The World Health Organization (WHO) recently declared mpox a global health emergency for the second time since 2022.
After experiencing worldwide lockdowns during the COVID-19 pandemic, seeing headlines like “global health emergency” might cause some unease. But what is mpox and how is it spread? We sat down with Dr. Adrienne Chan, infectious disease physician at Sunnybrook, to talk about the rising cases, how mpox is spread, and how people can protect themselves from infection.
What is mpox and how is it spread?
Mpox is a pox virus in the same family as smallpox. It historically was endemic to central and western Africa, but people around the world have become more familiar with it since 2022, when a global outbreak marked the first time there was widespread community transmission outside of Africa.
There are two types of mpox – Clade I and Clade II. The mpox outbreak we have been managing in Canada over the last couple of years has been Clade II, which typically causes a milder infection. WHO’s latest declaration of a global health emergency comes as a result of a new subvariant of the Clade I virus, called Clade 1b. This new subvariant, which had been causing a local outbreak in the Democratic Republic of Congo, has spread across borders within that region over the last few weeks. WHO’s emergency order was declared to help mobilize global resources to more equitably support the response in that region, and also develop a better understanding of the presentation and management of Clade 1b.
As a pox virus, mpox typically causes a painful rash or lesions that begin as flat red spots (that can look like pimples), which turn into blisters and then form a crust. The lesions can occur on the hands, feet, chest and other parts of the body (including the inner part of the mouth, tongue and genitals). The virus can also cause flu-like symptoms like fever, headache and a sore throat.
Mpox is spread in various ways, but the majority of cases we have seen in Canada are from close contact with persons with the disease, like through sexual contact and in household settings. This typically involves skin-to-skin contact with a mpox rash or lesions.
What are some ways people can protect themselves from mpox? Can people get vaccinated against it?
Canada has been able to manage our current Clade II mpox outbreak through a vaccination program and the leadership and engagement of affected communities. Canada has access to a mpox vaccine called Imvamune.
In Ontario, Imvamune is available for those who meet the eligibility critieria defined by the province’s Ministry of Health. We are seeing a slight uptick of local mpox cases in Ontario, and have been encouraging eligible higher risk patients to get vaccinated. Many eligible individuals received a single dose in 2022 and are encouraged to book a second dose now if they have not yet received it, to optimize protection.
To learn more about booking an mpox vaccination appointment, reach out to your local Public Health unit or sexual health clinic.
Practicing consistent and proper hand hygiene can also play an important role in the spread of infectious diseases like mpox, COVID-19 and the flu.
Are there specific populations that are more vulnerable to mpox?
Individuals who are immunocompromised (including people living with severe HIV), infants and children and people who are pregnant or breastfeeding, are at a higher risk of more severe infections and complications from mpox.
The majority of reported cases of mpox in Canada have been between people who have close, intimate or sexual contact with a person who has the virus, disproportionately affecting gay and bisexual men and other men who have sex with men.
Stigma and discrimination make it more difficult to stop the spread of mpox, and can harm the people and communities that experience it. It’s important to note that anyone can get mpox and although certain communities are currently more affected, there is nothing about the virus that specifically targets people of certain sexual orientations, genders, and races.
Is there anything else people should know about mpox?
It is important to know that travel is not a significant factor for the current increase in mpox cases in Canada, which rather suggests local ongoing community transmission of Clade II mpox.
The current risk of Clade I mpox is low for people in Canada. WHO’s declaration of a Global Health Emergency hopes to see the rollout of 10 million vaccine doses in Africa, an intervention that will be critical in the coming weeks.
Learn more about mpox
If you want to learn more about mpox, there are many helpful resources including:
