What is monkeypox? How contagious is it and what are the symptoms?

Canadian health officials are now looking into whether a rare case of monkeypox in a man who recently travelled to Canada is connected to small outbreaks in Europe.

The infection has mostly been contained to endemic areas in Africa but a recent rise in infections in European countries is leading to concern there could be community transmission.

Public Health Canada announced Wednesday they were closely monitoring the virus after the confirmed case in the U.S. was linked to travel in Canada. The CBC’s Radio Canada is reporting 13 suspected cases in Montreal, but a spokesperson for the Public Health Agency of Canada tells CityNews that no cases have been confirmed at this time.

There is still just the one confirmed case in the U.S. but the Centers for Disease Control and Prevention says they are “preparing for the possibility of more cases.”

What is monkeypox?

Monkeypox is a rare viral infection that is most common in rodent populations in Central or West Africa.

The virus can be transferred to humans from animals through bites or close contact and human-to-human transmission can then happen through prolonged contact or through bodily fluids. It was first identified in humans in 1970.

There have been several recorded cases in recent history of travellers carrying the infection from endemic areas in Africa to Europe or the United States.

Dr. Isaac Bogoch, infectious diseases specialist at the Toronto General Hospital, says the disease has typically been successfully contained in those instances.

“Once in a while there are cases that are isolated or identified in Europe,” he says. “Usually they’ve got a pretty strong travel history to West or Central Africa.”

A small number of confirmed or suspected cases have been reported this month in the United Kingdom, Portugal and Spain.

How contagious is monkeypox?

Monkeypox is not believe to be as transmissible as other common viruses, including COVID-19.

The virus is thought to be transmitted through close physical contact, bodily fluids, or droplets. Though most health experts acknowledge there is not a lot of available data on the infection compared to other contagious viruses.

“It’s thought that people generally need to be in much closer proximity for a prolonged period of time for this to be transmitted,”Bogoch says.

Monkeypox is not considered to be a sexually transmitted disease but close contact during sexual activity is considered a common form of transmission. Investigators in Europe say most of the cases there have been in gay or bisexual men, and officials are looking into the possibility that some infections were spread through contact during sex.

Previously, small outbreaks of the virus outside of Africa have been successfully contained.

“You can get these outbreaks under control,” says Bogoch, referencing a monkeypox outbreak in the U.S. in the early 2000s that was a result of different animals being housed together.

In 2003, a number of prairie dogs contracted the virus after sharing space with rodents from Africa. Some of the prairie dogs passed the virus on to humans and in the end around 40 or 50 individuals were infected before health officials were able to control the spread.

What are monkeypox symptoms?

After exposure there is around a 10- to 15-day incubation period followed by flu-like symptoms and swelling of the lymph nodes.

Typically, infected individuals develop a fever or a headache followed by a rash with skin lesions. Bogoch says the type of lesions that come with monkeypox are not similar to lesions associated with chickenpox.

“With this type of infection, most of those lesions are at the same level of development,” he says. “They come on at a similar time and they evolve at a similar time.”

He says the infection is typically mild with rare instances of severe cases. The World Health Organizations says the disease can be fatal for up to 1 in 10 individuals, but severe cases are usually limited to younger age groups.

Most people recover from monkeypox within weeks with severe instances being much more common in children.

Is there treatment/prevention for monkeypox?

There are no treatments designed specifically for monkeypox.

Bogoch says the typical monkeypox infection would likely not require any treatment, but says that some drugs exist that would offer protection.

A vaccine that was originally developed for smallpox has been proven to be 85 per cent effective in preventing monkeypox.

“Many people over a certain age have received the smallpox vaccine and some people have a scar on their shoulder as proof of this,” says Bogoch. “That vaccine does provide some protection.”

There are other known treatments that were originally geared towards smallpox that also offer cross-protection. Smallpox was declared eradicated in 1980.

Is there cause for concern from the general public?

Bogoch doesn’t think so.

He says there is no reason for panic in the general public but says it is important to be aware that there are chains of transmission that are not directly linked to travellers from endemic areas.

“I don’t think it’s time to be scared about anything, but it’s obviously time to take it seriously and at least acknowledge that this is here,” he says. “We’re going to hear about more cases popping up in different countries around the world.”

With files from CityNews reporter Michelle Mackey and The Associated Press