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We report laboratory-confirmed mpox in a Belgian man in his 40s presenting with an orofacial and a wrist lesion and his preschool daughter who developed a solitary gluteal lesion 4\u2009days after direct contact with the father\u2019s wrist lesion. The anatomical concordance between the child\u2019s gluteal and the father\u2019s wrist lesion suggested direct cutaneous transmission during routine caregiving activities. Comprehensive investigation included biological samples (saliva, urine, exhaled breath condensate), environmental samples (indoor air, high-touch surfaces) and companion animal specimens. Testing revealed extensive environmental MPXV DNA contamination. No replication-competent virus was recovered from any specimen, consistent with low viral loads in later stages of infection and in the environment of patients with mpox. Both patients achieved complete resolution without antiviral therapy or complications.<\/jats:p>","DOI":"10.1136\/bcr-2026-274463","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:20:25Z","timestamp":1786969225000},"page":"e274463","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Skin-to-skin household transmission of mpox from parental wrist lesion to child\u2019s gluteal region"],"prefix":"10.1136","volume":"19","author":[{"given":"Nikola","family":"Sklenovsk\u00e1","sequence":"first","affiliation":[{"name":"Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandy","family":"Bloemen","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graciela","family":"Andrei","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Van Ranst","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"2026081705201543000_19.8.e274463.1","doi-asserted-by":"crossref","DOI":"10.1017\/S0950268824000864","article-title":"Mpox in UK households: estimating secondary attack rates and factors associated with transmission, May-November 2022","volume":"152","author":"Packer","year":"2024","journal-title":"Epidemiol Infect"},{"key":"2026081705201543000_19.8.e274463.2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7134e1"},{"key":"2026081705201543000_19.8.e274463.3","doi-asserted-by":"crossref","first-page":"2381","DOI":"10.3201\/eid3011.241120","article-title":"Analysis of Monkeypox Virus Exposures and Lesions by Anatomic Site","volume":"30","author":"Guagliardo","year":"2024","journal-title":"Emerg Infect Dis"},{"key":"2026081705201543000_19.8.e274463.4","unstructured":"Information for healthcare professionals. 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