Molluscum Contagiosum: Nanny Worried About Infection

Patient

Q: I nanny for a little boy who just turned two. He has had bumps on the back of his neck ever since I started watching him (over a year ago). I just found out it was mollscum contagiousm and I'm wondering what the risk is of my children getting it as well. Like I said, they have been exposed for almost a year and have never shown any signs of developing it themselves. Now that I know what it is I try to make sure they don't touch it, but I'm sure they've come in contact with it at least once before now. Do some people have a natural resistance to getting the virus? Is there a way, other than covering the bumps or discontinuing our care of the child, to limit our exposure? Any other suggestions? Thank you!

Doctor

A:   Molluscum contagiosum (MC) is a skin rash caused by a virus; it is common worldwide and accounts for about 1% of all skin disorders in the United States. It affects children, boys more often than girls, and young adults. MC is transmitted by direct contact, person to person or by shared items, such as clothing, towels, and washcloths. MC can be spread by contact sports. Even, if a person touches the rash and then another part of his or her body, it can cause spread to that area (known as autoinoculation). If the face is involved, shaving may cause it to spread. Although the contagiousness is generally low, it is not known for how long an infected person can transmit the virus.
The lesions often disappear by themselves and heal without scarring unless infected by bacteria. Removal of lesions reduces the rate of spread to other people as well as from one part of the body to another. The most popular treatments are scraping of the lesions (curettage) or removal using heat (called cautery) or cold (cryotherapy performed with liquid nitrogen).
The overall prognosis is excellent. Spontaneous cure is the rule in people who have intact immune systems, but the process may take months or even years. Most cases go away by themselves in six to 12 months.
In your case, risk of infection can only be reduced if it is possible to avoaid direct skin to skin contact or sharing of items that touch the lesions.

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