Mpox

• On Aug. 14, 2024, the World Health Organization (WHO) declared a Public Health emergency of international concern due to the increase in a new clade (1b) of mpox in Democratic Republic of the Congo (DRC) with some spread to neighbouring countries. 
• The circulating clade of mpox virus in Africa clade (1), is currently not impacting Vancouver Coastal Health, at this time the risk to the B.C. population remains low. 
• All of cases detected to date in B.C. are clade 2b. Infections from clade 2 tend to be less severe. 
• In B.C., cases of mpox are limited in numbers and risk is considered low, even in populations at higher risk for mpox (e.g. gbMSM). 
• Second doses of Imvamune are now recommended for stronger, longer-lasting protection against mpox for people who received their first dose at least 28 days ago.
• If you are eligible for Imvamune, you are also eligible to receive HPV (up to 26 years of age), Hepatitis A, and Hepatitis B vaccines at no charge. Book an appointment for these vaccines at least 14 days after you have received Imvamune.
• If you have had close contact with a person with known or suspected mpox, contact your health-care provider about potential post-exposure immunization and monitor for symptoms. It can take around 5-21 days after exposure for a person to develop symptoms. 
• There is no vaccine (free or private pay) available for individuals who are travelling if they do not meet current vaccine eligibility criteria. 

Mpox is a disease caused by the mpox virus. It is endemic in parts of west and central Africa, where transmission has primarily been from infected animals to humans, with very limited human-to-human transmission. 

Since May 2022, one of the African strains — clade 2b — has spread to more than 70 countries where mpox is not endemic, including in Canada. The pattern of spread is human-to-human, sexually associated transmission, with the primary mode of transmission via close, skin-to-skin contact with a mpox rash. It primarily affects gay, bisexual and other men who have sex with men (gbMSM).

After a targeted vaccine campaign in the summer of 2022, the number of mpox cases in B.C. dropped dramatically, however, there continues to be a low level of transmission. Two doses of Imvamune are now recommended for people who are eligible for stronger, longer-lasting protection against mpox.

Find the current situation updates for Canada.

According to the World Health Organization (WHO), 98 per cent of clade 2b cases are among men who have sex with men. While other people — including those living in the same household or those who have close skin-to-skin contact with a person who has mpox — may be at risk of infection, transmission from this type of contact has been infrequent to date.

Stigmatizing people because of a disease is never okay.

To reduce local transmission, prevent severe illness, and limit risk to the public, VCH Public Health works with the BCCDC and community partners like Health Initiative for Men (HiM) and others, to provide information and vaccine to people most at risk of infection.

Vaccine is not recommended or available for the general public.

The mpox virus does not spread easily from person to person the way some viruses do, such as the virus that causes COVID-19. The primary mode of transmission is via close, sexually-associated skin-to-skin contact.

Symptoms for mpox usually appear one to two weeks after exposure but can take anywhere from five to 21 days to appear and can last up to two to four weeks.

• The infection may start with flu-like symptoms, including:
  • Fever or chills
  • Swollen lymph nodes
  • Intense headaches
  • Muscle aches
  • Back pain
  • Fatigue
• One to five days later, a skin rash appears, with lesions that can appear on genitals, hands, feet and/or mouth. The rash may start in one place and spread to other parts of the body.
• Some people only get the rash, and in some people it may be limited to one or more lesions in the genital area.

People are considered to be infectious from when symptoms first appear until the sores crust over, are dry, and new skin is visible. 

People experiencing symptoms of mpox can be assessed to see if they need testing via their primary care provider, at Sexual Health clinics, at an Urgent and Primary Care Centre, or at an Emergency Department. If possible, the clinic should be informed ahead of time about the reason for the visit. Sexual Health clinics can be found using the BCCDC SmartSexResource clinic finder.

Until they see a health-care provider, while awaiting results, and if they are confirmed positive, these prevention measures should be followed when around other people:

• Wear a mask
• Keep any sores or blisters covered as much as possible (e.g. long sleeves, long pants)
• Limit close contact, including with people you live with and sexual contact with others
• Practice good hand hygiene
• Try to avoid sharing items or spaces while infectious, but if you need to, wipe down items and surfaces after using them.
• Do not share towels, clothing, or linens 

If you have been in close contact with a person with a mpox infection, monitor for symptoms. Symptoms can start five to 21 days after exposure.

Mpox 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 will need to see their healthcare provider. People experiencing more severe disease may require medications to manage pain or skin infections, or in rare cases, need other supportive treatment in hospital.

Please see your healthcare provider or go to your nearest Urgent Primary Care Centre or Emergency Department if you experience the following after testing positive for mpox:

• Worsening or new throat or rectal pain
• Severe fever or chills
• Shortness of breath or chest pain

Imvamune, the vaccine used for the prevention of mpox is approved as a TWO-DOSE series by Health Canada. The National Advisory Committee on Immunization (NACI) recommends a complete vaccine series of two doses for stronger and longer-lasting protection against mpox infection. The vaccine is not recommended or available (free or private pay) to the general public, including individuals who are travelling if they do not meet current vaccine eligibility criteria. 

People who received a first dose at least 28 days ago can now book an appointment for a second dose. 

Mpox vaccine eligibility criteria 

Two-spirit people, transgender people, or cisgender males who also self-identify as belonging to the gay, bisexual and other men who have sex with men community

And at least 1 of the following:

• Have had sex with more than one partner;
• Have had sex with a partner who has more than one partner;
• Have had casual sex (e.g. cruising);
• Engage in sex work either as a worker or a client.

The vaccine is not recommended or available to the general public, including individuals who are travelling if they do not meet current vaccine eligibility criteria. 

Book an appointment at an Immunization Clinic near you

People who received a first dose at least 28 days ago can now book an appointment for a second dose. Book an appointment for these vaccines at least 14 days after you have received Imvamune.

If you are eligible for Imvamune, you are also eligible to receive HPV (up to 26 years of age), Hepatitis A, and Hepatitis B vaccines at no charge. Book an appointment for these vaccines at least 14 days after you have received Imvamune. 

Learn more about who is eligible to get a vaccine and how to book an appointment