State health officials recommend masks in schools but requirements are up to districts. (Jon Cherry/Getty Images)
The newest infection of monkeypox in Oregon involves a child, marking the first pediatric case in the state.
Oregon Health Authority officials said Wednesday the child is linked to another patient with the disease, which is usually transmitted through skin-to-skin contact with lesions. The child was tested for monkeypox on Aug. 11, and the test results were reported to the Health Authority on Monday, officials said.
With the school year starting, the announcement could alarm parents, health authorities acknowledged, but they said Covid presents a bigger risk.
“This child did not get the virus at school, child care or another community setting,” Sidelinger said in a statement released shortly before a news conference.
He declined to release the child’s age range or any other details to protect the child’s privacy. Doing so, he said, would not impact the risk to others.
“In general, being in a classroom, being in a hallway, eating lunch at a table with someone with monkeypox would not put that person at significant risk,” Sidelinger said in the news conference.
He said the outbreak is primarily linked to men who have sex with men.
The virus spreads through skin-to-skin contact, like cuddling, massage, kissing and sex. But it can be transmitted by contaminated clothes, bedding or other material. He advised patients to isolate and cover their lesions.
“Parents should keep children home if they’re sick, especially if they develop a new rash,” Sidelinger advised.
It can take up to four weeks for the disease to end. Patients are infectious until the scabs fall off.
The outbreak is growing, with 116 cases in Oregon. Sidelinger said that is an undercount.
“It is an undercount, but how much of an undercount I can’t be sure,” Sidelinger said.
So far, 112 men and four women in seven counties have been infected: four in Clackamas, one in Columbia, one in Coos, 20 in Lane, one in Marion, 73 in Multnomah and 16 in Washington. Nearly one-third of the cases are Hispanics.
Nationwide, according to the federal Centers for Disease Control and Prevention, there are nearly 12,700 cases in 49 states, the District of Columbia and Puerto Rico. They are among more than 38,000 cases in 93 countries.
Sidelinger said patients should talk to a health provider if they experience symptoms. Monkeypox can start with flu-like symptoms – fever, chills and swollen lymph nodes – and turn into a rash, often first on the face and spreading to the limbs.
Health officials will investigate any school cases and offer vaccines to anyone at risk of exposure, Sidelinger said. An investigation is underway in connection to the child with monkeypox.
The state has allocated its limited supplies of the only federally approved vaccine for monkeypox – Jynneos, which is made in Denmark – to people who’ve had contact with someone with monkeypox and those who’ve had more than one anonymous sexual partner in the previous two weeks.
Some Oregon providers have started to administer the vaccine just under the skin instead of in fatty tissue in the arm, Sidelinger said. Such intradermal shots of the vaccine just under the skin only require one-fifth a dose.
Risk of Covid falls
Though monkeypox is spreading, Covid appears to be waning. The seven-day average of new daily cases has fallen from about 1,400 the week of July 20 to about 850 the week of Aug. 16, Sidelinger said.
The test positivity rate – the number of positive tests among all Covid tests reported to the state – fell from 13.8% the week of July 20 to 11.4% the week of Aug. 7. The number of counties at high risk for Covid, according to the CDC, fell from 22 a month ago to five: Coos, Sherman, Umatilla, Wallowa and Wasco counties.
Hospitalizations have also declined from 464 on July 20 to 328 currently.
Nevertheless, Covid continues to spread. Sidelinger recommended that children and adults get vaccinated. A new booster is in the works from Pfizer and Moderna targeting the two latest omicron variants – BA.4 and BA.5 – and the original variant. But it’s not clear when those will be available.
“The good news is that the vaccines we currently have available to people to stay up to date with doses are keeping people out of the hospital, keeping people from having severe disease and keeping people from dying,” Sidelinger said.
The Health Authority has no plans to lift the masking requirement in health care settings but it does not foresee enacting any more requirements, including mandating Covid vaccines in schools.
“We’ll continue to review the effectiveness of our vaccines and the impact on schools, but I don’t see any recommendation for school vaccination requirements for COVID-19 coming any time soon,” Sidelinger said.
The Department of Education is also taking something of a hands-off strategy, leaving mitigation strategies up to schools.
“Almost all decisions will be local,” Colt Gill, director of the Education Department, said in the news conference. “Masking at times and ventilation will continue to be key as we adjust to the COVID-19 variants that may come our way, as well as other respiratory illnesses this year.”
The Education Department rolled back its requirements in spring and turned decisions over to schools, which vary among districts.
“I’m really confident in our local school leadership and our local public health authority leadership to manage and help maintain in-person instruction for our students,” Gill said. “We think that’s really important.”
The Education Department has developed a new tool for educators and students called Classroom Wise – a collection of articles and videos with guided tutorials, role playing scenarios and interviews with youth and school personnel.
“This self-guided content for adults and for youth is filled with tools for enhancing mental health and well-being,” Gill said. “It covers many important topics like building safe, healthy relationships, best practices for supporting youth, experiencing life challenges and distress, and skills for handling challenging behaviors.”
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