Cases of mpox in children and adolescents remain infrequent (<0.3% of total cases) and disease in children is generally not severe. When transmission to children has occurred, it has primarily happened from close contact with an infected person in the household (for example, from an adult caregiver of a young child), or among sexually active adolescents. The overall risk of transmission in child care facilities or K-12 schools is low. To date, there is no report of mpox transmission in these settings. 

Child care facilities and schools should follow their everyday operational guidance that reduces the transmission of infectious diseases. This includes children, staff, and volunteers staying home when sick, ensuring access to adequate handwashing supplies, including soap and water, maintaining routine cleaning and disinfection practices, identifying private spaces or isolation areas for assessment of an ill child away from others, and providing personal protective equipment (PPE) for staff who care for children or students with rashes, fevers, or other symptoms concerning for infections. If there is a mpox exposure as defined by the local health department, the local health department will help guide appropriate actions to prevent the spread of the virus. 

Child care facilities and schools that are informed that a person with mpox may have been present within their settings while having symptoms should contact their local health department for further assistance. Typically, local health departments will lead the response and provide recommendations on next steps, including assessing possible exposures and, if indicated, contact tracing. Recommendations for exposure notifications, symptom monitoring, or vaccination should be guided by the local health department. If requested, child care facilities and schools should support the health department in contact tracing efforts.  

Individuals in schools and child care settings who are determined by the local health department not to have been potentially exposed - do not need to be notified of mpox cases on the school campus or in the child care facility. While campus-wide notifications are generally not recommended, they can be considered in certain instances (such as to combat misinformation) after consulting the local health department. If campus-wide notification is recommended by the local health department, special care should be taken to avoid perpetuating stigma or providing any information which might identify the infected person. Such notifications should be non-specific, provide scientific facts, and confront and oppose stereotypes and stigma. They can also be a general reminder for all to not return to work, school, or child care, if they have new, unexplained symptoms until it is clear that symptoms are mild and improving or are due to a non-infectious cause (e.g., allergies, acne). School and child care administrators are strongly encouraged to work with their local health departments for assistance with any notifications. Child care providers should also contact their local Child Care Licensing Regional Offices if a mpox case is identified in a child care staff member or attendee per Title 22 CCR section 101212(d) and CCR section 102416.2(c)(3).   

As with other communicable diseases, schools and child care facilities should follow all applicable state and local reporting requirements.