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Mpox (Monkeypox) Virus

Currently, person-to-person transmission of mpox is occurring in Canada. In line with international trends, the majority of cases in Canada to date are men who reported intimate sexual contact with other men. However, it's important to stress that the risk of exposure to the monkeypox virus is not exclusive to any group or setting. According to the Public Health Agency of Canada (PHAC) the risk of infection is low for the general population.

What is mpox?

Mpox is a rare disease that is caused by infection with Monkeypox virus. Mpox can cause a rash, which may look like pimples or blisters, and sometimes can cause a flu-like illness.

What are the symptoms of mpox infection?

Symptoms of mpox typically include fever, headache, swollen lymph nodes, low energy, muscle aches and skin rash or lesions. The rash usually begins within one to three days after other symptoms. Lesions can be flat or slightly raised, filled with clear or yellowish fluid, and can then crust, dry up and fall off. Mpox symptoms can start within five to 21 days after exposure to mpox, but usually appear in six to 13 days. Symptoms can last between two to four weeks and generally, most people recover on their own after a few weeks.

Someone infected with the mpox virus is contagious from the onset of their first symptom until all of their scabs have fallen off and new intact skin has formed below the scab.

How does the mpox virus spread?

This infection can spread from a person with the virus to others through close contact with respiratory droplets from breathing, talking, coughing or sneezing, skin-to-skin contact with lesions, blisters, rashes or bodily fluids, such as saliva, and contact with objects, fabrics (such as bedding and towels), and surfaces used by someone who is infected with the virus.

Mpox vaccine and eligibility

Given the current supply constraints, Ontario is using a single dose of Imvamune® to limit ongoing transmission. Two doses are recommended for moderately to severely immunocompromised individuals and certain research laboratory employees.

Imvamune® should be considered for the following:

  1. Pre-Exposure Prophylaxis (PrEP)
    1. Two-spirited, non-binary, trans- or cis-gender individuals who self-identify or have sexual partners who self-identify as belonging to the gay, bisexual and other men who have sex with men (gbMSM) community AND at least one of the following:
      • Have received a diagnosis of bacterial STI (i.e., chlamydia, gonorrhea, syphilis) in the past 2 months;
      • Have had 2 or more sexual partners recently or may be planning to;
      • 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.
    2. Any individual who engages in sex work or may be planning to.

      Household and/or sexual contacts of those identified for PrEP eligibility in parts (a) and (b) above AND are moderately to severely immunocompromised (see Appendix A) or pregnant may be at higher risk for severe illness from a monkeypox infection may be considered for PrEP and should contact the Porcupine Health Unit for more information.

  2. Post-Exposure Prophylaxis (PEP)
    • A single dose of the vaccine should be offered ideally within 4 days (up to 14 days) from the date of the last exposure to individuals who are a high risk contact of a confirmed or probable case of mpox. 

Anyone who self-identifies as a high risk contact of a confirmed or probable case of mpox should contact the Porcupine Health Unit for further assessment to see if PEP would be recommended.

Where can I find more information?