Monkeypox in Canada: Act now to stop it, expert urges, before it's too late

With 26 confirmed cases of monkeypox in Canada, health officials warn there will likely be more cases reported in the coming days and weeks. However, one expert says the outbreak can be stopped if the country works quickly to get it under control.

Infectious disease expert Dr. Isaac Bogoch says that Canada will "definitely" see more cases of the virus in the "few days and weeks ahead."

"This outbreak is going to crumble along unfortunately for a bit of time," Bogoch told CTV's Your Morning on Friday.

However, if health officials act quickly, Bogoch said the outbreak in Canada can be stopped.

"Currently, there's only 26 people in a country of 38 million people and the risk of the general population today is extremely, extremely small. But let's play our cards right. Let's deal with this quickly and effectively so that no one else needs to get this infection and that we just get this under control," he said.

• What is monkeypox and how does it spread?

The Public Health Agency of Canada announced on Thursday there are now 25 confirmed cases of monkeypox in Quebec, and one confirmed case in Ontario. However, the health agency says several suspected and probable cases are still being investigated.

Prior to this month, monkeypox had never been detected in Canada.

Despite the unexplained rise in cases in Canada, and a growing number in other countries such as the U.S., Spain, Portugal, and the U.K., Bogoch says Canada has the tools to "quell this quickly," if federal and provincial health officials take a co-ordinated approach to vaccinating those at high risk.

"We have an outbreak of this right now, but there's no reason to let this run amok and there's no reason to have this infect many people," he said.

PHAC said they are focusing on a "targeted approach to vaccination and treatment" amid the current outbreak, and do not believe a mass vaccination campaign is necessary.

There is no proven treatment for the virus infection, but the smallpox vaccine is known to also protect against monkeypox, with a greater than 85 per cent efficacy. Because the smallpox vaccine eradicated the disease, however, routine smallpox immunization for the general population ended in Canada in 1972.

PHAC has already supplied Quebec with 1,000 doses of the smallpox vaccine Imvamune from Canada’s National Emergency Strategic Stockpile. Because of the limited supply, it is not yet clear who will be eligible for the vaccines, but Bogoch said they will likely be reserved for close contacts and health-care workers.

Bogoch said if vaccines are issued to high-risk groups quickly, officials "can certainly prevent the spread of this and fewer Canadians need to be impacted."

WHAT TO KNOW ABOUT MONKEYPOX

First discovered in 1958, monkeypox is a rare disease caused by a virus that belongs to the same family as the one that causes smallpox. The disease was first found in colonies of monkeys used for research.

The disease has primarily been reported in central and western African countries, with the first case outside the continent reported in 2003 in the United States.

The virus is transmitted through contact with an infected animal, human or contaminated material. Transmission between people is thought to primarily occur through large respiratory droplets, which generally do not travel far and would require extended close contact. Transmission from an animal can happen through bites or scratches, contact with an animal’s blood or body fluids.

Monkeypox symptoms are similar to those for the smallpox, but generally milder. The first signs are fever, headache, muscle aches, backaches, chills, and exhaustion.

The incubation period — the span of time between initial infection and seeing symptoms — for monkeypox is generally 6-13 days, but can range to as many as 21 days, according to PHAC.

The "pox" develops after the onset of a fever and usually occurs between one to three days later, sometimes longer. A rash usually begins on the face and spreads to other parts of the body, developing into distinct, raised bumps that then become filled with fluid or pus.

• How concerned should we be about monkeypox?

Dr. Howard Njoo, Deputy Chief Public Health Officer, said Canadians should be aware of these symptoms, and seek medical attention particularly if they have an unexplained rash.

He added that people can avoid infection by "maintaining physical distance from people outside their homes."

"As well, wearing masks, covering coughs and sneezes, and practicing frequent handwashing continues to be important, especially in public spaces," Njoo said.

While the overall risk of monkeypox to the general public is low, Njoo said it is important to remember that everyone is susceptible, despite most cases in the country and others appearing to be spread through sexual contact between men.

He added that more guidance on case identification and contact tracing, along with infection prevention, will be released shortly.

Monkeypox is endemic in animals in regions in Western Africa, and while cases have popped up in countries where it is not endemic before, the cases typically involved people who recently travelled from a country in Africa.

What is unusual right now is that officials in numerous countries that don’t usually deal with monkeypox are seeing cases where the patient has no travel history, Njoo said.

Due to the unexpected nature of the current outbreak, Njoo said health officials in Canada and abroad are looking at whether there are any changes from what was previously known about the rare illness, including incubation period and method of transmission.

He said global cases are "not all similar in how they're presenting," and said milder cases may even go undetected.

"Our understanding of the virus is still evolving, but I want to emphasize this is a global response," Njoo said.

With files from CTVNews.ca's Alexandra Mae Jones and Solarina Ho