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The ministry is resuming regular operations and supporting health sector stabilization.

Emergency Planning and Preparedness

Monkeypox Virus

On May 19, 2022 the Public Health Agency of Canada (PHAC) confirmed the first cases of Monkeypox in Canada. Monkeypox is an orthopoxvirus caused by the Monkeypox virus (MPXV), typically transmitted from animals to humans, that causes a disease with symptoms similar to, but less severe than, smallpox. Monkeypox is typically mild and self-limiting, with most people recovering within 2-4 weeks. However, severe illness can occur in some individuals.

Monkeypox is endemic in certain areas of Central and West Africa, but limited cases have been identified in other regions in the past, such as the United Kingdom, United States, Israel and Singapore. These are the first cases of Monkeypox in Canada.

Human-to-human transmission of monkeypox is uncommon. However, when spread does occur, transmission is primarily through respiratory droplets or direct or indirect contact with body fluids, material from skin lesions, and contaminated materials.

Only people with close contact with a person with monkeypox virus are at risk of infection. People can lower their risk of exposure to Monkeypox by maintaining physical distance and employing frequent hand and respiratory hygiene, including masking. Although the risk for monkeypox is low, anyone who is concerned about symptoms they are experiencing should self-isolate and contact a health care professional. There is currently no specific vaccine or treatment available for monkeypox, although prior vaccination against smallpox provides some cross-protection.

The Ministry of Health is working collaboratively with Public Health Ontario, the Public Health Agency of Canada, and public health units to monitor for cases in Ontario.

Health Sector Resources

Document Title Date
Imvamune® Vaccine Storage and Handling Guidance June 14, 2022
Monkeypox Vaccine (Imvamune®) Guidance for Health Care Providers June 14, 2022
Monkeypox Vaccine Information Sheet June 14, 2022
Memo - Chief Medical Officer of Health: Monkeypox June 16, 2022

Key Facts

  • Monkeypox virus causes disease in humans with symptoms similar to, but less severe than, smallpox.
  • Monkeypox is typically found in parts of central and west Africa. It does not usually circulate in humans or animals in Canada.
  • Initial symptoms of monkeypox may include fever, chills, headache, swollen lymph nodes, muscle pain, and fatigue followed by a rash or sores, usually one to three days later, on the palms of the hands, on the soles of the feet, inside the mouth, and/or on the genitals. In some cases, the rash is the first symptom.
  • Monkeypox is usually mild. It typically goes away on its own within two to four weeks.
  • Those who have close contact with someone who has monkeypox infection while the person has symptoms are at risk of getting the virus.
  • Severe cases are more common among newborns, children, pregnant people, and people who are immunocompromised. You can reduce your risk of getting monkeypox by avoiding close contact with people who have confirmed monkeypox or people with symptoms that might be due to monkeypox infection.

How does monkeypox spread?

Monkeypox can spread from person-to-person through respiratory droplets or through close, physical contact with someone who has monkeypox (especially from contact with the rash, bodily fluids, and/or scabs).

Monkeypox can also spread by touching materials and objects (e.g. clothing, bedding, towels, eating utensils, and dishes) that may be contaminated.

Monkeypox can also spread from someone who is pregnant to the fetus, or from a parent to a child during or after birth.

What should I do if I’ve been to a venue where there was someone with suspected or confirmed monkeypox?

Monitor for signs and symptoms for 21 days from the day you may have been exposed to someone with monkeypox. See below for what to do if you develop symptoms of monkeypox.

What should I do if I’ve been in contact with someone who has monkeypox?

Monitor for signs and symptoms of monkeypox for 21 days from the day of your last exposure to the person with suspected or confirmed monkeypox. See below for what to do if you develop symptoms of monkeypox.

Consider wearing a mask (medical mask preferred) when you are in indoors with other people.

Local Public Health Units will work to identify and notify close contacts of a person with monkeypox and may:

  • Advise you to avoid non-essential interactions with people at higher risk of severe monkeypox illness.
  • Advise you on whether Imvamune vaccine may help prevent monkeypox infection or reduce the risk of severe illness.  

What should I do if I develop symptoms of monkeypox?

If you develop symptoms of monkeypox (including fever, headache, muscle aches, swollen lymph nodes, and/or rash or sores) you should contact a health care provider to get advice on testing and/or medical care and tell them if you think you have had contact with a person with monkeypox. You should also follow the recommendations below:

  • Self-isolate at home if possible and avoid close contact with others, until you receive information from your local public health unit about when to end isolation. Stay in a separate room or area away from other people in the home and use a separate bathroom.
  • Wear a medical mask.
  • Cover any rashes or sores as best as possible when you are unable to avoid close contact with other people.
  • People should not visit a person with monkeypox symptoms unless it is for an essential purpose.
  • People with monkeypox symptoms should avoid contact with those at higher risk of severe illness including people who are pregnant or immunocompromised, and children under age 12 years.

Clean your hands and the environment:

  • Clean your hands often with soap and water or an alcohol-based hand sanitizer, including after touching the rash or sores, clothing, or objects and surfaces that may have had contact with the rash or sores.
  • Clean and disinfect contaminated surfaces (e.g., bathroom, if shared) after use with regular household cleaning/disinfectants according to the manufacturer’s instructions.
  • Do not share dishes or utensils when eating; however, dishes/utensils can be used by others in the home if these are properly washed between uses either in a dishwasher or in a sink, using warm water and soap.
  • Avoid direct contact with any laundry/linens that have touched the rash, bodily fluids, and scabs of the person with monkeypox symptoms. Handle laundry/linens with care and avoid shaking. Laundry can be cleaned in a washing machine with warm water and detergent.

What to do if I have been tested or test positive for monkeypox?

If you’ve been tested for monkeypox, self-isolate at home until your test results are known. If your test results are negative, you can stop self-isolating. If you test positive, continue to self-isolate at home until a staff person from your local public health unit contacts you to provide further information about when you can end your self insolation.

If you need to seek medical care:

  • Call a health care provider ahead of time to inform them of your health status, that you are being tested for monkeypox, and about any contact you had with a person with suspected or confirmed monkeypox.
  • Wear a medical mask when seeking medical care.

What treatment is available for monkeypox?

Symptoms usually go away on their own without the need for any treatment. In specific rare situations, your healthcare provider may recommend a medication for monkeypox.

Supportive care for managing symptoms includes:

  • Letting the rash dry or covering the rash with a moist dressing to protect the area, if needed.
  • Avoiding touching any sores in the mouth or eyes. If needed, mouth rinse or eye drops can be used, but products containing cortisone should be avoided.

How can I care for someone with monkeypox infection, or with symptoms that may be due to monkeypox infection?

If you need to provide care to someone with monkeypox symptoms or confirmed to have monkeypox, you should:

  • Encourage the person to cover their rash and sores as best as they can (e.g., wearing a long sleeve shirt and long pants).
  • Wear a medical mask and encourage the person to wear a medical mask when you are physically close to them.
  • Avoid skin-to-skin contact.
  • If you provide direct care that may involve touching the rash and sores, wear a medical mask and use disposable gloves.
  • Follow the guidelines above in Clean your Hands and the Environment.

What animals can get monkeypox?

There are several types of animals that have been found to be susceptible to infection with monkeypox, including several species of rodents (e.g., rats, mice, hamsters, gerbils, squirrels, chipmunks, etc.), rabbits, hedgehogs, opossums, and non-human primates (e.g., monkeys). It is unknown which other species may be at risk of infection.  Precautions should be taken to prevent exposure of any domestic or wild mammals to the virus.

Animals with monkeypox have been observed with clinical signs such as cough, fever, eye infections, lack of appetite, difficulty breathing, and rash. Veterinarians that suspect an animal has been infected with monkeypox should call the Ontario Ministry of Agriculture Food and Rural Affairs at 1-877-424-1300 to discuss the need for testing and/or management plans.

I have pets in my home. What precautions should I take if I have monkeypox or symptoms of monkeypox?

The risk of infection in different animal species is unclear, and because the monkeypox virus could be carried from one person to another on an animal's coat or feathers, it is best to find someone else to take care of your pet until you are out of isolation.

If you have or have recently been exposed to monkeypox and have been advised to self-isolate:

  • Keep your pets in your home. If possible, ask someone else in your home who is not sick and who has not been exposed to care for your pets.
  • Avoid close or prolonged contact with pets, for example, avoid direct contact, including touching, snuggling, and kissing animals, especially if you have unhealed sores on your face, hands, or arms.
  • Take precautions when providing care for pets, for example, wear a mask when in the same room as your pet, especially if you have sores in your mouth or are coughing/sneezing. Wash your hands with soap and water or use an alcohol-based hand rub immediately before and after touching pets, their food, or supplies.

What if my pet becomes sick while I am isolating?

If your animal is in quarantine with you and becomes sick, it is preferred to first seek care from a veterinary telemedicine service, to assess if the animal’s condition can be managed at home.

If your pet must be examined directly by a veterinarian or requires other procedures that cannot be reasonably delayed until the end of the isolation period, your veterinarian should be advised that your pet may have been exposed to monkeypox. Your veterinarian should then contact the Ontario Ministry of Agriculture Food and Rural Affairs at 1-877-424-1300 to ensure that they have proper infection control procedures in place and appropriate personal protective equipment prior to attending your pet at home (ideally) or at a veterinary clinic (if necessary).

I own or work with livestock or poultry, and I think I may have been exposed to monkeypox. What should I do?

Any person who may have been exposed to monkeypox should not work with livestock or poultry until they are advised by their physician or public health unit that they don’t pose any risk for transmission of the virus. Animal owners are responsible for providing basic care for their animals including food, water, and shelter. Livestock and poultry producers should always have a plan in place for others to provide care for their animals in case of emergencies, including the need to self-isolate due to illness.

Additional Resources

For More Information

Ministry of Health
Health System Emergency Management Branch
1075 Bay Street, Suite 810
Toronto, Ontario
Canada M5S 2B1
Fax : 416-212-4466
TTY : 1-800-387-5559
E-mail : emergencymanagement.moh@ontario.ca

 

Health workers and health sector employers can call the Healthcare Provider Hotline for more information
Toll free : 1-866-212-2272

CritiCall Ontario provides a 24 hour call centre for hospitals to contact on-call specialists; arrange for appropriate hospital bed access and facilitate urgent triage for patients
1-800-668-4357

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