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Here's what you need to know about monkeypox in B.C.

Monkeypox vaccinations can now be booked by anyone at high risk at clinics in Vancouver Coastal Health
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Who's most at risk for getting monkeypox? What are the monkeypox symptoms? Find out in this explainer.

The outbreak of monkeypox infections has recently been declared a public health emergency by the World Health Organization. So far, there are 58 cases of virus confirmed in B.C. Here’s what you need to know about how to protect yourself from the virus and who is eligible for a vaccine:

What is monkeypox?

Monkeypox is a virus related to smallpox, but fortunately results in a much milder illness. It was first discovered in laboratory monkeys in 1958 and was first identified in humans in 1970. It has become endemic to a group of countries in Central and West Africa, but until recently was largely unknown outside of that area.

Most recently, monkeypox infections have been been spreading around the world. Over 16,000 cases and have now been identified in over 70 countries. The World Health Organization declared monkeypox outbreak a Public Health Emergency of International Concern (PHEIC) on July 21.

In Canada as of July 26, a total of 745 confirmed cases of monkeypox have been reported , including 346 cases in Quebec, 326 in Ontario, and 58 in British Columbia.

How is it spread?

Monkeypox can spread from animals to humans, from person to person and through contaminated objects.

Monkeypox is mostly spread through contact with sores or blisters.

It can also be transmitted through items like bedding or towels that have monkeypox virus or respiratory droplets such as coughs and sneezes during close, face-to-face contact with a person who has monkeypox.

Monkeypox is not known to be a sexually transmitted infection, like syphilis or HIV, but sexual activities often include close contact.

According to Vancouver Coastal Health, all identified local transmission of monkeypox in B.C. so far has involved prolonged skin-to-skin contact, which is suspected to be the primary way the virus is spread.

Who is at risk?

Anyone can get monkeypox. However, where data is  available, 98.9 per cent of people with monkeypox are men and 98 per cent are men who have sex with men. To date, less than one percent of confirmed cases in Canada are in women or people under 20. The average age of someone who contracts monkeypox is 36.

To date in B.C., all 58 cases identified so far are among people who self-identify as men who have sex with men. Most cases are in the Vancouver Coastal Health Region, although there are also cases in Island Health and Fraser Health.

People considered particularly vulnerable include those 18 and older who are transgender people or men who self-identify as belonging to the gay or bisexual community, and who meet additional high-risk criteria.

People older than 50 likely received smallpox vaccinations as children (Canada stopped giving routine smallpox vaccinations in the early 1970s) so may have some protection from the virus.

What are the symptoms?

Monkeypox symptoms are very rarely life-threatening, and can present in different ways. Usually initial symptoms include fever, chills, fatigue, swollen lymph nodes and muscle pain. Other less common symptoms can include sore throat, cough, nausea or vomiting, and diarrhea.

The second stage usually starts one to five days after the first stage. In the second stage, a rash (sores/blisters) develops. Monkeypox sores/blisters are most commonly seen on the hands, feet, arms, legs, mouth and/or genitals and usually last between two to three weeks, according to the BC Centre for Disease Control.

Some people experience symptoms differently. For example: some people many only get the rash, or get the first-stage symptoms after the appearance of sores.

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 may require medications to manage pain or skin infections, or in rare cases, treatment in hospital.

Who should get a vaccine?

In B.C. vaccines are being made available to certain people including transgender people or those who self-identify as gay or bisexual men. Additional criteria include having received a diagnosis of chlamydia, gonorrhea, and/or syphilis in the past two months, or having two or more sexual partners in the last 21 days, or having attended bath houses or sex clubs, or having had anonymous sex in the past 21 days  or engaging in sex as a sex worker or a client.

Imvamune is the vaccine approved in Canada for immunization against smallpox, monkeypox and related Orthopoxvirus infections in adults 18 years of age and older determined to be at high risk for exposure.

B.C. has limited doses of the vaccine and the vaccine is not recommended for the general public.

How can people protect themselves from monkeypox?

People who are most at risk of infection should get vaccinated.

To help reduce the risk of becoming infected or spreading the monkeypox virus Health Canada also recommends:

  • staying home and limiting contact with others if you have symptoms
  • avoiding close physical contact, including sexual contact, with anyone who may have been exposed to the monkeypox virus
  • maintaining good hand hygiene and covering coughs and sneezes with the bend of your arm
  • wearing a well-fitting mask
  • cleaning and disinfecting high-touch surfaces and objects in your home, especially after having visitors.

How can I get a vaccine?

If you meet the eligibility criteria, you can book an appointment directly on the Vancouver Coastal Health booking app for appointments in North Vancouver, West Vancouver and other areas of VCH.

In addition to booked appointments, VCH will be holding a number of pop-up vaccine clinics in coordination with Pride, and on Sunday July 31, at Sunset Beach, during the Vancouver Pride Festival.

If you become ill:

Monitor for symptoms if you have had contact with a person with known or suspected monkeypox. It can take between five days to three weeks after exposure for a person to develop symptoms.

If you think you have been exposed, contact a healthcare provider to get tested as soon as possible. Be careful to avoid exposing others to the virus while you are infectious.

Treatment:

There are no well-established treatments for monkeypox. Antiviral medication may be considered on a limited case-by-case basis. 

In addition, the vaccine can be given after being exposed to the virus before you have symptoms to prevent illness or limit its severity.

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