Public health officials announced Friday the first cases of monkeypox in children in the United States, including one toddler living in California and an infant living in another state.
Both children likely became infected by others in their household, the Centers for Disease Control and Prevention said in a statement, though the causes are under investigation.
The child in California was in close contact with an adult who was infected with the virus in the same household, a spokesperson with the California Department of Public Health said in a statement.
“Because monkeypox spreads through close physical contact, it is not unusual for people living in the same household who are unable to isolate to contract the virus,” the department said.
The California case was unrelated to the other pediatric monkeypox case, which involved an infant who is not a U.S. resident and was infected in a separate state, the CDC said.
Both cases have links to gay men, CDC Director Rochelle Walensky said in a Washington Post livestream interview Thursday during which the cases were first announced. The virus, which spreads primarily through close skin-to-skin contact, is circulating mostly among men who have sex with men, as well as transgender and nonbinary people.
“When we have seen those cases in children, they have generally been adjacent to the community most at risk,” Walensky said, adding that both children “are doing well” and are receiving tecovirimat antiviral treatment, known as TPOXX.
While health officials have stressed that the virus is rare and not a threat to the general public, LGBTQ activists and health leaders have demanded a more aggressive response from public health officials who they say have left their community unprepared for its spread, pointing to a shortage of vaccines and a lack of awareness.
Although federal officials have promised more vaccines to Los Angeles County, experts still say the supply is falling short of demand.
In San Francisco, the waitlist for the the two-shot Jynneos vaccine, the primary option in the U.S., was in the thousands.
Walenksy said she expects the number of cases to rise in August as federal officials look to scale up testing and boost the amount of information shared with local providers.
Cases have already been surging across California, especially in San Francisco and Los Angeles, coinciding with Pride events. In late June, there were about 40 known cases of monkeypox in California. As of this week, that number has climbed to 434.
Monkeypox was confirmed or considered probable in 147 people in Los Angeles County alone, a nearly 80% increase from a week prior, according to county data. Cases in San Francisco more than doubled over the last week, increasing to 197 on Friday.
The virus has not caused any deaths in the U.S.; symptoms include severe pain and visible lesions on the skin and a rash that may look like pimples or blisters that often first appears in the genital area. Symptoms may last up to a month.
Though anyone who comes in close skin-to-skin contact with an infected person can receive the virus, it is more easily spread during sex or close face-to-face contact such as kissing.
Most of the U.S. monkeypox cases known to the CDC involve people who have recently traveled or have had close contact with someone who was infected.