A pediatric case of monkeypox has been described in a child under the age of 10 in the Netherlands. The little patient had arrived in an emergency room in Amsterdam. These are rare episodes, but the authors of the study that analyzes the episode, published in ‘Eurosurveillance’, explain that they have chosen to talk about it to raise doctors’ awareness of this possibility. What is striking in the story of the baby patient infected with monkeypox is the fact that they have not been able to trace the source of the infection, which is classified as unknown.
The call for attention is also reiterated by Catherine Smallwood, expert of the regional office of the World Health Organization (WHO) for Europe, who, commenting on the pediatric case of monkeypox described by the team of scientists from Dutch universities and institutions (the first signatures of the study are coats from Emma Children’s Hospital), highlights via social: “The investigation could not identify any source of infection. Doctors should be aware that, although rare, monkeypox can occur in children “.
So it was in this patient, that 3 weeks before going to hospital she had had a sore throat without fever which resolved spontaneously the next day. Then he had been on vacation in Turkey for a week. Upon returning, he noticed two small, round skin lesions on his face, left lower jaw and cheek. The general practitioner began to treat him with antifungal cream, but in the following days, more lesions appeared on the child’s face. The doctor suspected yet another pathology, until about 20 solitary lesions appeared in other parts of the body. And then the patient was transferred to the hospital with the clinical suspicion of monkeypox.
The baby’s overall health was good and he didn’t even have swollen lymph nodes. On the skin were vesicles, seen at the level of the limbs, for example, but not in the oral cavity or in the genital region. As the major route of transmission in the current monkeypox outbreak is related to sexual activity, experts have also ruled out the possibility of sexual abuse through a careful history.
The various samples taken from the patient were all positive except those relating to urine. And the virus identified belongs to the clade of the current monkeypox outbreak in Europe. The child’s family members tested negative and his higher-risk contacts were vaccinated.
Since it was not possible to identify a plausible source of the infection, “an open question remains about transmission”, reason the experts. “Other indirect routes of transmission have been described, such as respiratory transmission through droplets or contaminated materials such as bedding and towels.” Therefore, “it is possible that the child has been in close contact with an infected person or with a contaminated object that has not been recognized as such. Although the incubation described may vary between 5 and 21 days, the average incubation period estimated in the confirmed patients in the Netherlands was estimated at 8.5 days. This would indicate that the infection for the child may have occurred in early June. “