A person who works at a day care in Illinois has tested positive for monkeypox and potentially exposed children, who are at higher risk for severe outcomes from the virus, state officials announced Friday.
Authorities said no one else has tested positive. Illinois health officials had determined that between 40 and 50 people, many of whom are children, had been potentially exposed to the day-care worker directly or to items that had been handled by the person, officials said.
“We are casting a wide net,” Julie Pryde, administrator of the Champaign-Urbana Public Health District, wrote in a text message Friday night. Pryde said that several dozen children had been offered vaccines, pending their guardians’ approval.
Officials from the new White House team of monkeypox coordinators, the FDA and the Centers for Disease Control and Prevention learned of the day-care worker’s infection early Friday afternoon and worked to expedite vaccines to the potentially exposed individuals. One official estimated that the necessary paperwork to allow children to receive the vaccines was completed within an hour, noting that the faster a vaccine is given after exposure the more likely it is to prevent infection.
Local officials also credited the federal response, which has been scrutinized in recent weeks by physicians and patients who have complained of unnecessary bureaucracy when trying to access treatments, tests and vaccines. Sameer Vohra, director of the Illinois Department of Public Health, commended federal regulators Friday for allowing the swift vaccination of exposed children with their parents’ approval and “without jumping through the normal hoops in this process.”
The virus spreads by close contact to an infected person and is not airborne. State officials said the day-care worker is also employed in a home-health-care setting and that they were in touch with the affected client.
Federal officials have confirmed more than 7,500 cases of monkeypox across the United States, overwhelmingly among gay and bisexual men. At least five children have confirmed cases of monkeypox believed to be the result of household transmission, according to federal officials.
The case of the day-care worker in Illinois has heightened concerns among public health authorities who are worried the outbreak will circulate more broadly and affect populations that are more vulnerable to severe outcomes — including children — if it is not contained, particularly as students return to schools and college campuses this fall.
Monkeypox illnesses usually resolve after a few weeks and there are no known fatalities in the United States. But for children and people with weak immune systems, the disease can lead to severe medical complications and had a higher fatality rate in young children in past outbreaks, according to the World Health Organization.
Public health officials are trying to communicate a nuanced message that sexually active gay men face the highest risk of contracting monkeypox because it is currently spreading through close, often skin-to-skin contact, primarily among men who have sex with men. But, officials warn, viruses do not always remain in one demographic and can infect anybody.
“An infection anywhere is potentially an infection everywhere,” said Anne Rimoin, an epidemiologist at UCLA who has studied the monkeypox outbreak and praised officials’ effort to rapidly make vaccines available to people exposed in Illinois. “The more cases we see, the more opportunity for spread we see — and the more likely these scenarios are to exist.”
While monkeypox infections can incubate for weeks, Rimoin also stressed that people exposed to the day-care worker in Illinois would not necessarily test positive. “Household contacts do not always get monkeypox — it’s not as transmissible as coronavirus,” she said.
Although monkeypox, in the current outbreak, is primarily spread by close contact during sex among gay and bisexual men, global health authorities warn it can spread in other ways that usually involve prolonged contact, such as hugging, kissing and dancing without clothes. Potential sources of spread to children include prolonged holding, cuddling and feeding, as well as through shared items such as towels, bedding, cups and utensils.
Last week, the CDC sent a health advisory to clinicians alerting them to be on the lookout for symptoms of the virus among other vulnerable populations, including children and adolescents. To prevent the spread of the virus between children and caregivers or household members, officials recommend avoiding contact with people who are infected and their clothing, towels and bedding.
Illinois Gov. J.B. Pritzker (D) declared Monday that monkeypox was a public health emergency, saying the move would improve coordination among state agencies and expedite Illinois’ response to the virus. Health and Human Services Secretary Xavier Becerra on Thursday subsequently declared a national public health emergency for monkeypox, with Biden administration officials saying the move would unlock new funding and authority that could help contain the virus and end the U.S. outbreak.
In the Illinois case, the day-care worker with monkeypox is in isolation and in good condition, officials said. Families of potentially exposed children were offered mobile testing and financial assistance to isolate if necessary, authorities said.
“Anyone with even a tiny little suspicion, we will put them in isolation pending any type of results,” Pryde said.