The two cases are unrelated and likely the result of transmission from home, the CDC said.
One case is a young child who is a resident of California. The other is a non-US resident infant. Public health officials are investigating how the children were infected.
Both have symptoms but are in good health and are being treated with an antiviral drug called tecovirimat, or TPOXX, which the CDC recommends for children under 8 because they are considered to be at higher risk of infection.
Since the monkeypox outbreak began in May, most of the cases have been among men who have sex with men. However, anyone can catch the virus through close skin-to-skin contact. In the case of children, the agency said this could include “holding, cuddling, feeding, as well as through shared objects such as towels, bedding, cups and utensils”.
The CDC says the Jynneos monkeypox vaccine is provided to children through special extended use protocols. The agency has also developed new guidelines for healthcare providers on identifying, treating and preventing monkeypox in children and teenagers.
Dr. Jennifer McQuiston, deputy director of the CDC’s Division of Pathogens and High-Impact Pathology, said Friday that the cases in children were not surprising and that the U.S. should be prepared to respond to more.
“The social networks we have as humans mean we have contact with many different people. And while this epidemic is spreading in a particular social network right now, I think we’ve been sending messages from the beginning that there can be cases, they’re happening outside of those networks, and that we need to be vigilant about that and be ready to respond and we send messages about it,” she said.
“I know that in Europe and other places where this outbreak is also expanding, cases have been reported in children, in women. And I think the same thing is happening and expected to happen here in the United States,” she said.
“There is no evidence to date that we see this virus spreading outside of these populations to any degree,” McQuiston said.
Vaccine availability is improving
The US government had shipped 300,000 monkeypox vaccines to US states and territories as of Friday afternoon.
“That means hundreds of thousands of Americans will be vaccinated in a few days or weeks,” Dr. Ashish Jha, the White House’s co-ordinator of the Covid-19 response, said on Friday. “Jurisdictions, state territories, cities get their vaccines usually about 30 hours after they order them.”
Jha said Friday that New York has received enough monkeypox vaccine to provide at least one dose to about half of the eligible population, while D.C. has received enough to provide one dose to 70% of the eligible population .
Newly released doses increase the available supply but cover only a small fraction of the eligible population. The CDC estimates that more than 1.5 million people are eligible for the monkeypox vaccine.
The prescribing information for the Jynneos vaccine says the full course is two injections given four weeks apart. The CDC and US Food and Drug Administration said people need both doses to completely prevent the disease.
But in New York and some other places where the virus is spreading, officials are giving out the first shot to as many people as possible, even before second doses are available.
That strategy makes sense, Jha said Friday.
“FDA and CDC clearly believe that people need two doses. And the reason that New York and a lot of other places were able to move forward with a first dose for everyone is because we were able to show them that more doses are coming and that second doses will be able to be given to people,” he said. “So, with that in mind, we encourage people to go ahead and use all of their doses as first doses.”
People are eligible to be vaccinated against monkeypox if they know they have been exposed to the virus or if they suspect they have been exposed because they have had multiple sexual partners or attended an event where monkeypox is known to have spread smallpox.
“We continue to see the majority of cases in the United States reported among individuals who identify as gay, bisexual or other men who have sex with men,” McQuiston said. More than 99% of monkeypox cases in the U.S. for which the CDC has information have involved sexual contact between men.
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