2022–2023 mpox outbreak in Canada

The 2022–2023 mpox outbreak in Canada is a part of the outbreak of human mpox caused by the West African clade of the monkeypox virus. The outbreak started in Canada on May 19, 2022, with the country since then becoming one of the most affected in the Americas.

2022–2023 mpox outbreak in Canada
Spread of disease as of September 2, 2022
DiseaseMpox
Virus strainMonkeypox virus (West African clade)
LocationCanada
Index caseMontreal, Quebec (first suspected May 12, 2022)
Arrival dateMay 19, 2022
(1 year, 1 week and 2 days ago)
Confirmed cases1,460
Hospitalized cases44
Deaths
0
Government website
Government of Canada

Background
These paragraphs are an excerpt from Mpox and 2022–2023 mpox outbreak.

Mpox (formerly known as monkeypox)[1] is an infectious viral disease that can occur in humans and some other animals.[2] Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes.[2] The time from exposure to onset of symptoms ranges from five to twenty-one days and symptoms typically last from two to four weeks.[3][4] There may be mild symptoms, and it may occur without any symptoms being apparent.[3][5] Cases may be severe, especially in children, pregnant women or people with suppressed immune systems.[6]

The disease is caused by the monkeypox virus,[lower-alpha 1] a zoonotic virus in the genus Orthopoxvirus.[7] The variola virus, the causative agent of smallpox, is also in this genus.[8] It may spread from infected animals by handling infected meat or via bites or scratches.[9] Human-to-human transmission can occur through exposure to infected body fluids or contaminated objects, by small droplets, and possibly through the airborne route.[2][9] People can spread the virus from the onset of symptoms until all the lesions have scabbed and fallen off; with some evidence of spread for more than a week after lesions have crusted.[10] Diagnosis can be confirmed by testing a lesion for the virus's DNA.[11]

There is no known cure.[12] A study in 1988 found that the smallpox vaccine was around 85% protective in preventing infection in close contacts and in lessening the severity of the disease.[13] A newer smallpox and mpox vaccine based on modified vaccinia Ankara has been approved, but with limited availability.[3] Other measures include regular hand washing and avoiding sick people and animals.[14] Antiviral drugs, cidofovir and tecovirimat, vaccinia immune globulin and the smallpox vaccine may be used during outbreaks.[15][16] The illness is usually mild and most of those infected will recover within a few weeks without treatment.[16] Estimates of the risk of death vary from 1% to 10%, although few deaths as a consequence of mpox have been recorded since 2017.[17]

An ongoing outbreak of mpox was confirmed on May 6, 2022, beginning with a British resident who, after travelling to Nigeria (where the disease is endemic), presented symptoms consistent with mpox on 29 April 2022. The resident returned to the United Kingdom on 4 May, creating the country's index case of the outbreak.[18] The origin of several of the cases of mpox in the United Kingdom is unknown. Some monitors saw community transmission taking place in the London area as of mid-May,[19] but it has been suggested that cases were already spreading in Europe in the previous months.[20]

Transmission
Stages of lesion development.

A large portion of those infected were believed to have not recently traveled to areas of Africa where mpox is normally found, such as Nigeria, the Democratic Republic of the Congo as well as central and western Africa. It is believed to be transmitted by close contact with sick people, with extra caution for those individuals with lesions on their skin or genitals, along with their bedding and clothing. The CDC has also stated that individuals should avoid contact and consumption of dead animals such as rats, squirrels, monkeys and apes along with wild game or lotions derived from animals in Africa.[21]

Symptoms such as fever, headache, swollen lymph nodes, and rashes or lesions are fairly common. Additionally some patients also have presented with proctitis. The Public Health Agency of Canada has noted that person to person transmission of mpox is possible from direct contact with bodily fluids including sexual contact.[22]

History
Mpox cases in Canada  ()
     Deaths        Confirmed cases
2022202220232023
MayMayJunJunJulJulAugAugSepSepOctOctNovNovDecDec
JanJanFebFebMarMar
Last 15 daysLast 15 days
Date
Cases (rise)
Deaths (rise)
2022-05-19
2(n.a.)
⋮
2022-05-24
15(n.a.)
2022-05-25
16(+1)
2022-05-26
26(+10)
⋮
2022-06-02
58(n.a.)
2022-06-03
80(+22)
⋮
2022-06-06
81(n.a.)
2022-06-07
2022-06-08
101(n.a.)
2022-06-09
2022-06-10
115(n.a.)
⋮
2022-06-13
122(n.a.)
2022-06-14
2022-06-15
159(n.a.)
2022-06-16
2022-06-17
177(n.a.)
⋮
2022-06-21
210(n.a.)
2022-06-22
2022-06-23
223(n.a.)
2022-06-24
235(+12)
⋮
2022-06-27
275(n.a.)
2022-06-28
2022-06-29
278(n.a.)
2022-06-30
278(=)
2022-07-01
278(=)
2022-07-02
287(+9)
2022-07-03
298(+11)
2022-07-04
300(+2)
2022-07-05
300(=)
2022-07-06
300(=)
2022-07-07
358(+58)
2022-07-08
375(+17)
2022-07-09
378(+3)
2022-07-10
378(=)
2022-07-11
477(+99)
2022-07-12
477(=)
2022-07-13
493(+16)
2022-07-14
530(+37)
2022-07-15
538(+8)
2022-07-16
538(=)
2022-07-17
538(=)
2022-07-18
575(+37)
2022-07-19
604(+29)
2022-07-20
604(=)
2022-07-21
604(=)
2022-07-22
745(+141)
2022-07-23
745(=)
2022-07-24
745(=)
2022-07-25
745(=)
2022-07-26
745(=)
2022-07-27
745(=)
2022-07-28
745(=)
2022-07-29
803(+58)
2022-07-30
803(=)
2022-07-31
803(=)
2022-08-01
803(=)
2022-08-02
803(=)
2022-08-03
803(=)
2022-08-04
803(=)
2022-08-05
957(+154)
2022-08-06
957(=)
2022-08-07
957(=)
2022-08-08
957(=)
2022-08-09
957(=)
2022-08-10
1,008(+51)
2022-08-11
1,008(=)
2022-08-12
1,059(+51)
2022-08-13
1,059(=)
2022-08-14
1,059(=)
2022-08-15
1,059(=)
2022-08-16
1,059(=)
2022-08-17
1,112(+53)
2022-08-18
1,112(=)
2022-08-19
1,168(+56)
2022-08-20
1,168(=)
2022-08-21
1,168(=)
2022-08-22
1,168(=)
2022-08-23
1,168(=)
2022-08-24
1,206(+38)
2022-08-25
1,206(=)
2022-08-26
1,228(+22)
2022-08-27
1,228(=)
2022-08-28
1,228(=)
2022-08-29
1,228(=)
2022-08-30
1,228(=)
2022-08-31
1,289(+61)
2022-09-01
1,289(=)
2022-09-02
1,289(=)
2022-09-03
1,289(=)
2022-09-04
1,289(=)
2022-09-05
1,289(=)
2022-09-06
1,289(=)
2022-09-07
1,317(+28)
2022-09-08
2022-09-09
1,321(n.a.)
⋮
2022-09-14
1,338(n.a.)
2022-09-15
2022-09-16
1,363(n.a.)
⋮
2022-09-21
1,379(n.a.)
2022-09-22
2022-09-23
1,389(n.a.)
⋮
2022-09-28
1,396(n.a.)
⋮
2022-10-03
1,400(n.a.)
2022-10-04
2022-10-05
1,406(n.a.)
2022-10-06
2022-10-07
1,411(n.a.)
⋮
2022-10-12
1,411(n.a.)
2022-10-13
2022-10-14
1,410(n.a.)
⋮
2022-10-21
1,436(n.a.)
⋮
2022-10-28
1,435(n.a.)
⋮
2022-11-04
1,444(n.a.)
⋮
2022-11-14
1,445(n.a.)
⋮
2022-11-18
1,449(n.a.)
⋮
2022-11-25
1,456(n.a.)
⋮
2022-12-02
1,459(n.a.)
⋮
2022-12-09
1,459(n.a.)
⋮
2022-12-16
1,459(n.a.)
⋮
2022-12-23
1,460(n.a.)
⋮
2023-01-06
1,460(n.a.)
⋮
2023-01-20
1,460(n.a.)
⋮
2023-02-03
1,460(n.a.)
⋮
2023-02-17
1,460(n.a.)
⋮
2023-03-04
1,460(n.a.)

On May 18, the United States confirmed its first 2022 case of mpox and Canada reported 13 suspected cases.[23] On May 19, the first confirmed case of mpox was reported in Toronto.[24] On May 27, 500 people in Montreal, Quebec, received smallpox vaccinations. By July 6, 800 Montrealers had lined up at the clinic in the center of the Gay Village that was offering the initial vaccination.[25][26]

Number of cases confirmed in the Canadian provinces

Canada currently has the 8th most mpox cases.[27]

Cases of mpox
Province or territory Cases
 Nova Scotia 1[28]
 New Brunswick 1[28]
 Manitoba 1[28]
 Yukon 2[28]
 Saskatchewan 6[28]
 Alberta 43[28]
 British Columbia 190[28]
 Quebec 525[28]
 Ontario 691[28]
Total cases 1,460[28]
As of March 3, 2022 at 12:00 PM EDT

Responses

This was the first time in history that mpox was in Canada.[29]

See also

Notes
  1. The World Health Organization (the authority on disease names) announced the new name "mpox" in November 2022. But virus naming is the responsibility of the International Committee on the Taxonomy of Viruses (ICTV), who are currently reviewing all orthopoxvirus species. As of March 2023, the official name of the virus remains "monkeypox virus".[1]

References
  1. "WHO recommends new name for monkeypox disease" (Press release). World Health Organization (WHO). November 28, 2022. Retrieved November 29, 2022.
  2. "Multi-country monkeypox outbreak: situation update". www.who.int. World Health Organization (WHO). June 4, 2022. Archived from the original on June 6, 2022. Retrieved June 7, 2022.
  3. "WHO Factsheet – Monkeypox". World Health Organization (WHO). May 19, 2022. Retrieved May 28, 2022.
  4. "Signs and Symptoms Monkeypox". U.S. Centers for Disease Control and Prevention (CDC). May 11, 2015. Archived from the original on October 15, 2017. Retrieved October 15, 2017.
  5. Sutcliffe, Catherine G.; Rimone, Anne W.; Moss, William J. (2020). "32.2. Poxviruses". In Ryan, Edward T.; Hill, David R.; Solomon, Tom; Aronson, Naomi; Endy, Timothy P. (eds.). Hunter's Tropical Medicine and Emerging Infectious Diseases E-Book (Tenth ed.). Edinburgh: Elsevier. pp. 272–277. ISBN 978-0-323-55512-8.
  6. "Multi-country monkeypox outbreak in non-endemic countries". World Health Organization. May 21, 2022. Archived from the original on May 22, 2022. Retrieved May 25, 2022.
  7. Taha, M. J., Abuawwad, M. T., Alrubasy, W. A., Sameer, S. K., Alsafi, T., Al-Bustanji, Y., ... & Nashwan, A. J. Ocular manifestations of recent viral pandemics: A literature. health, 13, 14.
  8. Petersen, Brett W.; Damon, Inger K. (2020). "348. Smallpox, monkeypox and other poxvirus infections". In Goldman, Lee; Schafer, Andrew I. (eds.). Goldman-Cecil Medicine. Vol. 2 (26th ed.). Philadelphia: Elsevier. pp. 2180–2183. ISBN 978-0-323-53266-2.
  9. "Transmission Monkeypox". U.S. Centers for Disease Control and Prevention (CDC). May 11, 2015. Archived from the original on October 15, 2017. Retrieved October 15, 2017.
  10. Adler, Hugh; Gould, Susan; Hine, Paul; Snell, Luke B.; Wong, Waison; Houlihan, Catherine F.; et al. (May 24, 2022). "Clinical features and management of human monkeypox: a retrospective observational study in the UK". The Lancet. Infectious Diseases. 22 (8): S1473–3099(22)00228–6. doi:10.1016/S1473-3099(22)00228-6. PMC 9300470. PMID 35623380. S2CID 249057804.
  11. "2003 U.S. Outbreak Monkeypox". U.S. Centers for Disease Control and Prevention (CDC). May 11, 2015. Archived from the original on October 15, 2017. Retrieved October 15, 2017.
  12. "Treatment Monkeypox Poxvirus CDC". U.S. Centers for Disease Control and Prevention (CDC). December 28, 2018. Archived from the original on June 15, 2019. Retrieved October 11, 2019.
  13. Fine, P. E.; Jezek, Z.; Grab, B.; Dixon, H. (September 1988). "The transmission potential of monkeypox virus in human populations". International Journal of Epidemiology. 17 (3): 643–650. doi:10.1093/ije/17.3.643. ISSN 0300-5771. PMID 2850277.
  14. "Prevention". U.S. Centers for Disease Control and Prevention (CDC). November 29, 2019. Archived from the original on March 14, 2022. Retrieved May 14, 2022.
  15. "Interim Clinical Guidance for the Treatment of Monkeypox | Monkeypox | Poxvirus | CDC". U.S. Centers for Disease Control and Prevention (CDC). May 26, 2022. Archived from the original on June 7, 2022. Retrieved June 8, 2022.
  16. "Monkeypox". GOV.UK. May 24, 2022. Archived from the original on May 18, 2022. Retrieved May 28, 2022.
  17. "Multi-country monkeypox outbreak in non-endemic countries: Update" (Press release). World Health Organization (WHO). Retrieved July 2, 2022.
  18. "Monkeypox – United Kingdom of Great Britain and Northern Ireland". World Health Organization. May 16, 2022. Archived from the original on May 17, 2022. Retrieved May 17, 2022.
  19. Pinkstone, Joe (May 17, 2022). "Monkeypox 'spreading in sexual networks'". The Telegraph. Archived from the original on May 17, 2022. Retrieved May 17, 2022.
  20. Nsofor, Ifeanyi (June 2, 2022). "OPINION: Media coverage of monkeypox paints it as an African virus. That makes me mad". NPR. Retrieved June 2, 2022.{{cite web}}: CS1 maint: url-status (link)
  21. Vargas, Ramon Antonio (June 7, 2022). "US raises monkeypox alert level but says risk to public remains low". The Guardian. Retrieved June 9, 2022.
  22. Canada, Public Health Agency of (June 30, 2022). "Monkeypox: For health professionals". www.canada.ca. Retrieved July 12, 2022.
  23. "Massachusetts confirms rare monkeypox case, the first in the US this year". Boston Herald. May 18, 2022. Archived from the original on May 20, 2022. Retrieved May 18, 2022.
  24. ICI.Radio-Canada.ca, Zone Santé-. "Variole du singe : au moins 13 cas en cours d'examen à Montréal" [Monkey pox: at least 13 cases being examined in Montreal]. Radio-Canada.ca (in Canadian French). Archived from the original on May 18, 2022. Retrieved May 18, 2022.
  25. "Hundreds of Montrealers seek vaccine protecting against monkeypox". Cbc.ca. Retrieved July 5, 2022.
  26. "Smallpox vaccine: Canadian Immunization Guide". Canada.ca. July 18, 2007.
  27. "2022 Monkeypox Outbreak: Global Trends". World Health Organization. August 10, 2022. Retrieved August 10, 2022.
  28. "Monkeypox: Outbreak update". Canada.ca. August 14, 2022.
  29. "P.E.I.'s Chief Public Health Office preparing as monkeypox cases rise across Canada". Cbc.ca. Retrieved July 5, 2022.
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