Records reveal mpox exposures in elementary school as Mecklenburg County cases grow

More than 20 people at a Charlotte elementary school were exposed to a virus that can cause skin lesions and respiratory issues in March, according to a letter sent to parents by county health officials.

The March 5 letter from Mecklenburg County Public Health Director Raynard Washington — and obtained by The Charlotte Observer via an open records request — told parents and guardians that a case of the mpox virus, formerly known as monkeypox, “connected to your child’s classroom has been identified.” A similar letter was also sent to four staff members at the school, records show.

The incident happened at the Charles H. Parker Academic Center, a magnet elementary school in CMS, according to public records. Mpox is a viral disease that can cause a rash, respiratory problems and other symptoms.

The warning came as the county sees a growing number of cases and exposures, something Washington called “concerning for kids.” One expert noted that while transmission in schools is rare, it’s not impossible.

“Mpox can spread through close contact with an infected person. While the risk of airborne transmission is considered low, it’s important to be aware of all potential transmission routes,” Washington wrote. He told parents to monitor their children for symptoms and talk to a health care provider about vaccination against the virus.

The school’s principal also posted in the school’s ParentSquare information page March 5 that some students may have been exposed to “a communicable disease.”

No one exposed in the classroom has tested positive for the virus, the health department confirmed.

Charlotte-Mecklenburg Schools did not confirm or deny whether Charles H. Parker was the only school in the district with confirmed Mpox cases this year and was largely unresponsive to questions.

The Observer requested additional information about the number of cases in CMS multiple times between March 7 and Apr. 15, but school district officials said to “direct any questions to the local health department.”

Charlotte-Mecklenburg Schools exposure

The health department confirmed to the Observer that “an individual with mpox interacted, while potentially infectious, with other individuals connected to CMS” and said “22 exposures were determined to be either low or intermediate (risk), related to sharing of the same physical space, not physical contact.”

“There were no high risk exposures connected to this investigation,” the department said in an emailed statement.

Mecklenburg County Public Health said in a March 6 advisory that six mpox cases were confirmed in the county in January and 10 in February. Additionally, “nearly 120 residents” were exposed to the virus in that timeframe.

That group of people recently exposed to the virus included “a large number of children,” Washington told the Observer in mid-March.

Those exposures “were not sexual in nature,” he added. Though mpox is frequently spread through close physical contact such as sexual activity, it is not a sexually transmitted disease.

The children exposed in Mecklenburg County were either “a close household contact” of an infected person or in a situation where they were with an infected person “for an extended period of time,” Washington said.

“What’s concerning for me is that the ratio of cases to exposures is growing substantially, which is concerning for kids,” he said.

Since the mid-March advisory, three additional mpox cases and six new exposures have been confirmed in Mecklenburg County, the health department said. None of those cases stemmed from the classroom exposure, department spokeswoman Suzette Nedrich confirmed.

How did CMS, Charlotte health officials handle mpox in classroom?

Emails between CMS and public health officials obtained by the Observer show a virtual meeting titled “MPOX School Case” was called March 4. Public Health drafted a letter March 5, and that letter was reviewed by district leadership and communications staff before it was sent out, the emails show.

The letter was only sent to the parents and guardians of students who were in a single classroom, according to the emails.

Public Health said “all individuals who were potentially exposed” at the school “were notified immediately” of the situation.

Dr. David Weber, medical director for infection prevention at UNC Hospitals, told the Observer it’s rare to see an exposure to mpox in a school setting because transmission usually occurs from skin-to-skin contact.

Such contact could happen during a sports practice or physical education class, he noted. And it would be more likely for the infected person to spread the virus via airborne transmission if they had a respiratory complication, such as pneumonia.

“Just having someone sitting in class would not generally lead to transmission,” Weber said.

Is mpox dangerous in children? Can kids get mpox vaccine?

Mpox does not typically cause “severe disease,” Washington said, but kids who are immuno-compromised are at greater risk.

The rash associated with the virus can also cause other complications in infants and “really small children,” he said. While there is a vaccine for mpox, it is not universally recommended for kids, Washington said.

The vaccine would be recommended for a child that had a “high-risk exposure,” he said. In the case of an intermediate- or low-risk exposure, medical professionals would “make a risk assessment” to determine whether the child should be vaccinated, weighing whether there are other risk factors such as an autoimmune disease or certain skin conditions at play.

Weber agreed with the health department’s advisory for parents to watch for symptoms and discuss the vaccine with a health care professional but that decisions on vaccination should be made on a case-by-case basis in kids.

Today’s vaccines have fewer side effects than previous iterations that were initially designed to combat smallpox, Weber said. “The vaccine is relatively safe,” he said.

Common symptoms of mpox, according to the health department, include:

• Fever and/or chills

• Headache and/or body aches

• Swollen lymph nodes

• Exhaustion

• Skin rash on any part of the body, including the genitals, with lesions

An mpox rash “can be as small as one or two bumps or cover the entire body,” the health department said, and the “lesions can look like bumps, warts, pimples, sores or scabs.” A person is considered contagious until all lesions have heal and new skin is intact.

Washington said it’s vital that people who experience symptoms take them seriously and isolate when necessary in order to limit the virus’s spread. Cases are on the rise around North Carolina and the country, he noted, though not at the levels seen in 2022.

How to get mpox vaccine in Charlotte

Washington said anyone “engaging in higher risk sexual activities, specifically folks who have anonymous partners or have multiple partners,” should consider getting the vaccine.

People who have a high-risk exposure to the virus and/or have symptoms but test negative for mpox can also get the vaccine, health department guidance notes.

Mecklenburg County residents can schedule an appointment to get a free mpox vaccine by calling the health department at 704-336-6500 or walking into one of four public health clinics at:

• Northwest Health Department: 2845 Beatties Ford Road

• Southeast Health Department: 249 Billingsley Road

• Valerie C. Woodard Community Resource Center: 3205 Freedom Drive

• Ella B. Scarborough Community Resource Center: 430 Stitt Road

NC Reality Check reflects the Charlotte Observer’s commitment to holding those in power to account, shining a light on public issues that affect our local readers and illuminating the stories that sets the Charlotte region apart. Email realitycheck@charlotteobserver.com