Monkeypox is a disease caused by the monkeypox virus. It is endemic in parts of west and central Africa, where transmission has primarily been from infected animals to humans, with very limited human-to-human transmission.

Since mid-May, one of the African strains has spread to more than 70 countries where monkeypox is not endemic, including in Canada. The pattern of spread in this global outbreak has been different: it is primarily human-to-human, sexually associated transmission.

In this global outbreak of monkeypox the primary mode of transmission is via close, skin-to-skin contact with a monkeypox rash.

Although the number of monkeypox cases in B.C. remains low, some transmission within the province has been identified. Learn more about current situation updates for Canada and British Columbia, including case counts.

According to the World Health Organization (WHO), 98 per cent of the cases in this global outbreak identified to date are among men who have sex with men; in B.C., all cases reported to date are among this demographic. While other people — including those living in the same household or those who have close skin-to-skin contact with a person who has monkeypox — may be at risk of infection, transmission from this type of contact has been infrequent to date.

To reduce local transmission, prevent severe illness and limit risk to the public, Public Health has launched a targeted vaccine campaign, working with the BCCDC and community partners like Health Initiative for Men (HiM) and others, to provide information and vaccine to people most at risk of infection.

Vaccine is not recommended or available for the general public.

How monkeypox is spread

The monkeypox virus does not spread easily from person to person the way some viruses do, such as the virus that causes COVID-19. In this global outbreak of monkeypox the primary mode of transmission is via close, sexually-associated skin-to-skin contact.

Symptoms

Symptoms for monkeypox usually appear one to two weeks after exposure but can take anywhere from five to 21 days to appear and can last up to two to four weeks.

  • The infection may start with flu-like symptoms including:
    • Fever or chills
    • Swollen lymph nodes
    • Intense headaches
    • Muscle aches
    • Back pain
    • Fatigue
  • One to five days later, a skin rash appears, with lesions that can appear on genitals, hands, feet and/or mouth. The rash may start in one place and spread to other parts of the body.
  • Some people only get the rash and in some people it may be limited to one or more lesions in the genital area.

People are considered to be infectious from when symptoms first appear until the sores crust over, are dry and new skin is visible.

Get tested for monkeypox

People experiencing symptoms of monkeypox can be assessed to see if they need testing via their primary care provider, at Sexual Health clinics or at an Urgent and Primary Care Centre. If possible, the clinic should be informed ahead of time about the reason for the visit. 

Sexual Health clinics can be found using the BCCDC SmartSexResource clinic finder.

Until they see a health care provider, while awaiting results and if they are confirmed positive, these prevention measures should be followed when around other people:

  • Wear a mask
  • Keep any sores or blisters covered as much as possible (e.g. long sleeves, long pants)
  • Limit close contact, including with people you live with and sexual contact with others
  • Practice good hand hygiene
  • Try to avoid sharing items or spaces while infectious, but if you need to, wipe down items and surfaces after using them
  • Do not share towels, clothing, or linens

If you have been in close contact with a person with a monkeypox infection, monitor for symptoms. Symptoms can start five to 21 days after exposure.

Managing symptoms

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 health care 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 health care provider or go to your nearest Urgent Primary Care Centre 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

Vaccination against monkeypox

Experience of other jurisdictions shows early use of vaccines among groups who are at the highest risk of spread, along with case and contact tracing efforts by Public Health, can reduce transmission, prevent severe illness and limit risk to the wider population. Vaccine is not recommended or available for the general public.

We are working closely with community partners on a focused vaccine campaign to provide a single dose of vaccine to people at risk through a combination of outreach and appointments booked online. If required, Public Health will make second doses available in the future.

Eligibility:

  • Two-spirit people who self-identify as belonging to the gay, bisexual and other men who have sex with men community
  • Transgender people who self-identify as belonging to the gay, bisexual and other people who have sex with men community
  • Cisgender males who 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 two 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 https://smartsexresource.com/get-tested/clinic-finder

People who live in the Fraser Health region and are eligible for the vaccine can book themselves an appointment online.

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

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.

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 Fraser Health 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.

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