Monkeypox case under investigation in Canada as outbreak spreads to Europe and the United States


Health officials in Quebec are investigating more than a dozen suspected cases of monkeypox in Canada, after US and European health authorities confirmed rising cases of the rare infectious disease – suggesting a wider outbreak could happen globally.

Radio-Canada reported Wednesday that Montreal public health officials are investigating at least 13 cases reported by doctors in the city, following diagnoses made at three clinics specializing in sexually transmitted and blood-borne infections. Laboratory confirmation of cases is ongoing and an announcement is expected in the coming days.

The United States has confirmed its first case of monkeypox in a man who recently traveled to Canada, after European health officials confirmed more than two dozen cases of the rare infectious disease this week, suggesting an outbreak wider could occur on a global scale.

A man in an American business traveled to Canada

The Massachusetts Department of Public Health on Wednesday confirmed a single case of monkeypox infection in an adult male who had traveled to Canada and returned to the state – but did not specify which province the man had traveled to. New statistics reported Wednesday that the man had traveled to Quebec.

The Public Health Agency of Canada (PHAC) said in a statement to CBC News on Wednesday that no cases of monkeypox have yet been reported to the agency.

“PHAC is aware of and is closely monitoring the current situation with reporting monkeypox cases in Europe. No cases have been reported to PHAC at this time,” a spokesperson said in an email. .

“PHAC has alerted provincial and territorial public health authorities and partner laboratories across Canada to be vigilant and investigate any potential cases. As the situation evolves, we will continue to keep Canadians informed.

The agency said it was also “working closely” with international partners, including the World Health Organization (WHO), the Centers for Disease Control (CDC) and the US Prevention and UK Agency Health Safety (UKHSA) on the investigation.

Britain reported its first case of monkeypox on May 7 and has found nine in total since then, while Portuguese health authorities have confirmed five cases Wednesday and Spain is investigating more than 20 possible infections.

“This, once again, highlights the threat of viruses like this,” said Dr Maria Van Kerkhove, infectious disease epidemiologist and technical lead for COVID-19 and emerging diseases at WHO, during a press conference this week.

“We really need to better understand the extent of monkeypox in endemic countries like DRC and Nigeria, Central African Republic and others to really understand how much is circulating and the risk it poses to people who live there – as well as the risk of export.”

During a monkeypox outbreak in the Democratic Republic of the Congo, a young man shows off his hands, which show the characteristic monkeypox rash during the recovery phase. (CDC)

UK cases may suggest community transmission

It is unusual to see monkeypox in Europe and North America, but there are thousands of cases every year across West and Central Africa, WHO officials said this week.

The first known case in the UK was linked to travel to Nigeria, according to the UK Health Security Agency. But the latest two infections there, reported on Wednesday, were unrelated to travel or other previously confirmed cases.

“It is therefore possible that they acquired the infection through community transmission,” the agency said.

Angela Rasmussen, a virologist and researcher at the Vaccine and Infectious Disease Organization (VIDO) at the University of Saskatchewan, said the spread of cases in Europe and North America was surprising compared to previous outbreaks of monkeypox.

“It appears to be spreading, at least from the information we have so far, through human-to-human contact,” she told CBC News.

“Which means it’s either that it’s a more transmissible variant of monkeypox than any we’ve seen before between humans, or there are behaviors associated with increased transmission.”

Possible sexual transmission

The UKHSA said four of the cases detected in Britain identified as gay, bisexual or other men who have sex with men and urged gay and bisexual men to be aware of any unusual rashes or lesions and to contact a sexual person immediately. health services.

The virus is known to be spread by surface transmission or close contact, but has not previously been characterized as a sexually transmitted infection – although it can be transmitted by direct contact during sex.

“We didn’t think Ebola was sexually transmitted and of course it was found in semen. Same thing with Zika virus,” said Dr. Isaac Bogoch, an infectious disease physician at Toronto General Hospital.

“The question is, is it sexually transmitted? The answer is unknown. But of course we know it is transmitted by people close to each other. sexual networks of people.”

Monkeypox was first identified in the 1950s when two outbreaks occurred in colonies of monkeys used for research purposes, with the first human case reported in 1970 in the Democratic Republic of Congo.

The disease is often equated with a milder form of smallpox, a disease that has been eradicated worldwide thanks to widespread vaccination against the smallpox virus.

The smallpox vaccine is effective

The smallpox vaccine is also largely effective against monkeypox, but routine vaccination programs ended in Canada in the early 1970s, leaving Canadians under 50 vulnerable to infection.

“There are certainly generations of people who have not received a smallpox vaccine and who would have no protection against monkeypox infection if exposed,” Bogoch said.

Symptoms of a monkeypox infection can include fever, headache, swollen lymph nodes, chills and exhaustion, and sores all over the body.

There is no proven treatment, and infections can be fatal for at least 1 in 10 people infected. A vaccine developed against smallpox has been approved for monkeypox, and several antivirals also appear to be somewhat effective.

“It is possible that even if supplies of this vaccine are somewhat limited from one country to another, a ring vaccination strategy could be used to prevent people who have been exposed from becoming infected,” Rasmussen said.

“There is also a drug that can also be used to treat smallpox virus infections, so it’s not like we don’t have any tools to contain this outbreak.”