MPOX: 2024 Updated FAQ (Frequently Asked Questions)

Last updated: April 15, 2024
          
The monkeypox virus (MPX/MPOX) has been circulating in Ontario since 2022 has mostly been reported among gay and bisexual men, passing through close personal and sexual networks.
 
While confirmed case numbers dropped off in 2023, numbers are rising again in 2024 here and in the United States as well.
 

MPOX: Frequently Asked Questions

 

What is Mpox?

Mpox (formerly called monkeypox) is a virus that spreads from person to person through direct close contact (skin-to-skin) and or with infected lesions, skin blisters, body fluids. 

Mpox Symptoms

Symptoms start 5 days to 21 days after exposure. The symptoms of Mpox include, rash, oral/rectal/genital lesions, painful urination, fever, swollen lymph nodes, chills, headache, sweating, sore throat, exhaustion, back pain/back ache, runny nose, diarrhea, and nausea. The rash with blister can appear within one to three days before or after symptoms.  The rash begin as flat red spot usually start on the face and spread to body, including inner parts of the mouth, tongue, genitals or peri-anal region, palms of hands, soles of the feet. The rash will turn to blister and form a crust. 

Update on confirmed Mpox cases

·       26 cases of Mpox, have been reported (as of February 29, 2024).

·       Of the cases, none of them were fully vaccinated.

·       In 2023 there were 33 cases.  In 2022, there were over 500 cases of Mpox infections.

·       The most recent cases in 2024 have been in gay, bisexual and other men who have sex with men (gbMSM)

·       The virus is circulating locally in Toronto, with only two travel-related cases. 

Virus spread

·       The virus is spread mostly between people who have had close/intimate or sexual contact with a person who has the virus.

·       Gay, bisexual and other men who have sex (gbMSM) with men are most commonly affected.

·       There is no treatment approved specifically for Mpox virus infections, except a few antivirals to treat severe Mpox cases.

·       More information is available at, How to Prevent the Spread of Mpox

Risk factors

·       The most common risk factors for gbMSM are: new/multiple sexual contacts, anonymous sex, and meeting sexual partners from online.

Vaccine effectiveness and safety

·       The vaccine being used against Mpox is called Imvamune and it is 85% effective in preventing Mpox transmission. The vaccine is safe. It is for people 18 years, and older and delivered by injection into the arm.  

·       People who have been vaccinated have much less severe symptoms.

·       gbMSM who have not been vaccinated are recommended to get their first vaccine dose as soon as possible and receive the second dose in 28 days as per vaccine guidelines.

·       The vaccine is free, and OHIP is not required.

·       Inquire about the Mpox vaccine where you access sexual health care.

·       Full vaccine eligibility requirements can be found on the City of Toronto website

·       Further information on vaccine clinics is available at www.GMSH.ca/mpox

If you have been exposed to Mpox

·       The vaccine can be given within 14 days of being exposed to Mpox (post-exposure vaccination)

·       Contact your healthcare provider.  

·       More information post exposure is available at, How to Prevent the Spread of Mpox

Mpox and PLHIV

·       It is also important for people living with HIV (PLHIV) to have both vaccinations and speak to their healthcare provider.

·       PLHIV should avoid skin-to-skin contact or other close intimate contact (including sex) with other people who may have Mpox symptoms or suspicious rash for Mpox and avoid contact with contaminated surfaces or items (towels, linens) used by a person with Mpox.

·        PLHIV should perform frequent hand washing/hygiene after touching rash surfaces, items, or materials that may have contact with rash contents. 

·       More information about Mpox and people living with HIV is here.

Community concerns

·       Over the last two years, gbMSM communities in Ontario were instrumental in sharing Mpox information in their social networks to take care of their health and look out for one another. We hope for a similar uptake this year to help keep transmission contained.

Further information on vaccine clinics is available at www.GMSH.ca/mpox

Ontario Public Health Unit Locator. Ministry of Health. To find your Public Health Unit,  https://www.phdapps.health.gov.on.ca/PHULocator/  

 

 

References:

CBC. Toronto Public Health urgers people to vaccinated against mpox amidst rising cases. Retrieved March 21, 2024, from https://www.cbc.ca/news/canada/toronto/mpox-cases-toronto-1.7149525

Clinical Info. HIV.Gov. Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV. (2024). Retrieved March 21, 2024,  from  https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/mpox

CATIE. Mpox resources. (2022). Retrieved March 21, 2024, from https://www.catie.ca/monkeypox-resources

Epidemiological summary report: 2022-23 mpox outbreak in Canada. Retrieved May 14, 2024,  from https://www.canada.ca/en/public-health/services/publications/diseases-conditions/epidemiological-summary-report-2022-23-mpox-outbreak-canada.html

Government of Ontario. Mpox resources for health care professionals. Retrieved March 22, 2024, from https://www.ontario.ca/page/mpox-monkeypox-resources-health-care-professionals

Li P, et al. Preventing drug resistance: combination treatment for mpox. The Lancet.2023, 402 (10414). pp.1750-1751. https://doi.org/10.1016/S0140-6736(23)01673-2

Mpox for Health Professionals. Government of Canada. Retrieved May 10, 2024, from https://www.canada.ca/en/public-health/services/diseases/mpox/health-professionals.html

National Advisory Committee on Immunization Rapid Response: Updated interim guidance on Imvamune in the context of ongoing monkeypox outbreaks. (2022). Retrieved on March 22, 2024, from https://www.canada.ca/en/public-health/services/publications/vaccines-immunization/rapid-response-updated-interim-guidance-imvamune-monkeypox-outbreaks.html

Newfoundland Labrador.  Imvamune Vaccine Information Sheet for Healthcare Providers.  Retrieved March 22, 2024, from https://www.gov.nl.ca/hcs/files/Imvamune-Vaccine-Info-Sheet-for-HCP.pdf

Public Health Ontario. Mpox (2024). Retrieved March 23, 2024, from Mpox (formerly known as monkeypox) | Public Health Ontario

Public Health Ontario. Enhanced Epidemiological Summary (2024). Retrieved March 26, 2024, from Updated Mpox in Ontario Epidemiological Summary

Public Health Ontario. Enhanced Epidemiological Summary. (2023). Retrieved March 22, 2024, from Updated Mpox in Ontario Epidemiological Summary  

Public Health Ontario. (2022). Retrieved March 22, 2024, from  https://www.publichealthontario.ca/-/media/Documents/M/2022/monkeypox-vaccine.pdf?rev=7a114766e8de4e52b8fdb9d8911f55b3&la=fr

Smallpox and mpox vaccines: Canadian Immunization Guide. (2023). Retrieved on  March 22, 2024. https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-21-smallpox-vaccine.html

Toronto Public Health. 2024. Retrieved March 21, 2024, from, https://www.toronto.ca/community-people/health-wellness-care/health-programs-advice/mpox/ 

Treatment information for Healthcare Providers. CDC. (2023). Retrieved on March 22, 2024, from https://www.cdc.gov/poxvirus/mpox/clinicians/treatment.html   

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