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Monkeypox

Monkeypox is a disease caused by the monkeypox virus. It enters the body through broken skin (even if not visible), the respiratory tract or the eyes, nose, or mouth.

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Current Situation


Last updated: August 9, 2022

Confirmed cases in BC:  85
Health authorities with cases:

  • Vancouver Coastal Health: 73
  • Island Health: 6
  • Fraser Health: 6

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. The risk to the general population in B.C. is considered low. 

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.

Monkeypox infections have been found in over 70 countries. The World Health Organization declared monkeypox outbreak a Public Health Emergency of International Concern (PHEIC) on July 21, 2022.

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.

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 contaminated objects.
  • Monkeypox is mostly spread through contact with sores or blisters.
  • It can also be transmitted through items like bedding or towels that have monkeypox virus or respiratory droplets such as coughs and sneezes during close, face-to-face contact with a person who has monkeypox.
  • Monkeypox is not known to be a sexually transmitted infection, like syphilis or HIV, but sexual activities often include close contact.

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 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. This is called Pre-Exposure Prophylaxis.
  2. After exposure to monkeypox virus, before you have symptoms
    • The vaccine is given after being exposed to prevent illness or severe outcomes. This is called Post-Exposure Prophylaxis
The global supply of Imvamune is very limited and a large vaccine program for pre-exposure prophylaxis is not currently possible in B.C. 

Medical Health Officers are using the following principles to guide who is prioritized to receive Imvamune: 

Maximize benefit 
  • People who are at highest risk for infection and severe illness are prioritized. This is based on what is known about monkeypox and its spread within B.C.  

Equity 

  • Consideration is being given to populations who have faced and/or are facing barriers and discrimination. Outreach and trauma-informed approaches help to reduce inequities. 

Transparency

  • Openness about how the limited monkeypox vaccine supply is being used in B.C.  
The populations at greatest risk of being exposed to monkeypox are eligible to receive pre-exposure prophylaxis. Eligible individuals are transgender people or those who self-identify as belonging to the gay, bisexual and other men who have sex with men community and answer yes to any of the questions below:
  • Have received a diagnosis of chlamydia, gonorrhea, and/or syphilis in the past two months, or
  • Have had two or more sexual partners in the last 21 days, or
  • Have attended bath houses, sex clubs, or park play, or are planning to 
  • Have had anonymous sex in the past 21 days (i.e. using apps, online sites, formal/informal gatherings) or are planning to, or 
  • Engage in sex work or plan to, either as a worker or a client
Vaccination efforts are currently focused in the Lower Mainland as the majority of cases have been reported in this area and there is evidence of local spread (i.e. among people who have not travelled outside their home community). 

Public health is continuing to monitor the spread of monkeypox and responding based on the latest evidence on monkeypox. 
To learn more about vaccinations, eligibility criteria and to book an appointment, refer to your region:
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.

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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