The test the US Centers for Disease Control and Prevention uses to identify clade I mpox cases is 'most likely not reliable' for detection of the substrain identified in the study, the authors say.
Black children made up 47% of the 83 pediatric patients, with Latinos making up 35%.
Data show 53% of infections are transmitted 1 to 4 days before symptoms appear.
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As small clusters continue, the CDC notes that only 1 in 4 eligible people have received both mpox vaccine doses.
Early tecovirimat was associated with shorter time to symptom improvement (by 5.5 days) among participants with severe illness.
Wastewater tests had a sensitivity of 32% for detecting 1 or more people shedding mpox virus, but it was 77% for detecting 15 or more people shedding virus.
Countries reporting the most cases were Spain, Portugal, the UK, and Germany.
The most common adverse event was mild to moderate injection-site pain, which was reported by 60% of vaccinated participants
Mpox disease progression occurred in 5% of those who received Tpoxx early and in 27% of people who received it later or not at all.
Two of the animals died, for a case-fatality rate of 10%, while no animal caretakers were affected.
Cases also continue from China and Singapore in the Western Pacific region.
Another mpox study today showed that dose-sparing vaccine administration of the Jynneos vaccine appeared to have worked.
In US mpox news, some cities are starting to report an increase in cases.