Monkeypox is an infectious disease caused by the monkeypox virus. It is transmitted to humans by animals, but can spread between people. Cases have been reported mostly in West and Central Africa (endemic countries), with recent cases and outbreaks in non-endemic countries such as Canada, the United States, and the United Kingdom.
This webpage provides an overview of clinical considerations, general resources, and frequently asked questions about monkeypox. For health care professionals, consult provincial or territorial authorities for applicable testing, contacts and case management guidance.
Clinical considerations
symptoms
According to the Public Health Agency of Canada, symptoms can take 5 to 21 days to appear after exposure to the virus. Symptoms are usually 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: The rash (usually within 1-3 days after the onset of fever) usually appears on the face or limbs, but may appear on other parts of the body; it can go through several stages, but eventually it forms a crust, falls off, and new skin develops
A person can be contagious from the onset of symptoms until new skin replaces the scabbed areas.
transmission
Although little is known about the specific mode of transmission, monkeypox is known to be transmitted through close contact with an infected person. The virus can enter the body through the eyes, mouth, nose, or open skin after direct exposure to monkeypox rashes, broken skin, or scabs.
Transmission can also occur by indirect contact, such as exposure to contaminated clothing, bed linen or other objects of an infected person.
More testing is needed to determine whether transmission can occur if there is exposure to a person who does not have symptoms.
Read the Public Health Agency of Canada’s information for health professionals.
prevention
General public health measures (similar to measures for COVID-19) can help reduce the risk of monkeypox transmission.
General measures for citizens:
- Avoid close contact with people who have suspected or known monkeypox infection
- Isolate when sick and/or have skin sores
- Practice respiratory etiquette and frequent hand hygiene
- Practice safe sex
Contact your local public health unit for guidance if you cannot avoid close contact with a person (for example, a household member) who has suspected or known monkeypox infection.
vaccines
Monkeypox and smallpox virus are related; therefore, smallpox vaccines may provide some degree of protection after exposure to smallpox. Smallpox vaccines should be administered according to the guidelines outlined by the National Advisory Committee on Immunization (NACI).
For more information, read NACI’s Interim Guidance on the Use of Imvamune® in the Context of Monkeypox Outbreaks in Canada.
Treatment
There is little evidence for effective treatments for monkeypox; interventions therefore focus on symptom management.
Vulnerable populations
Specific groups may be at higher risk of serious illness, such as:
- newborns
- children
- People with compromised immune systems and/or multiple health conditions
General resources
The National Collaborating Center for Infectious Diseases, in partnership with the Public Health Agency of Canada and the Canadian Association for Medical Microbiology and Infectious Diseases, has hosted a series of webinars for health professionals:
The World Health Organization has offered free OpenWHO courses on monkeypox for health professionals. Courses include:
Note: Course material may not reflect updated WHO guidelines for the 2022 monkeypox outbreak.
Frequently asked questions
What is significant about the 2022 monkeypox outbreak?
Cases of monkeypox have been widely reported in non-endemic countries such as the UK, Canada and the US since May 2022. Without direct links to travel to endemic countries, the cases suggest that there there has been community transmission for a period of time.
How is monkey pox transmitted?
Currently, there is limited evidence as to whether the mode of transmission is primarily contact, respiratory, or airborne.
How is monkey pox diagnosed?
Monkeypox is diagnosed by a health care professional through evaluation and diagnostic testing (ie, polymerase chain reaction testing).
Who is at risk of getting infected with monkey pox?
Anyone, regardless of age or sex, is at risk of monkeypox infection. Those who have received the smallpox vaccine may have some level of protection against the virus. Regardless of vaccination status, everyone is encouraged 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 on its spread in Canada, visit the Public Health Agency of Canada website.