Differences and similarities between Monkeypox and Chickenpox in children during an outbreak

Area of Science:

• Pediatric Infectious Diseases
• Viral Dermatology
• Epidemiology of Zoonotic Diseases

Background:

• The 2022 Monkeypox virus (MKPV) outbreak saw rare pediatric cases in non-endemic countries.
• Distinguishing MKPV from other rash-inducing illnesses in children is challenging.
• Chickenpox, caused by varicella-zoster virus (VZV), is a common childhood illness with rash presentation.

Purpose of the Study:

• To investigate the incidence of Monkeypox virus (MKPV) in children initially suspected of infection.
• To differentiate MKPV from varicella-zoster virus (VZV) in pediatric patients presenting with rash.
• To assess the diagnostic accuracy for MKPV in a pediatric cohort.

Main Methods:

• Retrospective study of children under 16 years old suspected of MKPV infection.
• PCR testing for MKPV DNA and VZV DNA on cutaneous lesion swabs.
• Data collected from March 23rd, 2022, to October 20th, 2022.

Main Results:

• None of the 14 children suspected of MKPV tested positive for MKPV DNA.
• Varicella-zoster virus (VZV) DNA was detected in 17% (30/168) of pediatric cutaneous swabs.
• Seven VZV-positive children had atypical rashes initially suspected as MKPV.

Conclusions:

• Pediatric Monkeypox virus (MKPV) cases were rare during the 2022 outbreak in non-endemic regions.
• Varicella-zoster virus (VZV) infection is a more common cause of rash in children than MKPV.
• Vigilance is needed for potential close contact or sexual transmission of MKPV in children, and for novel, more contagious variants.