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China is the biggest trading partner of most countries. The next SARS-CoV-2 wave in China may cause major disruptions in supply chains, including between other countries and in items that contain Chinese parts or materials.


Individuals infected with monkeypox can self-inoculate themselves (spread the infection to other areas of skin) by touching lesions and then other parts of their body, or through the repeated use of towels, bed sheets etc. This is especially risky for the eyes and may even cause permanent blindness. Touching lesions may also lead to a secondary infection that may cause scars and other damages.

It is best to:

  • Cover lesions at all times with disposable bandaids
  • Clean hands regularly
  • Use disposable gloves when touching lesions.
  • Never scratch a lesion (with hands or other objects/materials).
  • Change sheets and towels after each use.
  • Avoid touching your face.
  • NEVER touch your eyes with your hands, dirty towels, etc.
  • Avoid touching other sensitive areas, nose, mouth, genitals and rectum.
  • Do not wear contact lenses while you have active lesions.
  • Don’t shave
  • If a child is infected, do your best to protect their eyes and prevent them from touching lesions.
  • Taking a bath carries some risk, adding vinegar to the bath has been mentioned as a potential mitigation, though evidence is not direct. Showers may have lower risk


The main risk groups for severe illness and death following monkeypox infection are children up to the age of 10, and pregnant or immuno-compromised people. The overall death rate in Africa of the spreading variant has been estimated to be 3.6%, with a significantly larger proportion of deaths occurring in children. Another significant fraction of children become permanently blind. In the developed world, percentages may be lower, but if kids become infected, many of them will suffer badly. Monkeypox virus remains infectious for an extended time on surfaces and is believed to infect through the skin as well as through airborne transmission. With an incubation period of 4-21 days, kindergartens and schools are likely to have super-spreader events that may be very hard to contain. In addition, about half the lesions in people infected in Africa turned into scars lasting for years. Such scars may stress kids, damage their mental well-being, and harm them socially. Isolation of up to 21 days may be hard for young children, and because a parent may readily get infected by simple touch as well as through shared air, many parents will get infected, which can extend the disruption for children for another few weeks. Kids may be infectious with very few symptoms, so it’s critical to ramp up testing capabilities in advance.

Initial symptoms include swollen lymph nodes, fever, headache, cough, muscle and back pain, fatigue, and chills. Within a few days, a rash of blisters develops, often beginning on the face, with some recent cases starting on the genitals or anus, then spreading to other parts of the body including the chest, palms of the hands and soles of the feet, and even inside the mouth. The rash, which can be extremely painful, and often causes scarring, goes through spots, pimples, blisters, abscesses, and scabs, before finally falling off.


Parents? Teachers? Look for these symptoms in kids, they may have Severe Hepatitis and require immediate care.
– Jaundice – yellowing of the skin or the whites of the eyes
– Pale stools
– Black urine
– Lethargy – lack of energy

These common symptoms may also be present:
– Loss of appetite
– Vomiting
– Diarrhea
– Nausea
– Abdominal pain
– Fever

Other than jaundice (yellowing of the skin/eyes) and pale stools, the symptoms of hepatitis overlap with other illnesses. It is important that children get a timely and appropriate medical evaluation when new and unexplained symptoms arise. Treatment earlier in the course of hepatitis may help prevent permanent damage.


Monkeypox can infect most mammals and as a DNA virus may survive long periods viable on surfaces. Over 500 human cases have recently been reported in over 28 new countries in all major parts of the world, besides the ones already endemic in Africa. The risk of spillover into local animal populations and hence further risk of constant reintroduction back to humans in all connected areas should be a major policy consideration.

Last reviewed on September 1, 2023

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