The two cases are unrelated and likely the result of household transmission, the CDC said.
One case is a child who is a resident of California. The other is a non-US resident infant. Public health officials are investigating how the children became infected.
Both have symptoms but are in good health and are being treated with an antiviral drug called tecovirimat, or TPOXX, which the CDC recommends for children younger than 8 because they are considered to be at higher risk of infection.
Since the monkeypox outbreak began in May, most cases have occurred among men who have sex with men. However, anyone can spread the virus through close skin-to-skin contact. In the case of children, the agency said this could include “holding, cuddling, feeding, as well as through shared items such as towels, bedding, cups and utensils”.
The CDC says the Jynneos monkeypox vaccine is available for children through special expanded use protocols. The agency has also developed new guidance for health care providers on the identification, treatment and prevention of monkeypox in children and adolescents.
Dr. Jennifer McQuiston, deputy director of the CDC’s Division of Pathogens and High Consequence Pathology, said Friday that the cases in children were not surprising and that the US should be prepared to respond to more.
“The social networks that we have as humans means that we have contact with a lot of different people. And while this outbreak is spreading in a particular social network at the moment, I think we’ve sent a message from the beginning that there could be cases that occur outside of these networks and that we need to be alert and ready to respond and message them,” he said.
“I know in Europe and other places where this outbreak is also expanding, they’ve reported cases in children, in women. And I think the same thing is happening and expected to happen here in the United States,” he said.
“There’s no evidence so far that we’re seeing this virus spread outside of these populations to any degree,” McQuiston said.
Improve the supply of vaccines
The US government has sent 300,000 monkeypox vaccines to US states and territories by Friday afternoon.
“This means hundreds of thousands of Americans will be vaccinated in a matter of days or weeks,” Dr. Ashish Jha, the White House’s co-ordinator of the Covid-19 response, said on Friday. “Jurisdictions, state territories and cities receive their vaccines typically about 30 hours after ordering them.”
Jha said Friday that New York City had received enough monkeypox vaccine to provide at least one dose to about half of its eligible population, while D.C. had obtained enough to provide a dose to 70 percent of its eligible population.
Newly released doses increase the available supply, but cover only a small portion of the eligible population. The CDC estimates that more than 1.5 million people are eligible for the monkeypox vaccine.
The prescribing information for the Jynneos vaccine says that a full course is two injections four weeks apart. The CDC and the US Food and Drug Administration have said that people need both doses to fully prevent the disease.
But in New York City and some other places seeing a high degree of viral spread, officials have been giving as many people as they can a first shot, even before second doses are available.
That strategy makes sense, Jha said Friday.
“The FDA and the CDC clearly believe that people need two doses. And the reason New York and many other places have been able to move forward with a first dose to everyone is because we’ve been able to show them that more doses are coming. and that the second doses can be given to people,” he said. “So with that in mind, we encourage people to go ahead and use all their doses as first doses.”
People can be vaccinated against monkeypox if they know they were exposed to the virus or if they suspect they were exposed because they had multiple sexual partners or were at an event where smallpox is known to have spread.
“We continue to see that the majority of cases in the United States have been reported among people who identify as gay, bisexual or other men who have sex with men,” McQuiston said. More than 99% of cases of monkeypox in the United States for which the CDC has information have involved sexual contact between men.