: What about kids playing together in the playground? Would touching the same objects put them at risk of transmitting monkeypox?

Wayne: In theory, it is possible that a child who has an exposed rash may touch another child while playing together. Young children also put things in their mouths that other children can touch and thus can cause infection.

If it starts spreading in children, then this may change, but we have not seen this till now.

CNN: Can sharing drinks or food spread monkeypox?

Wayne: Yes. Again, this is a lower risk than other close activities such as sexual activity discussed earlier, but sharing drinks or food is a possible mode of transmission. People infected with monkeypox should not share utensils or food items with others.

CNN: You said earlier that it can be spread with bedsheets and towels. Should parents and caregivers worry about trying on their children’s clothes and avoiding traveling to hotels?

Wayne: I do not think so. If someone is infected with monkeypox, they can put the virus on their clothing and other things their rash touches – for example, sheets, towels and other linens. If someone in your family has monkeypox, no one should share their clothes or bedding.

But this is very different from trying on clothes at the mall or going so far as to avoid staying in hotels. Of course, there is a theoretical possibility that a person who had just tried on the same clothes got monkeypox and left the virus on the clothes, but this is very unlikely. The same goes for hotels, where sheets and towels must be changed between guests anyway.

CNN: Are there certain activities for K-12 students that are at high risk?

Wayne: Activities that involve prolonged skin-to-skin contact will have a higher risk. For example, children involved in wrestling or tackle football will be at greater risk than those involved in cross-country running or swimming.

This does not mean that children should not participate in contact sports. Again, the incidence of monkeypox in children is currently so low that it should not be a major concern.

Some students in the school are sexually active. My concern would be to students, especially those who have multiple partners or are involved in sexual encounters with people they do not know well, because it is through this kind of intimate activity that mainly Monkeypox spreads.

CNN: This brings me to college students. What are the high-risk activities for them and what precautions should they take?

Wayne: Let’s look at activities according to the level of risk. The highest risk would be having sex with multiple partners. Intimate activity such as kissing and hugging with multiple people will also be at high risk.

Monkeypox transmission can also occur by sharing drinks, food, and items such as cigarettes and vapes, although this risk is low. Monkeypox transmission has also been documented in individuals who dance for long periods of time with many other people, especially if most individuals are not wearing clothing on certain parts of their body – resulting in greater skin-to-skin contact.

The risk of having a platonic roommate with someone is low, as is participating in most sports. Other day-to-day activities, such as going to class, dining with peers, and socializing with friends, are much less at risk. Teaching staff, professors and other school and university staff are at extremely low risk if they are not in direct skin-to-skin contact with students or each other.

CNN: What precautions would you advise college students to take?

Wayne: Know the activities that carry the most risk and try to reduce your risk. Since sexual activity is the highest risk, consider reducing the number of sexual partners until you have been vaccinated. Before engaging in intimate activity, ask if the other person has had new or unexpected rashes – and, if possible, consider exchanging contact information with any new sexual partners, if you or the latter develop symptoms. Try not to share drinks, food or cigarettes with many unknown people. If you’re going to a nightclub or bar where you expect to be very close with a lot of people, consider wearing long sleeves and pants to cover areas that will be touching others up close.

This reminds me – students should know where to go for the test. Many colleges will offer on-site testing. Others will advise you to visit a nearby commercial laboratory. All isolation procedures should be established in colleges. It will help to know what they are beforehand so that you are not alerted in case your test is positive.

CNN: The big picture – how should parents, caregivers, teachers and students consider the risk of monkeypox along with the risk of other infectious diseases?