Question Period Note: CASES OF MONKEYPOX IN CANADA

As of June 15, 2022, at 1:00 pm EDT, there are 159 confirmed cases of Monkeypox in Canada (132 in QC, 21 in ON, 4 in AB, and 2 in British Columbia). Follow-up with provinces to confirm new cases is underway. The PHAC-verified case count will be updated each week. Prior to the current international outbreak of Monkeypox, Canada has never had any confirmed cases of Monkeypox.

• Keeping people in Canada safe from threats to their health, and keeping our most vulnerable citizens safe and healthy is a top priority of the Government of Canada.
• The Public Health Agency of Canada is actively working with public health partners to investigate reports of suspect cases of Monkeypox in Canada.
• The Public Health Agency of Canada has alerted public health authorities to work with health care providers to look for patients who have signs or symptoms consistent with Monkeypox, including whether they have reported travel or have specific risk factors for Monkeypox.
• PHAC’s National Microbiology Laboratory (NML) is conducting testing to confirm or rule out a diagnosis of monkeypox for suspected cases.
• Monkeypox can affect anyone in close contact with an infected person. People in Canada should be aware of the symptoms of Monkeypox and report any concerns to their health care provider. Information is available on Canada.ca.
• As with many other diseases spread through close contact, people can lower their risk by maintaining physical distance, wearing masks, covering coughs and sneezes and, practicing frequent hand washing.
• The investigation is evolving in Canada and internationally. The Public Health Agency of Canada will continue to work with the provinces and territories to assess the risks to people in Canada, respond to the evolving situation, and continue to provide updates to the public as new information becomes available.

If pressed on vaccinations:
• There is ongoing work underway with provinces and territories to provide access to approved vaccines in Canada that, if required, can be used in managing Monkeypox in their jurisdiction.
• As a preparedness step, the Public Health Agency of Canada is providing shipments of the Imvamune vaccine from Canada's National Emergency Strategic Stockpile to affected jurisdictions to support their targeted response.
• At this time, and in alignment with international expert assessments, including the World Health Organization, there is no need for the vaccine to be used for mass immunization.

If pressed on the risk to people in Canada:
• The Agency is continually assessing the possible risk of exposure to Monkeypox virus in Canada. At this time, people who might be at risk of contracting monkeypox in Canada are those who have had close or intimate contact with a person experiencing monkeypox.
• People who have a new rash or sores on their skin, fever or swollen lymph nodes, should contact their health care provider and let them know if they have had sexual activity or close personal contact with others in the last 21 days.
• As with many other diseases spread through close contact, people can lower their risk by maintaining physical distance, and frequent hand and respiratory hygiene, including masking.

Limited cases of travel-related Monkeypox were identified internationally prior to the current outbreak. As of June 14, 2022, there have been 1,285 confirmed cases reported to the WHO across 32 non-endemic countries, including Canada. There have been no deaths associated within the current monkeypox outbreak in non-endemic countries, however, cases and deaths continue to be reported from endemic countries, according to the WHO.

Monkeypox is typically transmitted from animals to humans. However, human-to-human transmission can result from direct contact with their body fluids, respiratory droplets, or Monkeypox sores, or by sharing clothing, bedding or common items that have been contaminated with the infected person’s fluids or sores. Transmission via respiratory droplets usually requires prolonged face-to-face contact, which can put health care providers and household members of active cases at greater risk.

Canadian samples of suspected Monkeypox virus infection are being sent to the National Microbiology Laboratory or jurisdictions with certified capacity for laboratory analysis and confirmation. Results are being shared with local health authorities in the respective jurisdictions so appropriate public health measures can be taken if necessary. To date, confirmed cases have been identified in both the Provinces of Quebec, Ontario, Alberta and British Columbia.

Currently, there is no specific treatment approved for Monkeypox, however, it is often self-limiting and symptoms usually resolve spontaneously within 14 to 21 days. Health Canada has authorized the vaccine Imvamune for active immunization against Monkeypox, smallpox and related Orthopox virus infections and diseases in adults 18 years of age and older determined to be at high risk for exposure. Imvamune is authorized under the Extraordinary Use New Drugs regulatory pathway, which permits the restricted sale of the product for emergency preparedness in Canada for use by federal, provincial and territorial, and municipal governments.

PHAC continues to support provincial public health authorities to manage this outbreak by coordinating national surveillance, providing guidance and medical countermeasures. PHAC will continue to monitor this evolving outbreak and work collaboratively with public health authorities to protect the health of Canadians.

Key Facts
• Monkeypox is a zoonotic infectious disease found in parts of central and West Africa. It results in occasional human infections that are usually associated with exposure to infected animals or contaminated materials.
• Following notification received from the United States Centers for Disease Control and Prevention about a U.S. traveler with Monkeypox who visited Montreal, Quebec in early May 2022, the Public Health Agency of Canada, in collaboration with public health authorities, launched activities to raise awareness and vigilance for Monkeypox.
• The first two cases of Monkeypox in Canada were reported on May 19, 2022 in Quebec.
• Signs and symptoms of Monkeypox can typically include fever, a rash that often appears within a few days after symptoms such as fever develop, as well as headache, muscle aches, exhaustion, and swollen lymph nodes.
• Monkeypox is spread to people through: 1) direct contact with bodily fluids; 2) lesions of infected animals or people; 3) respiratory droplets from an infected person; and 4) from mother to fetus.
• The incubation is usually between 6 to 13 days but can range from 5 to 21 days.
• There are no well-established treatments for Monkeypox and limited data is available on the clinical effectiveness of specific treatments in humans, although antivirals developed for use against smallpox and post-exposure vaccination with
the smallpox vaccine may help. Prior vaccination against smallpox provides cross-protection.