'Urgent' response required as monkeypox cases rise in Canada: Tam

With 745 confirmed cases of monkeypox in Canada, Chief Public Health Officer Dr. Theresa Tam says that an "urgent" response is required to address the outbreak, and is encouraging those at highest risk to get vaccinated.

"Our understanding of this virus is still evolving, and this declaration makes clear that the situation requires urgent global response," Tam said Wednesday, citing the World Health Organization's recent declaration of monkeypox as a public health emergency of international concern.

As of Wednesday, according to the Public Health Agency of Canada (PHAC), there are 346 cases reported in Quebec, 326 cases in Ontario, 58 cases in British Columbia, 12 cases in Alberta, two cases in Saskatchewan and one case in Yukon.

"What we need right now is actually those in the highest risk groups, including gay, bisexual, and men who have sex with men, take up the vaccine in order to protect themselves and others," Tam said.

The viral disease—often presenting as a flu-like infection with a rash—spreads through close personal contact with those who have a symptomatic case. This can occur in a few ways:

• Contact with lesions or scabs found on the skin or mucosal surfaces such as eyes, mouth, genitalia, and anus;
• Contact with an infected person's bodily fluids such as blood, saliva, and semen; and
• Contact with contaminated objects or shared personal items such as bedding, towels, toothbrushes, and utensils.

PHAC says the virus may also spread through respiratory particles from talking, breathing, coughing or sneezing during close contact, but scientists are still gathering information on that mode of transmission. "We're at the sort of infancy in understanding the spread of this outbreak," Tam said.

While in Canada monkeypox is predominantly spreading among gay, bisexual, and other men who have sex with men—with 99 per cent of cases reported to date occurring in people who identify as male and the majority having reported same-sex sexual contact—health officials have sought to emphasize that anyone can become infected and transmit the virus.

To date, less than one per cent of confirmed cases in Canada were in females or people under 20 years of age, Tam said, adding that while PHAC is aware of international cases involving women and children, they also account for one per cent of all known cases.

CALLS FOR SUPPORTS, SAFE SEX

Tam said Wednesday PHAC is working with international and domestic health authorities, as well as dating apps such as Grindr, to try to spread awareness about how to stop the chains of transmission "to prevent the establishment of monkeypox in Canada."

Echoing a call from the WHO, Tam said Canadian health authorities recommend practicing safer sex, having fewer sexual partners, and staying home when sick as ways to reduce the risk of getting infected.

She said federal officials are "closely monitoring emerging data," pledging the public health response will evolve as they learn more. For now, Tam said officials are "being constantly vigilant about potential for spread to other higher risk communities."

While efforts have been made by the federal government to provide funding to community groups to raise awareness and fight the stigma around the disease, there are calls for a more comprehensive national response to the emerging public health concern.

"Our leaders really need to get together and start forming a strategy so that we can limit the spread of this. We don't want it to get into schools, daycares, things like that. Now's the time— like we had early in COVID— to really nip this thing in the bud," said emergency physician Dr. Kashif Pirzada in an interview on CTV News Channel on Wednesday.

Among the suggestions being made include offering direct financial assistance or covering sick leave, as was offered to Canadians early in the COVID-19 pandemic, should people have to isolate.

Tam said that with the period of incubation lasting up to 21 days and the potential for those who contract the virus to remain infectious for a number of weeks, "from a public health perspective, we need to be able to do that, so that people can do the right thing in terms of reducing their contacts."

VACCINE SUPPLY OK 'FOR NOW'

Some local public health authorities across the country have begun offering one dose of a smallpox vaccine as a pre-exposure prophylaxis or as post-exposure protection, to those who are eligible.

The shot being offered in Canada is Imvamune, which the National Advisory Committee on Immunization (NACI) has recommended as an effective form of protection against monkeypox.

So far, the federal government has distributed more than 70,000 doses of the vaccine to the provinces and territories, of which approximately 27,000 doses have been administered.

Asked where Canada's current supply of doses stands, Tam said that while the vaccine is in limited supply globally, the stockpile is sufficient for now and the federal government is looking to secure more.

"I think for now, we're OK, and of course we're trying to estimate the size of the population and the potential vaccine coverage required," Tam said. "We're fortunate in that we had already been stockpiling the vaccine for another purpose, and so that's how we were able to get ahead."

To date more than 18,000 cases of monkeypox have been reported globally from 78 countries, according to the World Health Organization. As Reuters reported Wednesday, scientists advising the WHO have said that the window to stop the virus' spread is closing. With new cases doubling every two weeks, there's concern that it could be several months before the current outbreak peaks.