Mpox

Current situation
What is mpox?
What are the symptoms?
How is mpox spread?
How do I prevent mpox?
Is there an mpox vaccine?
What do I do if I think I have mpox?
Resources

What is mpox?

Mpox is an infectious disease caused by the mpox virus, an Orthopoxvirus from the same family as smallpox. Mpox is less transmissible than smallpox, and cases are often less severe. The virus first was discovered in 1958, and cases have been found in both humans and animals, most often in central and west African countries. The virus is rare in Canada; however, cases occurred in 2022 and numbers have been increasing.

What are the symptoms?

Symptoms of mpox include some or all of the following:

  • Fever
  • Chills
  • Headache
  • Muscle pain
  • Low energy and fatigue
  • Swollen lymph nodes
  • Rash, sores, or lesions on the body, including hands, face, feet, and genitals

The rash or sores may appear a few days after other symptoms and the way they look may change over time, such as from flat red marks, to raised pimple-like bumps, to scabs as they heal. Symptoms usually begin within 1 week but can start 1-21 days after exposure. Mpox often clears up on its own, however some cases can be more severe and may require treatment.

How is mpox spread?

Mpox is spread from someone with the virus passing it to someone else, and usually requires close contact. Common ways the virus is spread include:

  • Physical contact such as:
    • Intimate sexual contact (including kissing)
    • Direct skin-to-skin contact with sores from the virus
  • Respiratory droplets, from coughing or sneezing, or from long conversations had in close proximity (such as when caring for someone with mpox)
  • Contact with material with the mpox virus on it such as:
    • Used utensils or dishes which have not been properly cleaned
    • Unwashed bedding, towels or clothing

PLEASE NOTE: Mpox is not spread through brief contact such as short conversations or walking past someone with mpox.

How do I prevent mpox?

Proper hand washing and hand hygiene are important in preventing illnesses of all kinds, including mpox. Other ways you can help prevent getting mpox include:

  • Not visiting people who have, or suspect they have mpox
  • Self-monitoring for symptoms if you think you have had contact with someone who has or suspects they have mpox
  • Wearing protective equipment such as a mask and gloves if you are caring for someone with mpox
  • Limiting use of hookup apps or anonymous dating services, and the number of sexual partners
  • Not sharing personal items such as water bottles, toothbrushes, etc.
  • Avoiding close contact, including sex, kissing, or cuddling, with people with symptoms like sores or rashes

Is there an mpox vaccine?

The Imvamune vaccine has been approved by Health Canada and may be offered as part of prevention against the virus. The vaccine can be given after exposure to an infected person, or before for individuals who may be at a higher risk for exposure. A second dose should be received at least 28 days after the first dose. If you have been vaccinated against smallpox, only one dose of Imvamune is required. The Imvamune vaccine can only be given before symptoms appear and can’t be given to those who have had mpox before.

Post-Exposure Prophylaxis (PEP)

If you have been exposed to someone who has tested positive for mpox, you may be eligible for vaccination. The Imvamune vaccine should be offered ideally within 4 to 14 days from when you were exposed. Please contact the Eastern Ontario Health Unit (EOHU) to find out if you are eligible for vaccination and to book your appointment.

If you have been identified as a contact of a positive case of mpox, you may also be contacted by the EOHU.

Pre-Exposure Prophylaxis (PrEP)

The Ontario Ministry of Health has provided guidelines for the use of the Imvamune vaccine for pre-exposure vaccination in certain at-risk groups, including:

A) Two-spirit, non-binary, transgender, cisgender, intersex or gender-queer individuals who self-identify or have sexual partners who self-identify as belonging to the gay, bisexual, pansexual and other men who have sex with men (gbMSM) community AND at least one of the following:

  • Had a confirmed sexually transmitted infection within the last year;
  • Have or are planning to have two or more sexual partners, or are in a relationship where at least one of the partners may have other sexual partners;
  • Have attended venues for sexual contact (i.e., bath houses, sex clubs) recently or may be planning to, or who work/volunteer in these settings; or
  • Have had anonymous sex (e.g., using hookup apps) recently or may be planning to; and/or
  • Are a sexual contact of an individual who engages in sex work.

B) Individuals who self-identify as engaging in sex work or are planning to, regardless of self-identified sex or gender.

C) Research laboratory employees working directly with replicating orthopoxviruses.

Household and/or sexual contacts of those identified for PrEP eligibility in parts (a) and (b) above AND who are moderately to severely immunocompromised or pregnant may be at higher risk for severe illness from an mpox infection. These individuals may be considered for PrEP and should contact their healthcare provider (or their local public health unit) for more information.

The EOHU is offering pre-exposure vaccinations by appointment only. Please call the EOHU at 613-933-1375 or 1-800-267-7120 to book.

What do I do if I think I have mpox?

If you think you may have mpox, contact the EOHU or your health care provider, and self-isolate and stay home, except to seek medical treatment or testing.

Isolate from the other people in your house, to prevent the spread. Wear a mask and cover any sores you may have if you cannot avoid contact with another person. Some people, such as immunocompromised individuals, people who are pregnant, and children under 12 years old are at a higher risk of complications from mpox, so it is important to avoid contact with them.

To be assessed and tested for mpox, please visit your local emergency room, as the EOHU does not provide testing or diagnosis for mpox. If you test positive, you should contact your health care provider and/or the EOHU with the results of your test.

Resources

  • Mpox: Outbreak Update (Government of Canada)  
  • Mpox: Transmission, symptoms and more (Ontario Ministry of Health)
  • Mpox Fact Sheet: Overview of the virus, transmission, epidemiology, clinical considerations including treatment, case and contact management, and prevention (World Health Organization)
  • Mpox: Questions and Answers (World Health Organization)
  • Mpox (USA Centers for Disease Control and Prevention)
  • Mpox: What We Know (Gay Men's Sexual Health Alliance)