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Monkeypox

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

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Current Situation


Last updated: October 5, 2022

Confirmed cases in BC:  167
Health authorities with cases:

  • Vancouver Coastal Health: 135
  • Fraser Health: 20
  • Island Health: 6
  • Interior Health: 6

Epidemiological data are summarized to provide an understanding of the population(s) affected by monkeypox 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 monkeypox. 

Local public health is reaching out to known contacts of cases who may be at risk of developing monkeypox. 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. 

Monkeypox infections have been found in over 75 countries. The World Health Organization declared monkeypox 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

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

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

Symptoms

Monkeypox 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.

  • Monkeypox sores/blisters are most commonly seen on the hands, feet, arms, legs, mouth and/or genitals.
  • Monkeypox 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 monkeypox.
  • 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

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 monkeypox. 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 monkeypox 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 monkeypox is confirmed, public health will contact you to give more instructions. Monkeypox 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 monkeypox:
  • 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 monkeypox. Antiviral medication may be considered on a case-by-case basis. 

Vaccination

Imvamune is the vaccine used in Canada to protect against monkeypox.   It helps your body build immunity without getting very sick.

The global supply of Imvamune is very limited and a large vaccine program is not currently possible in B.C.  People who are eligible can now book first or second dose appointments.

The vaccine can be used two ways

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

  2. After exposure to monkeypox virus, before you have symptoms
    • The vaccine is given after being exposed to prevent illness or severe outcomes. 
We are working closely with community partners on a focused vaccine campaign to people at risk through a combination of outreach and appointments booked online. 

Eligibility

All of the following criteria:
  • Two-Spirit or Transgender person, or a cisgender male 
  • Self-identify as belonging to the gay, bisexual and other men who have sex with men community
As well as at least one of the following:
  • Have had 2 or more sexual partners within the past 21 days;
  • Have received a diagnosis of bacterial STI in the past 2 months;
  • Have attended venues or other locations for sexual contact within the past 21 days (e.g., bath houses, sex clubs, park play) or may be planning to;
  • Have had anonymous/casual sex in the past 21 days (e.g., using apps, online sites, formal/informal gatherings) or may be planning to;
  • Engage in sex work or may be planning to, either as a worker or a client.
The vaccine cannot be administered to people who have symptoms that could be due to monkeypox. 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 monkeypox 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 monkeypox vaccine.

People who have received one dose of vaccine can begin booking appointments for a second dose. 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.

Monkeypox vaccine information sheet

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

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: Monkeypox Guidance for Events during Pride Festival Season

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

Most of the recent monkeypox 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 monkeypox, regardless of their sexuality. 

The 2SGBTQ+ community can
  • Be aware: Know the symptoms of a monkeypox 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

Travel and monkeypox awareness

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

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

International travel

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