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Could someone unknowingly spread monkeypox? A Vancouver expert weighs in

"You're infectious for a number of weeks."
monkeypox-virus-laboratory-sample
The BC Centre for Disease Control says the monkeypox outbreak in Canada hasn't reached British Columbia but a Vancouver expert weighs in on the data.

As cases of monkeypox continue to climb across Canada and around the world, local experts are growing concerned about the way it is spreading. 

Chief Public Health Officer Dr. Theresa Tam told reporters in a press briefing Friday (May 20) that just under a "couple dozen" individuals were being investigated by local authorities, mainly in Quebec.

The BC Centre for Disease Control later confirmed that two suspected cases in B.C. were not monkeypox. As of Tuesday, however, Quebec health officials are now reporting 10 more cases of monkeypox, for a total of 15 confirmed cases across the province.

The rare zoonotic virus is typically limited to Africa, and rare cases in the U.S. and elsewhere are usually linked to travel there.

Dr. Stephen Hoption Cann, clinical professor in the school of population and public health at the University of British Columbia (UBC), told Vancouver Is Awesome in a phone interview that it is "unusual" to see a number of individuals in a few countries developing the infection.

And while the West African variant is the one that is currently spreading and considered less dangerous, epidemiologists haven't determined at what stage the virus is spreading. 

"We don't really have information on what stage its spreading because...it can take a few days, up to a week or two weeks, from the time you are exposed by the virus to the time you develop symptoms," he said. "So it's primarily spreading before people have those symptoms, which would be concerning, obviously, because if you don't know you're sick, obviously you wouldn't be taking precautions versus if it's spreading after. 

"If you have a mild fever or rash on your face...the first thing that comes to mind would be monkeypox. You might not know that you're carrying this virus so I think we need some more data on these cases and what stage of the disease is spreading from one person to the next."

"You're infectious for a number of weeks."

The two main countries that see monkeypox outbreaks, The Democratic Republic of Congo and Nigeria, have seen an uptick in cases in recent years.

"So we see that and, you know, with international travelling... in the coming years, we can expect to see more of this coming out of Africa," noted Cann. 

Monkeypox may also be transmitted by close contacts, such as through sexual activity. But someone who had an active illness with lesions would be noticeable. 

"So normally...it starts on the face, spreads to the hands and the feet and other areas of the body. So if you have a rash, a lesion...on your hands...it's kind of pretty obvious," he noted, adding that the virus can also appear in the mouth. 

"So there [are] various ways it can spread...so it's concerning. But we don't know yet [how] it is spreading from one individual to the next. And also the other factor is...you're infectious for a number of weeks."

Someone who did not show symptoms of monkeypox and had several sexual partners before they recognized they were ill could possibly unknowingly spread the virus, too. 

What is a monkeypox virus infection? 

Monkeypox comes from the same family of viruses as smallpox. Most people recover from monkeypox within weeks, but the disease is fatal for up to 1 in 10 people, according to the World Health Organization (WHO).

It typically begins with a flu-like illness and swelling of the lymph nodes, followed by a rash on the face and body. In Africa, people have been infected through bites from rodents or small animals, and it does not usually spread easily among people. 

Similar to COVID-19, medical health professionals use a Polymerase chain reaction (PCR) test for patients who they suspect have the monkeypox virus. "For this, optimal diagnostic samples for monkeypox are from skin lesions – the roof or fluid from vesicles and pustules, and dry crusts," explains the WHO.

With files from the Canadian Press.