Review ArticlesMonkeypox—What Pediatricians Need to KnowZimmermann, Petra MD, PhD*,†,‡; Curtis, Nigel FRCPCH, PhD‡,§,¶ Author Information From the *Department of Community Health, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland †Department of Paediatrics, Fribourg Hospital, Fribourg, Switzerland ‡Infectious Diseases Research Group, Murdoch Children’s Research Institute, Parkville, VIC, Australia §Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia ¶Infectious Diseases Unit, The Royal Children’s Hospital Melbourne, Parkville, VIC, Australia. Accepted for publication September 4, 2022 The authors declare no conflict of interest. P.Z. drafted the initial article. N.C. critically revised the article and both authors approved the final article as submitted. Address for correspondence: Petra Zimmermann, MD, PhD, Department of Community Health, Faculty of Science and Medicine, University of Fribourg, Route des Arsenaux 41, 1700 Fribourg, Switzerland. E-mail: [email protected]. The Pediatric Infectious Disease Journal: December 2022 - Volume 41 - Issue 12 - p 1020-1031 doi: 10.1097/INF.0000000000003720 Buy Metrics Abstract Monkeypox is a zoonotic disease, presenting with fever, lymphadenopathy and vesicular-pustular skin lesions, that historically has rarely been reported outside the endemic regions of Central and West Africa. It was previously thought that human-to-human transmission was too low to sustain spread. During 2022, the number of cases of monkeypox, caused by clade II, rose rapidly globally, predominantly among men who have sex with men. In previous outbreaks with monkeypox clade 1 in endemic areas, children were disproportionately more affected with higher morbidity and mortality. It is unclear whether children are at similarly higher risk from monkeypox clade II. Nonetheless, children and pregnant women are considered high-risk groups and antiviral treatment should be considered for those affected. While smallpox vaccination offers good protection against monkeypox, the duration of protection is unknown, and infection occurs in vaccinated individuals. Should the current outbreak spread to children, authorities should be prepared to rapidly implement vaccination for children. In this review, we summarize epidemiological and clinical features, as well as the pathogenesis, treatment, and prevention options for monkeypox with a focus on considerations for children. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.