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Mpox

Mpox is a disease caused by the monkeypox virus. It spreads through close, personal, often skin-to-skin contact.

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Current Situation


Cases as of January 9, 2023

The routine surveillance report and case counts will be discontinued as of the January 9, 2023 report due to the decline in mpox cases in British Columbia.

Confirmed cases in BC:  190
Health authorities with cases:

  • Vancouver Coastal Health: 151
  • Fraser Health: 25
  • Island Health: 7
  • Interior Health: 6
  • Northern Health: 1

Epidemiological data are summarized to provide an understanding of the population(s) affected by mpox transmission and potential exposures to support the response.


For information on the situation in Canada, refer to the Public Health Agency of Canada.

B.C. is working closely with federal and provincial partners to stop the spread of mpox

Local public health is reaching out to known contacts of cases who may be at risk of developing mpox. Vaccination is available to close contacts and those at the highest risk of infection.

While most, but not all, recent global infections are among men who identify as gay, bisexual, or other men who have sex with other men, the virus can affect anyone through close person-to-person contact. Most cases in the current outbreak have occurred from close, intimate contact during sex. The risk to the general population in B.C. is considered low. 

Mpox infections have been found in over 75 countries. The World Health Organization declared mpox outbreak a Public Health Emergency of International Concern (PHEIC) on July 21, 2022.

We will update this information as we learn more about the current outbreak.

How it spreads

Mpox can spread from animals to humans, from person to person and through contact with objects that have been used by someone with mpox. 

Mpox spreads through close, personal, often skin-to-skin contact, including through:
  • Direct contact with sores or blisters of a person with mpox. 
  • Contact with items like bedding or towels that have been used by someone with mpox.
  • Respiratory droplets during prolonged close, face-to-face contact with a person who has mpox, such as kissing.
Most cases in the current outbreak have been passed from person to person during close, intimate contact during sex. 

Symptoms

Mpox can present in different ways. Most people experience symptoms that last 2 to 4 weeks and occur in two stages. 

In the first stage, symptoms can include:

  • Fever
  • Chills
  • Intense headache
  • Swollen lymph nodes 
  • Back pain
  • Muscle pain
  • Fatigue or exhaustion
  • Other less common symptoms can include sore throat, cough, nausea or vomiting, and diarrhea

The second stage usually starts 1 to 5 days after the first stage.

In the second stage, a rash (sores/blisters) develops.

  • Mpox sores/blisters are most commonly seen on the hands, feet, arms, legs, mouth and/or genitals.
  • Mpox sores/blisters usually last between 2 to 3 weeks. The rash change in appearance over time from raised spots to small blisters filled with fluid. They eventually form a scab and fall off. 

Some people experience symptoms differently. For example:

  • they may not experience first-stage symptoms but will develop sores
  • some may experience first-stage symptoms after the appearance of sores
  • some can have a small number of sores on one or a few body parts, sometimes only in the mouth or genital areas.

Monkeypox sores at different stages: raised spots, blisters filled with fluid, scabs. Image credit: United Kingdom

If you have been exposed

Public health is reaching out to known contacts of the cases at risk of developing the infection.
  • Monitor for symptoms if you have had contact with a person with known or suspected mpox.
  • It can take around 5 days to 3 weeks after exposure for a person to develop symptoms.
  • If you think you have been exposed but have not yet been contacted by public health, you can contact your regional health authority’s local public health office
Please note: Public health does not use pre-recorded or automated calls to notify individuals of infections or possible exposure to mpox or other communicable diseases. If you receive one of these scam calls, do not engage and do not provide personal information over the phone.

If you become ill

  • Contact a healthcare provider to get tested as soon as possible. Tell your healthcare provider if you have had contact with a person with known or suspected mpox. Find a clinic.
  • Until you see a healthcare provider:
    • Avoid close, intimate contact and sex with others 
    • It is especially important to avoid close contact with people who may be at greater risk of experiencing severe illness including pregnant people, people with a weakened immune system or children. 
    • Do not share towels, clothing, sheets or other things that have touched your skin.
    • Cover any sores or blisters as much as possible with clothing or bandages.
    • Wear a mask when you are in close contact with others.
    • If possible, have another member of your household care for your animals/pets so you do not spread mpox to animals.  If you need to care for your animals during your illness, take the same precautions that you use to protect other people. 
    • Dispose masks, bandages, or other contaminated materials in a high-quality garbage bag and keep in an animal-proof receptacle to prevent access by pets or wild animals (particularly rodents).

If mpox is confirmed, public health will contact you to give more instructions. Mpox is usually a mild illness and most people recover on their own after a few weeks.  However, some people may experience moderate or severe disease, and will need to see their healthcare provider.  People experiencing more severe disease may require medications to manage pain or skin infections, or in rare cases, need other supportive treatment in hospital. 

Please see your healthcare provider or go to your nearest Urgent Primary Care Centre or Emergency Department if you experience the following after testing positive for mpox:
  • Worsening or new throat or rectal pain
  • Severe Fever or chills 
  •  Shortness of breath or chest pain
  • New pox lesions on multiple parts of your body

There are no well-established treatments for mpox. Antiviral medication may be considered on a case-by-case basis. 

Vaccination

A supply of vaccine that protects against mpox has been made available to B.C. by the federal government and vaccination has been offered to at-risk populations since June 2022.  The vaccine, called IMVAMUNE®, is given in a series of two doses given 28 or more days apart. It can be given following a recognized exposure to infection (ideally within 4 days) to provide protection against mpox, or can be given in advance of an exposure.  It helps your body build immunity.

People who are eligible can now book first or second-dose appointments.
 
Eligibility for the vaccine in BC has been guided by information about people who have acquired this infection. Should the characteristics of these people change as transmission continues to occur, the eligibility may be adjusted accordingly. 
 
Use of this vaccine to control the outbreak of mpox in BC has been successful in bringing cases to a low number. As of October 2022, small numbers of infections continue to occur each week among unvaccinated eligible individuals which is why they continue to be encouraged to get vaccinated.

The vaccine can be used two ways

  1. Before exposure to mpox virus
    • The vaccine is given before getting exposed to the virus to help protect against mpox. 

  2. After exposure to mpox virus, before you have symptoms
    • The vaccine is given after being exposed to prevent illness or severe outcomes. 

Two-Spirit and transgender people and cisgender males who self-identify as belonging to the gay, bisexual and other men who have sex with men community.


And at least one of the following:
  • Has sex with more than one partner,
  • Has sex with a partner who has more than one partner,
  • Has casual sex (e.g. cruising),
  • Engages in sex work as a worker or client.
The vaccine cannot be administered to people who have symptoms that could be due to mpox. Instead, find a location for testing at smartsexresource.com/get-tested/clinic-finder

The vaccine is not available to individuals of any gender who are not part of the community of gay, bisexual and other men who have sex men, unless they have been identified as a close contact of a confirmed case.

Misidentifying oneself as eligible for mpox vaccine directs this critical tool away from people most at risk, and limits its utility in preventing onward transmission, and from protecting the wider population from a bigger outbreak.

Due to limited supply, this vaccine is intended for residents of Canada or those visiting B.C. for prolonged periods of time. People from outside Canada should not travel to B.C. vaccine clinics for immunization; we cannot provide the vaccine to those visiting the province for the purpose of being vaccinated. Please contact your local Public Health unit for information about receiving mpox vaccine.

Book your second dose of vaccine

Imvamune is given in a series of two doses. You must wait at least 28 days after your first dose to get your second dose.


Subcutaneous or intradermal injection


To ensure there is enough vaccine to offer second doses to all who are eligible, a second dose will be offered one of two ways: subcutaneous injection or intradermal injection. 

  • Subcutaneous injection is familiar to people who have received other vaccines such as measles, mumps and rubella or chickenpox vaccines, or the first dose of Imvamune. It is an injection into the tissues underneath the skin but above the muscle, usually on the upper outer arm.

  • Intradermal injection delivers vaccines into the layer of skin, usually on the forearm.  It requires less of the vaccine (one-fifth dose) and generates a similar immune response. This technique is used for select medications, and for TB skin tests. 
To learn more about vaccinations, eligibility criteria and to book an appointment, refer to your region:
Appointments are added regularly. If there are no available appointments, please check back.
No vaccine is 100% effective. If you have been vaccinated and develop symptoms, follow the steps above for if you become ill to protect yourself and others.

Mpox vaccine information sheet

  • Read about the vaccine, benefits of vaccination, possible side effects and reactions, and other considerations: Vaccine Information sheet

Community Resources

Recommendations for Two-Spirit, gay, bisexual, transgender and queer communities (2SGBTQ+)

Most of the recent mpox cases are happening through close contacts between men who identify as having sex with other men. 

Stigmatizing people because of a disease is never okay. Anyone can get or pass on mpox, regardless of their sexuality. 

The 2SGBTQ+ community can
  • Be aware: Know the symptoms of a mpox infection.
  • Watch for symptoms: Look for new ulcers or blisters on your body.
  • See a doctor or nurse: Seek medical care if you have symptoms. Find a clinic


Indigenous communities

This 3-page handout was developed to support conversations about mpox among First Nations, Inuit, and Métis people. It describes:

  • What is mpox (monkeypox)
  • How it spreads
  • What to do if you test positive

Guidance for event planning during Pride

This document provides suggestions for event organizers, business owners, community organizations and leaders to help prevent spread as people gather to celebrate during the Pride festival season. It includes information about:

  • Educating staff
  • Promoting health information to attendees
  • Cleaning and hand hygiene

Learn more: Mpox Guidance for Events during Pride Festival Season

Travel and mpox awareness

Be aware of the mpox situation in the places you visit and take the same precautions you would use at home. Some people have been exposed or got mpox from close contact during sexual activity while travelling.

Domestic travel
The Public Health Agency of Canada has information about the mpox outbreak in provinces and territories in Canada 

International travel

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