Mpox in Children and Adolescents: Epidemiology, Clinical Features, Diagnosis, and Management

Abstract

Although mpox is rare among children in the United States, pediatric cases are being reported during the 2022 multinational mpox outbreak. Vaccines and antiviral medications developed for other orthopoxviruses have recently become widely used to prevent and treat mpox in both children and adults in the United States. Although scientific literature regarding mpox in children and adolescents is scant, prior case reports can provide valuable information about the clinical features and potential complications of untreated clade II mpox in these age groups. In this review, we summarize the epidemiology and clinical features of mpox in children and adolescents and provide recommendations for clinicians regarding its diagnosis, management, and prevention. Robust, dedicated surveillance of pediatric exposures and cases in the current outbreak, including the use of vaccines and therapeutics, are needed to guide clinical management and public health strategies.

FIGURE 1

Mpox photos. Clinical photographs depicting an early vesicle (1A), umbilicated pustule (1B), ulcerated lesion (1C), and diffuse pustular rash (1D). 1A, 1B, 1C image credit: UK Health Security Agency. 1D image credit: NHS England High Consequence Infectious Diseases Network.

FIGURE 2

Epidemiologic criteria. See https://www.cdc.gov/poxvirus/monkeypox/clinicians/case-definition.html for Case Definitions for Use in the 2022 Mpox Response.