今年秋天家長和學校需要了解的關於猴痘的知識

資料來源：莉哈.蒂爾尼 / 2022 年 8 月 18 日 / WebMD / 財團法人台灣紅絲帶基金會編譯

 

到目前為止，美國至少有九名兒童的猴痘檢測呈陽性。截至目前，美國兒科學會表示，兒童感染病毒的風險很低。

儘管如此，「如果兒童和青少年生活在或最近去過感染率較高的社區，他們更有可能接觸猴痘」，該學院表示。

隨著返校季正式開始，請繼續閱讀以了解有關如何防止猴痘傳播的更多信息。

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兒童患猴痘有什麼症狀？

兒童感染猴痘的方式與成人感染的方式相同。根據疾病預防控制中心的說法，兒童和成人最常見的猴痘症狀是皮疹，看起來像凸起的腫塊。

Paulette Gray Riveria 醫學博士是路易斯安那州衛生部的家庭醫學醫生和區域醫療主任，她說，您可以透過皮疹隨時間的變化來判斷皮疹是否是猴痘。「猴痘皮疹會從最初的扁平、凸起、充滿液體，最後變成結痂，最終脫落並被一層新鮮的皮膚取代」，她說。

Riveria 說，猴痘瘡通常同時出現，並一起經歷不同階段，不同階段的瘡不太常見，發燒、頭痛、疲勞和淋巴結腫大在猴痘兒童中也很常見，但可能不會出現在每一個案例中，疾病預防控制中心說。

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孩子們有罹患猴痘重病的風險嗎？

康乃迪克州耶魯紐黑文兒童醫院的兒科傳染病醫生 Carlos Oliveira 醫學博士說，大多數猴痘病例都是「自限性的」，這意味著它們會自行消失而無需治療。也就是說，美國兒科學會警告，嬰兒、幼兒、免疫系統較弱的兒童以及患有濕疹等皮膚病的兒童如果感染猴痘，更有可能導致重症。

疾病預防控制中心還表示，若感染了剛果盆地猴痘病毒株的 8 歲以下兒童更有可能發生嚴重感染。 （也就是說，目前在世界範圍內傳播的猴痘是西非病毒株，已知它會引起較輕的疾病。）

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學校如何預防猴痘的傳播？

猴痘病毒主要在人們直接接觸猴痘皮疹內的液體時傳播。這可能透過皮膚接觸或接觸感染者皮疹污染的物品而發生。毛巾、床上用品、衣服、洗漱用品和共用器具等物品都可能傳播猴痘。

疾病預防控制中心還表示，像猴痘這樣的痘病毒很頑固。研究人員在一名感染猴痘的人離開後 15 天在家中仍發現了活病毒。

好消息是，學校已經用於防止 COVID-19 傳播的策略也可用於預防猴痘，例如「鼓勵個人空間，促進經常洗手，並告訴父母生病時讓孩子留在家中」，里維利亞說。

對於年齡較大的學生，比如高中生，里維里亞說「最好的預防措施就是提高疾病意識」。她說，對於年輕人來說，了解猴痘皮疹的樣子、猴痘如何傳播以及他們在哪裡可以獲得醫療照護和治療非常重要。

她說，年輕人應該「避免與患有猴痘或接觸過病毒的人接觸」。「雖然疾病意識很重要，但將負責任的行為與這種意識保持一致同樣重要」。

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有兒童猴痘治療藥物和疫苗嗎？

Oliveira 說藥物 tecovirimat 和 Jynneos 疫苗可用於預防兒童嚴重的猴痘感染。

Tecovirimat 是一種可以治療與猴痘屬同一家族的病毒的藥物。它已獲得 FDA 批准用於治療天花，但 CDC 允許將其用於嚴重的猴痘感染。根據 CDC 的說法，一名 28 個月大的兒童接受了 tecovirimat且並沒有有害的副作用，但還沒有任何關於藥物如何影響兒童的研究。

Jynneos 疫苗於 2019 年獲得批准，用於預防成人的天花和猴痘。本月，FDA 授予該疫苗緊急使用授權，該疫苗將用於 18 歲以下罹患猴痘嚴重疾病風險的兒童。也就是說，據 Oliveira 說，兒科醫生需要獲得 FDA 的許可才能給兒童接種 Jynneos 疫苗。 

世界衛生組織表示，對於輕度猴痘病例，照護應側重於緩解症狀和控制併發症。患有猴痘的兒童的父母或看護人應避免接觸兒童可能與皮膚接觸過的任何物品，並在處理受污染的物品時使用手套等個人防護設備。奧利維拉說，任何患有猴痘的人都具有傳染性，直到他們的所有病變都結痂並癒合。

「疾病預防控制中心建議患有猴痘的人在他們的病程中保持隔離，通常持續 2 到 4 週」，他說。 「手部衛生是預防感染的簡單有效工具。還建議對密切接觸者進行隔離和接種疫苗」。

Riveria 向家長們保證，雖然猴痘會導致兒童患上更嚴重的疾病，但與成人相比，「到目前為止，我們還沒有看到這種理論上的風險在現實中發揮作用」。

「父母應該保持警惕，但不要過度警惕」，她說。

 

資訊來源：

Paulette Gray Riveria，醫學博士，家庭醫學醫師；路易斯安那州衛生部公共衛生辦公室區域醫療主任。

Carlos Oliveira，醫學博士，兒科傳染病醫師，耶魯紐黑文兒童醫院。

美國兒科學會：「猴痘」。

CDC：「兒童和青少年猴痘的臨床考慮」，「猴痘病毒家庭消毒臨時指南」，「更安全的性行為、社交聚會和猴痘」，「美國2022 年期間猴痘病例根據擴大取得研究新藥協議使用 Tecovirimat 的指南」。

FDA：「猴痘更新：FDA 緊急授權使用 JYNNEOS 疫苗以增加疫苗供應」。

世界衛生組織：「猴痘」。

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What Parents Need to Know About Monkeypox and School This Fall

Leigha Tierney / August 18, 2022 /  WebMD

So far, at least nine children in the U.S. have tested positive for monkeypox. As of now, the American Academy of Pediatrics says the risk of children becoming infected with the virus is low.

Still, “children and adolescents are more likely to be exposed to monkeypox if they live in or have recently traveled to a community with higher rates of infection,” the academy says.

As back-to-school season officially kicks off, read on to learn more about how to prevent the spread of monkeypox.

What Are the Signs of Monkeypox in Children?

Monkeypox infection in children appears in the same way it shows up in adults. The most common sign of monkeypox in children and adults is a skin rash that looks like raised bumps, according to the CDC.

Paulette Grey Riveria, MD, a family medicine doctor and a regional medical director for the Louisiana Department of Health, says that you can tell if a rash is monkeypox by the way it changes over time. “A monkeypox rash will change from being initially flat, to raised, to filled with fluid, and finally to a scab that eventually falls off and is replaced by a fresh layer of skin,” she says.

Monkeypox sores usually appear all at once and go through the different stages together, and it’s less common to have sores in different stages, Riveria says Fever, headache, fatigue, and swollen lymph nodes are also common in children with monkeypox, but they may not appear in every single case, the CDC says.

Are Kids at Risk for Severe Sickness From Monkeypox?

Carlos Oliveira, MD, a pediatric infectious disease doctor at Yale New Haven Children’s Hospital in Connecticut, says most monkeypox cases are “self-limiting,” meaning they go away on their own without treatment. That said, the American Academy of Pediatrics warns that infants, young children, children with weakened immune systems, and children with skin conditions like eczema are more likely to become severely sick if they catch monkeypox.

The CDC also says that children under 8 years old infected with the Congo Basin variant of monkeypox are more likely to have a severe infection. (That said, the monkeypox variant spreading around the world right now is the West African variant, which is known to cause a milder illness.)

How Can Schools Prevent the Spread of Monkeypox?

The monkeypox virus mainly spreads when people have direct contact with the fluid inside monkeypox rashes. This can happen through skin-to-skin contact or by touching items that have encountered the rash of an infected person. Things like towels, bedding, clothing, toiletries, and shared utensils all can spread monkeypox.

The CDC also says poxviruses like monkeypox are hardy; researchers have found live virus in the home of a person infected with monkeypox 15 days after they had left.

The good news is that the strategies schools have already used to prevent the spread of COVID-19 can be used to prevent monkeypox as well, like “encouraging personal space, promoting frequent hand-washing, and telling parents to keep kids home when sick,” Riveria says.

For older students, like those in high school, Riveria says “the best precaution is awareness.” She says it’s important for young adults to know what monkeypox rashes look like, how monkeypox spreads, and where they can get health care and treatment.

Young adults should “avoid contact with a person who has monkeypox or has been exposed to the virus,” she says. “While awareness is critical, aligning responsible behavior with that awareness is just as important.”

Are There Monkeypox Treatments and Vaccines for Kids?

Oliveira says the medication tecovirimat and the Jynneos vaccine can be used to prevent severe monkeypox infections in children.

Tecovirimat is a medication that can treat viruses in the same family as monkeypox. It is FDA-approved for treating smallpox, but the CDC allows it to be used for severe monkeypox infection. According to the CDC, a 28-month-old child received tecovirimat and had no harmful side effects, but there haven’t been any studies on how the medication affects kids.

The Jynneos vaccine was approved in 2019 to prevent smallpox and monkeypox in adults. This month, the FDA gave emergency use authorization for the vaccine to be given to children younger than 18 years old who are at risk of severe sickness from monkeypox. That said, pediatricians need permission from the FDA to give the Jynneos vaccine to children, according to Oliveira.

For mild cases of monkeypox, the World Health Organization says care should focus on easing symptoms and managing complications. Parents or caretakers of children with monkeypox should avoid touching any items the child may have had skin contact with and use personal protective equipment like gloves when handling contaminated items. Any person with monkeypox is contagious until all their lesions have scabbed over and healed, says Oliveira.

“The CDC recommends that individuals with monkeypox stay in isolation for the course of their disease, which normally lasts between 2 to 4 weeks,” he says. “Hand hygiene is a simple and effective tool to prevent infection. Isolation and vaccination of close contacts is also recommended.”

Riveria reassured parents that while monkeypox can cause more severe illness in children, compared to adults, “we are not seeing this theoretical risk play out in reality thus far.”

“Parents should be vigilant, but not hypervigilant,” she says.

Sources

Paulette Grey Riveria, MD, family medicine doctor; regional medical director, Louisiana Department of Health, Office of Public Health.

Carlos Oliveira, MD, PhD, pediatric infectious disease doctor, Yale New Haven Children’s Hospital.

American Academy of Pediatrics: “Monkeypox.”

CDC: “Clinical Considerations for Monkeypox in Children and Adolescents,” “Interim Guidance for Household Disinfection of Monkeypox Virus,” “Safer Sex, Social Gatherings, and Monkeypox,” “Guidance for Tecovirimat Use Under Expanded Access Investigational New Drug Protocol during 2022 U.S. Monkeypox Cases.”

FDA: “Monkeypox Update: FDA Authorizes Emergency Use of JYNNEOS Vaccine to Increase Vaccine Supply.”

World Health Organization: “Monkeypox.”