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.
On August 14, 2024, the World Health Organization (WHO) declared the recent rise in mpox cases in central and eastern Africa a public health emergency of international concern. This declaration allows support to be directed to the most affected countries. Most of the mpox cases in central and eastern Africa are classified as clade or subfamily 1b (clade/subfamily are sometimes known as “strain" of the virus).
In British Columbia, there are very few cases of mpox and the risk of getting mpox is low.
Fraser Health continues to work with the BC Centre for Disease Control, other regional health authorities and other partners, to ensure evidence-based practices are being followed, including recommending vaccination for people at higher risk for mpox.
Background
In May 2022, mpox clade 2b spread to more than 70 countries where mpox is not endemic, including Canada. The pattern of spread in this global outbreak was different from the usual experience of mpox transmission in Africa: Instead of transmission occurring primarily from animals-to-humans, this outbreak was spread by close human-to-human, sexually associated transmission.
This mpox outbreak was declared over in B.C. on January 9, 2023. Mpox clade 2b continues to circulate both globally and locally but is no longer considered an outbreak.
According to the WHO, 98 per cent of the cases during the initial global outbreak were among men who have sex with men; in B.C., the majority of cases reported to date are among this demographic. Much less often, transmission occurs to those living in the same household or to those who have close, non-sexual skin-to-skin contact with a person who has mpox.
To reduce local transmission, prevent severe illness and limit risk to the public, Public Health offers an ongoing vaccine campaign, working 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 currently recommended or available for the general public or for travel purposes.
How mpox is spread
The mpox virus circulating in B.C. does not spread easily from person to person - the main way the virus has been spread is by close, sexually-associated skin-to-skin contact.
Symptoms
Mpox symptoms 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 with lesions appears on genitals, hands, feet and/or mouth. The rash may start in one place and spread to other parts of the body.
- In some people, the rash may be limited to one or more lesions in the genital area.
People are considered to be infectious from the time symptoms first appear until the sores crust over, are dry and new skin is visible. If a person does not have a rash, but has other mpox symptoms, their infectious period ends when symptoms resolve.
Getting tested for mpox
People experiencing symptoms of mpox should see their primary care provider, or visit a sexual health clinic or an Urgent and Primary Care Centre. 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.
If someone thinks they have been exposed to mpox or have symptoms, they should follow these prevention measures when around other people until they can be tested:
- Wear a medical grade 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 bedding
If you have been in close contact with a person with an mpox infection, monitor for symptoms. Symptoms can start five to 21 days after exposure.
Managing symptoms
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 health care 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 health care provider or go to your nearest Urgent and Primary Care Centre 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
Vaccination against mpox
Early use of vaccines among groups who are at the highest risk of spread, along with case and contact tracing efforts by Public Health, can reduce transmission, prevent severe illness and limit risk to the wider population.
Most B.C. cases to date in 2024 have occurred in people who are not vaccinated or not fully vaccinated.
Vaccine is not currently recommended or available for the general public or for travel purposes.
Eligibility
Eligible individuals include Two-Spirit and transgender people and men who may self-identify as gay or bisexual or who have sex with men and answer yes to any of the criteria below:
- Has sex with more than one partner, or
- Has sex with a partner who has more than one partner, or
- Has casual sex (e.g. cruising), or
- Engages in sex work or plans to, either as a worker or a client.
The vaccine cannot be administered to people who have symptoms that could be due to mpox. Instead, find a location for testing at https://smartsexresource.com/get-tested/clinic-finder
To book an appointment please call our central booking line to schedule an appointment at select health units:
- Residents of Fraser East (Mission, Abbotsford, Chilliwack, Agassiz and Hope), call 604-702-4906.
- Residents in any other area of Fraser Health, call 604-476-7087.
Misidentifying oneself as eligible for mpox vaccine directs this important prevention away from people most at risk and limits its utility in preventing further transmission and protecting against further outbreaks.
The vaccine is not available to individuals of any gender who are not included within the eligibility criteria, unless they have been identified as a close contact of a confirmed case.
Second doses
The BC Centre for Disease Control strongly recommends that people who are eligible get two doses of the mpox vaccine. The vaccine can be given following exposure (ideally within four days), or in advance of an exposure to help the body build immunity.
Ideally, the second dose is given at least 28 days after the first dose.
Your protection is not reduced if you receive a second dose more than 28 days after a first dose. You don't need to start the series over if it's been longer than 28 days since your first dose.
If you received one dose of vaccine and then had a lab-confirmed mpox infection, you do not need a second dose.