More than 100,000 San Diego Unified students will head back to in-person learning in coming weeks as the rare monkeypox disease spreads in the region.
County officials declared the disease a public health emergency last Tuesday, following Gov. Gavin Newsom’s lead to bolster vaccination efforts. Parents say they’re not too worried about monkeypox spreading in schools, but a health expert says schools and families should take precautions. Student athletes who participate in close-contact sports are at highest risk, but the district has no plans to discontinue sports, a spokesperson said.
Monkeypox cases have increased throughout the country since mid-May, when the first case in the U.S. was detected in Massachusetts. There are 8,934 confirmed cases in the U.S. and 1,310 in California as of Monday, the Centers for Disease Control and Prevention reports.
San Diego County data shows that the region has 98 monkeypox cases as of Sunday. None of those cases are children. According to the CDC, children younger than age 8 are at an increased risk of experiencing severe outcomes. But so far, at least four children in the United States have confirmed cases of monkeypox, including three cases in California.
The viral infection can be transmitted from an animal or human to another human through close contact with skin lesions, respiratory secretions and objects that an infected person or animal has touched, according to the World Health Organization.
Symptoms typically last up to four weeks and include a fever, an intense headache, swollen lymph nodes, back pain, muscle aches and a rash on the face and or body parts.
Despite the county’s decision to declare a public health emergency, guidance for San Diego schools may likely go unchanged. Instead, the district will send families a fact sheet about monkeypox and strategies for preventing the disease in their back-to-school packets, said Maureen Magee, communications director for San Diego Unified.
Schools may not be the primary place where students get monkeypox because it’s spread through close contact and it’s not moving quickly among school age populations, said Dr. Howard Taras, a pediatrician at UC San Diego who advises the county and school districts on health policies.
“In school, very close skin to skin contact is not all that frequent,” he said. “But there are important exceptions.”
Student athletes that participate in wrestling, rugby and certain types of dancing – where exposed skin and close contact are likely – are at an increased risk of getting monkeypox, Taras said.
Other sports, such as football, also carry a risk of spreading monkeypox, Taras said, but the risk is lower because athletes wear long sleeves and helmets. He said at this time he has no additional guidance for schools.
“I think what really may be more important to do is to re-emphasize a lot of the public health precautions that we asked schools to take for other skin transmitted diseases,” he said.
Workout mats should be cleaned, and athletes especially should check their skin before playing, he said, adding that other skin infections like staph, hand, foot and mouth disease and boils also can be prevented by following these precautions. Children should avoid touching each other, being near individuals that may be ill and sharing utensils, drinks and smoking devices.
Monkeypox may also spread through droplets in the air, so a mask may offer some protection for anyone in a room for a long time with an infected person, Taras said.
San Diego Unified students and staff will be required to wear a mask indoors as long as COVID-19 transmission levels remain high.
Magee said the district had no plans to discontinue close contact sports.
The district, which is the second largest in the state, also will not track monkeypox cases in schools publicly as it does with COVID-19 cases, and there are no plans to offer testing at school sites, Magee said.
A health care provider would be able to test for monkeypox, but Taras said results tend to take a long time and there are limited labs available to process them.
“It's going to be up to the student's own doctor about how much they feel that this child or staff member has the chance of having monkeypox,” he said.
The risks for children
Vaccines for monkeypox are not widely available, but that should not worry families, Taras said.
“It's not going to become a school-required vaccine anytime soon because there's just not enough of it, and school age children are really a very low risk group at this point,” he said.
Days before the county announced the public health emergency, San Diego health clinics ran out of monkeypox vaccination appointments after going through its supply of the JYNNEOS vaccine, one of two vaccines used for the prevention of monkeypox.
There’s currently a larger supply of the ACAM2000 vaccine in the U.S. compared to the JYNNEOS vaccine, but the CDC does not recommend the ACAM2000 vaccine for everyone because of its more severe side effects.
The supply of JYNNEOS is expected to increase in the following weeks and months, the CDC reports.
Jessica Vasquez, a San Diego Unified parent, isn’t worried about children catching monkeypox in schools.
“I’m not very concerned about monkeypox,” Vasquez said. “I feel like most of the COVID-19 mitigation in place right now will definitely help with reducing the chance of monkeypox transmission as well.”
If cases crop up in schools, it’s unlikely that schools will close or transition to remote learning as they did for COVID-19, Taras said, adding school closures happen if there’s an outbreak of a respiratory illness or disease like COVID-19 or chickenpox.
“Monkeypox is rarely respiratory, although it can be,” Taras said. “I don't think that you'll see that around the world. It's going to be a different kind of epidemic.”
For now, Taras advises parents to avoid sending their ill children to school. If lesions begin to appear on the body, parents should notify their doctor immediately, he said.
“I think now it's more worthwhile to bring your doctor into the conversation (early on),” Taras said.
San Diego Mayor Todd Gloria has asked the public to take monkeypox seriously.
“Take a moment to educate yourself about monkeypox, understand the risk factors that are involved and make sure you take the proper precautions for yourself and for your loved ones to make sure we stop the spread of monkeypox within our community,” he said.
