Monkeypox is an infectious disease that is caused by the monkeypox virus. It is transmitted to humans from animals but can spread between people. Cases have mostly been reported in Central and West Africa (endemic countries), with recent cases and outbreaks in non-endemic countries such as Canada, the United States, and the United Kingdom.
This web page provides an overview of clinical considerations, general resources, and frequently asked questions regarding monkeypox. For health professionals, please refer to provincial or territorial authorities for applicable monkeypox testing, contact, and case management guidance.
Clinical considerations
Symptoms
According to the Public Health Agency of Canada, symptoms may take 5-21 days to appear after exposure to the virus. Generally, symptoms are mild and self-limiting and occur in two stages over 2-4 weeks:
- Stage 1: fever, chills, headache, swollen lymph nodes, muscle pain, joint pain, back pain, fatigue
- Stage 2: rash (usually within 1-3 days following fever onset) generally appears on the face or extremities, but can appear on other body parts; it may go through various stages but eventually forms a scab, falls off, and new skin develops
A person may be contagious from symptom onset until new skin replaces scabbed areas.
Transmission
While there is little known about the specific mode of transmission, monkeypox is known to be transmitted through close contact with a person who is infected. The virus can enter the body through the eyes, mouth, nose, or open skin following direct exposure to monkeypox rashes, broken skin, or scabs.
Transmission can also occur via indirect contact, such as through exposure to an infected person’s contaminated clothing, linens, or other objects.
Further evidence is needed to determine if transmission can occur if there is exposure to an individual who does not have symptoms.
Read the Public Health Agency of Canada’s information for health professionals.
Prevention
General public health measures (similar to COVID-19 measures) can help reduce the risk of monkeypox transmission.
General measures for the public:
- Avoid close contact with people who have a suspected or known monkeypox infection
- Self-isolate when sick and/or have skin sores
- Practise respiratory etiquette and frequent hand hygiene
- Practise safe sex
Contact your local public health unit for guidance if you cannot avoid close contact with a person (e.g., household member) who has a suspected or known monkeypox infection.
Vaccinations
Monkeypox and the smallpox virus are related; therefore, smallpox vaccines may provide some degree of protection following monkeypox exposure. Smallpox vaccines should be administered in accordance to guidelines outlined by the National Advisory Committee on Immunization (NACI).
For more information, please read NACI’s Interim Guidance on the use of Imvamune® in the Context of Monkeypox Outbreaks in Canada.
Treatment
There is little evidence on effective monkeypox treatments; interventions, therefore, focus on managing symptoms.
Vulnerable populations
Specific groups may be at higher risk for severe disease, such as:
- Newborns
- Children
- People with compromised immune systems and/or multiple health conditions
General resources
The National Collaborating Centre for Infectious Diseases, in collaboration with the Public Health Agency of Canada and Association of Medical Microbiology and Infectious Disease Canada, have hosted a series of webinars for health professionals:
The World Health Organization has provided free OpenWHO courses on monkeypox for health-care providers. Courses include:
Note: The course material may not reflect up-to-date WHO guidelines for the 2022 monkeypox outbreak.
FAQs
What is significant about the 2022 monkeypox outbreak?
Monkeypox cases have been widely reported in non-endemic countries — such as the United Kingdom, Canada, and the United States — since May 2022. With no direct links to travel in endemic countries, the cases suggest that there has been community transmission for a period of time.
How is monkeypox transmitted?
Currently, there is limited evidence on whether the mode of transmission is primarily contact, respiratory, or airborne.
How is monkeypox diagnosed?
Monkeypox is diagnosed by a health professional through assessment and diagnostic testing (i.e., polymerase chain reaction testing).
Who is at risk of being infected with monkeypox?
Any person, regardless of age or sex, is at risk for monkeypox infection. Those who have received the smallpox vaccination may have some level of protection against the virus. Regardless of vaccination status, everyone is advised to take the necessary precautions to protect themselves from infection.
Where can I find more information about monkeypox, including statistics?
For general information about monkeypox, as well as current statistics regarding its spread in Canada, please visit the Public Health Agency of Canada’s website.