Monkeypox

The Facts

Monkeypox is a viral infection that is related to the virus that causes smallpox. It was first discovered in 1958 after a pox-like disease occurred in a colony of monkeys used for research purposes. The first human case was in 1970.

Historically, it has been found in West or Central African countries, though the 2022 multi-country monkeypox outbreak marks the first time it has spread widely outside of these regions. The first cases of monkeypox in Canada were identified in May 2022. As a result, the Public Health Agency of Canada is working with provincial and territorial public health partners to collect information about monkeypox cases and to monitor the situation.

The Causes

The monkeypox virus belongs to the Orthopoxvirus family. While the original source of the virus remains unclear, it's thought that monkeypox is spread from rodents such as dormice, striped mice, Gambian rats, and African rope squirrels. Anyone can get infected by the virus, regardless of their age, sex, race, gender, or sexual orientation.

Monkeypox infections can spread through both animal-to-human contact and human-to-human contact. Monkeypox can spread from an infected animal to a human through scratching, licking, or biting; through contact with bodily fluids or lesions of an infected animal; or by preparing or eating meat of an infected animal.

Human-to-human spread of monkeypox can occur through contact with an infected person's skin lesions, blood, or body fluids, including via sexual activity. Transmission can also occur by touching infected body areas like the eyes, mouth, or genitals, or surfaces that have been in contact with an infectious person, such as bedding or towels.

Less commonly, coming into contact with infected respiratory droplets created when coughing or sneezing can also lead to infection. It is possible for pregnant people who are infected to transmit the virus to their fetus.

Symptoms And Complications

Monkeypox infections traditionally have 2 stages: an invasion stage where you may develop general symptoms and then a rash stage. It is important to note that during the 2022 outbreak, there have been unusual situations in which people have not developed a rash or generalized symptoms, or where the order of the 2 stages was reversed.

In the invasion stage, you may develop general symptoms for up to 5 days. These signs and symptoms can include:

back pain
chills
exhaustion
fever
headache
joint pain
muscle pain
swollen lymph nodes

Infected individuals usually develop a rash starting 1 to 3 days after the start of their fever in the invasion stage. The rash stage can last for 2 to 4 weeks. It generally affects the face and limbs, but can also affect other areas like the hands, feet, mouth, genitals, and around the anus.

Skin rashes change in appearance during this period; they may start as more flat and reddish areas that become fluid-filled and raised. Keep in mind that skin rashes may change at different rates if multiple areas are affected. Eventually, ulcers will form and scab over. Infected people are considered to be infectious starting from the time that they show symptoms until their rash scabs have fallen off on their own and the skin has healed.

In most cases, monkeypox infections are mild and resolve on their own. In rarer situations, infections can lead to complications such as:

bacterial infections
death
eye infections, possibly leading to vision loss
inflammation of the brain
pneumonia
sepsis

People who are at higher risk of developing complications include children under the age of 12, pregnant people, and people who are immunocompromised or who have weakened immune systems.

Making A Diagnosis

Since monkeypox infections can share similar symptoms with other infectious diseases, like chickenpox, or certain sexually transmitted infections, like herpes, it's important to contact your health care provider if you have signs or symptoms, or if you have come into close contact with a confirmed or suspected case of monkeypox.

Monkeypox infections can be confirmed via laboratory testing, such as by using PCR testing to detect for the presence of the virus DNA. Ask your health care provider or local health authority for more information on how to get tested.

Treatment And Prevention

Currently, there are no approved treatments for monkeypox in Canada. If you are infected with the virus, you can treat certain symptoms that you may be experiencing, such as bacterial infections or pain. It's important to isolate yourself at home away from others to prevent spreading the virus further. If you live with others, helpful precautions can include:

following the instructions provided to you by your local public health authority
avoiding physical contact with others, especially children under the age of 12, people with weakened immune systems, or pregnant people
avoiding contact with pets and livestock when possible
avoiding the use of shared items, objects, or utensils
covering all your lesions with clothing or bandages as much as possible
cleaning and disinfecting all surfaces and objects that you come into contact with regularly

If someone you know is infected with the virus or is suspected of being infected, you can reduce your risk of getting or spreading the virus by practising similar proper hand and environmental hygiene measures. Contact your health care provider or local public health authority if you develop any signs or symptoms.

Certain individuals who are at a high risk of being exposed to the virus may be eligible to receive vaccination to reduce their risk of infection, depending on their province or territory. The Imvamune® vaccine is a smallpox vaccine that has been authorised by Health Canada for protection against smallpox, monkeypox, and other Orthopoxvirus infections for adults 18 years of age who are considered to be at high risk.