In the meantime, students are coming back to school. Parents, caregivers, teachers and students have a lot of questions. Can monkeypox be spread by sitting next to someone with the virus in a classroom or playing in the playground together? Could it be transmitted by sharing food or drinks? Are there certain activities for K-12 students that are higher risk? What about for college students? And what about the risk of other infectious diseases?
CNN: Let’s talk about some examples of common scenarios in school settings. Can monkeypox be spread by sitting next to someone in a classroom or riding the bus together?
Wen: That’s extremely unlikely. Monkeypox is not transmitted just by sitting next to a person. Again, this is not Covid-19 — this virus is not nearly as contagious.
CNN: What about kids playing closely on the playground together? Would touching the same objects put them at risk for monkeypox transmission?
Wen: In theory, it’s possible that a child who has an exposed rash could touch another child while playing together. Small kids also put objects in their mouth that could then be touched by other kids, and transmission could occur that way.
This could change if outbreaks start happening in children, but that’s not what we have seen thus far.
CNN: Could monkeypox be spread by sharing drinks or food?
Wen: Yes. Again, this is lower risk than the other close activities discussed earlier like sexual activity, but sharing drinks or food is a possible method of transmission. People infected with monkeypox should not be sharing utensils or food or drink with others.
CNN: You said earlier that it could be spread through bedsheets and towels. Should parents and caregivers worry about their kids trying on clothes and avoid travel in hotels?
Wen: I don’t think so. If someone is infected with monkeypox, they could shed the virus onto their clothing and other things that touch their rash — for example, bedsheets, towels and other linen. If someone in your family has monkeypox, no one should share their clothes or bed.
But that’s very different from going so far as to avoid trying on clothes at the mall or staying in hotels. Of course, there is a theoretical possibility that the person who just tried on the same clothes had monkeypox and left virus on the clothes, but the odds of that happening are very low. Same goes for hotels, where the sheets and towels should be replaced between guests anyway.
CNN: Are there certain activities for K-12 students that are higher risk?
Wen: Activities that involve prolonged skin-to-skin contact will be higher risk. Kids involved in wrestling or tackle football, for example, would be higher risk than if they did cross-country running or swimming.
That doesn’t mean children shouldn’t participate in contact sports. Again, the incidence of monkeypox in kids is currently so low that this shouldn’t be a major concern.
Some students in school are sexually active. My concern would be for those students, especially those with multiple partners or engaging in sexual encounters with people they don’t know well, as it’s through such intimate activity that monkeypox is primarily spread.
CNN: That brings me to college students. What are high-risk activities for them, and what precautions should they be taking?
Wen: Let’s go through activities by level of risk. Highest risk would be sexual intercourse with multiple partners. Intimate activity like kissing and cuddling with multiple people would also be high risk.
Sharing drinks, food and objects like cigarettes and vapes, could also result in monkeypox transmission, though that risk is lower. Monkeypox transmission has also been documented in individuals dancing for long periods of time in close quarters with numerous other people, especially if most individuals are not wearing clothes over parts of their body — that results in more skin-to-skin contact.
Being platonic roommates with someone is lower risk, as is participating in most sports. Other day-to-day activities, like going to class, dining with peers and socializing with friends, are extremely low risk. Teaching staff, professors and other school and university staff are at extremely low risk if they are not engaging in skin-to-skin direct contact with students or one another.
CNN: What precautions would you advise college students to take?
Wen: Know the activities that have the highest risk and try to reduce your risk. Since sexual activity is highest risk, consider reducing the number of sex partners until you are vaccinated. Before engaging in intimate activity, ask if the other person has had new or unexpected rashes — and, if possible, consider exchanging contact information with any new sexual partners in case you or they later develop symptoms. Try not to share drinks, food or cigarettes with multiple unknown people. If you’re going to nightclubs or bars where you expect to be in very close quarters with many individuals, consider wearing long sleeves and pants to cover the areas that will be closely touching others.
This reminds me — students should know where to go for testing. Many colleges will offer testing on-site. Others will recommend that you go to a nearby commercial laboratory. Colleges should all have isolation procedures set up. It would help to know what they are in advance so that you’re not caught off-guard in case your test is positive.
CNN: Big picture — how should parents, caregivers, teachers and students consider the risk of monkeypox along with the risk of other infectious diseases?