MPOX is a virus that causes fever, headache, swollen lymph nodes, and tiredness, usually followed by a rash and blisters on the skin. It is usually spread by very close contact with someone who has the virus. Anyone can get MPOX. However, during this outbreak, gay, bisexual, and other men who have sex with men have been impacted the most.

Symptoms usually start within 6 to 13 days after being exposed to monkeypox, but can also start anywhere from 5 to 21 days after exposure. Symptoms include:

• Fever
• Headache Muscle aches
• Backache
• Swollen lymph nodes
• Chills
• Feeling extremely tired
• Cough or sore throat (sometimes)
• Runny nose
• Rash with blisters that can appear 1 to 3 days after fever, but in some cases, can appear before fever or other symptoms. The rash usually begins as flat red spots (that can look like pimples or heat rash), which turn into blisters and then form a crust. In some cases, the rash appears around the mouth, genital, or anorectal (bum) areas.

Monkeypox typically spreads from a person with the virus to others through:

• Prolonged close contact with respiratory droplets from breathing, talking, coughing, or sneezing
• Skin-to-skin contact with lesions, blisters, rashes
• Contact with objects, fabrics, and surfaces used by someone who has the virus.

The virus enters the body through breaks in the skin or through the eyes and mouth. Someone with Monkeypox can usually pass on the virus when they develop a skin rash or blisters, but it may also spread when they have early symptoms including fever and headache. At this time, Monkeypox has mostly spread among people who had close intimate/sexual contact with a person who has the virus.

It does not spread as easily or quickly as COVID-19 and does not spread through casual contact.

Isolate right away and contact a health care provider. Avoid contact with animals, including household pets.

People who have been in contact with a person who has monkeypox should monitor themselves for symptoms for 21 days. If no symptoms appear you can continue with normal activities. If symptoms develop, you should isolate and contact a healthcare provider.

Grey Bruce Public Health will contact and give guidance to people who test positive for monkeypox as well as known close contacts of the individual who tests positive. Most people recover from monkeypox on their own within 2 to 4 weeks and do not need any specific treatment. However, some people can get seriously sick. Contact a health care provider if you have any concerns about your symptoms.

• Consider limiting the number of people you have close skin-to-skin contact with.
• Avoid touching blisters or rashes on another person.
• Talk to sexual partners about sexual health and use barriers such as gloves and condoms.
• Avoid sharing objects that come into contact with another person’s skin or body fluids such as toothbrushes, sex toys, and drug use supplies.
• Avoid prolonged close face-to-face contact with others, especially indoors.
• Wear a mask in indoor public spaces, when possible.
• Clean and disinfect frequently-touched surfaces (such as door handles, countertops, and phones) and fabrics (such as clothing and bedding). Standard household cleaners/ disinfectants can be used to kill the virus on surfaces.
• Avoid touching bedding and laundry that has been in contact with someone who has monkeypox.
• Use personal protective equipment (PPE) when caring for someone who has the virus, including a gown, gloves, mask, and eye protection.
• Stay home if you are sick, and encourage others to do the same.
• Clean your hands with soap and water, or use an alcohol-based hand sanitizer.
• Get vaccinated, if eligible.

A vaccine (Imvamune) is approved in Canada for protection against MPOX. The vaccine can be used for protection against monkeypox before getting exposed to the virus (pre-exposure prophylaxis) or after being exposed (post-exposure prophylaxis) for eligible groups. The vaccine contains a modified virus and cannot make you sick.

Vaccine eligibility

On Oct. 7, 2022, the Ontario Ministry of Health released updated guidance on monkeypox vaccine (Imvamune) eligibility.

It is now recommended that Imvamune be offered as a two-dose primary series, with at least 28 days between first and second doses, for individuals eligible (see below) for pre-exposure or post-exposure prophylaxis.

Pre-Exposure Vaccination Eligibility Criteria

Based on Ontario Ministry of Health guidelines, individuals who meet the following criteria are eligible for a two-dose series of Imvamune:

Two-spirit, non-binary, transgender, cisgender, intersex, or gender-queer individuals who self-identify or have sexual partners who self-identify as belonging to the gay, bisexual, pansexual and other men who have sex with men (gbMSM) community and at least one of the following:

Had a confirmed sexually transmitted infection within the last year;

Have or are planning to have two or more sexual partners or are in a relationship where at least one of the partners may have other sexual partners;

Have attended venues for sexual contact (i.e. bath houses, sex clubs) recently or may be planning to, or who work/volunteer in these settings;

Have had anonymous sex (e.g., using hookup aps) recently or may be planning to; and/or

Are a sexual contact of an individual who engages in sex work.

Individuals who self-identify as engaging in sex work or are planning to, regardless of self-identified sex or gender.

 Household and/or sexual contacts of those identified for pre-exposure vaccination AND who are moderately to severely immunocompromised or pregnant may be at higher risk for severe illness from monkeypox infection and may be considered for pre-exposure vaccination and are encouraged to contact their health provider for more information.

Imvamune® vaccine eligibility after being exposed to the monkeypox virus (PEP)

Based on the Ontario Ministry of Health guidelines, individuals who have been identified by their local public health unit as having a high or intermediate-risk exposure with someone who has the monkeypox virus are eligible to receive Imvamune®. These individuals will be contacted directly by their local public health unit.