Contagiousness of Molluscum Contagiosum
Molluscum contagiosum is highly contagious and spreads primarily through direct skin contact, autoinoculation, or via fomites, affecting 5-11% of children aged 0-16 years. 1
Transmission Methods
Molluscum contagiosum virus (MCV) spreads through several mechanisms:
- Direct skin-to-skin contact - both sexual and non-sexual contact can transmit the virus 2
- Autoinoculation - patients can spread the infection to other parts of their own body 1, 2
- Fomites - shared personal items like towels and clothing can transmit the virus 1
Population Susceptibility
Different populations show varying susceptibility:
- Children - most commonly affected group, with 5-11% prevalence in those aged 0-16 years 1
- Sexually active adults - genital molluscum is considered a sexually transmitted infection 2, 3
- Immunocompromised individuals - at higher risk for extensive disease with larger, more numerous, and persistent lesions 1, 4
Contagious Period
The contagious period is prolonged:
- Duration of active lesions - patients remain contagious as long as visible lesions persist 1
- Natural resolution - typically takes 6-12 months but can extend up to 4 years without treatment 1, 5
- Immunocompromised patients - have increased difficulty clearing lesions, resulting in prolonged contagious periods 5
Prevention Strategies
To prevent transmission, the American Academy of Pediatrics recommends:
- Cover visible lesions with clothing or bandages when possible 1
- Maintain good hand hygiene, especially after touching lesions 1
- Avoid sharing personal items like towels and clothing 1
- Special precautions for high-risk occupations - food service workers, athletes/contact sports professionals, and childcare workers should follow specific guidelines 1
Clinical Implications
The high contagiousness has several clinical implications:
- Treatment considerations - while the infection is self-limiting, treatment may be warranted to prevent spread to others 1, 5
- Complications - untreated lesions can lead to conjunctival scarring, epithelial keratitis, and pannus when near the eyes 6
- Psychosocial impact - the visible nature and prolonged duration of lesions can affect quality of life 5, 4
Common Pitfalls
- Underestimating contagiousness - the "benign neglect" approach may increase risk of spreading infection 4
- Delayed treatment - waiting for spontaneous resolution can lead to wider spread through autoinoculation 5
- Inadequate prevention measures - failure to cover lesions or maintain hand hygiene increases transmission risk 1
The high contagiousness of molluscum contagiosum makes it important to consider active treatment in cases where there is risk of spread to others, especially in settings like schools, daycares, or households with multiple children.