Canada may deliver vaccines to Quebec against monkeypox
Province's confirmed cases at five as community transmission suspected
Federal health authorities are looking into providing vaccines to Quebec for protection against monkeypox after an outbreak of the rare disease was discovered in Montreal.
“For the moment, we have doses and we are discussing with Quebec the possibility of using them,” Howard Njoo, Canada's deputy chief public health officer, said during a press conference Friday.
The announcement came as the World Health Organization called an emergency meeting Friday to discuss a rash of cases of the virus worldwide. Normally confined to western and Central Africa, monkeypox cases are now suspected in eight countries in Europe — where more than 100 confirmed and suspected cases have been reported in all — as well as the United States, Canada and Australia.
The vaccines once used against smallpox have been found to be effective against monkeypox. Even though smallpox was eradicated in the late 1970s, and vaccinations largely stopped in Canada in 1972, samples of the disease remain in laboratories. A certain number of vaccines are kept on hand in case of an emergency, Njoo explained.
Canada is having discussions internationally about acquiring vaccines, said Dr. Theresa Tam, the country's chief public health officer. Just under two dozen cases are being investigated by local officials, mainly in Quebec but also in British Columbia.
Quebec health officials reported Thursday evening they had confirmed two cases of monkeypox and were investigating 20 other suspected instances. The confirmed cases, both involving men from the Montreal area, were determined through genetic sequencing tests at the national microbiology laboratory in Winnipeg.
As of Friday evening, the number of confirmed cases in Quebec stood at five.
The outbreaks in numerous countries suggest the disease is spreading through community transmission, and could indicate the virus has altered from its previous form, Njoo said.
Montreal public health director Dr. Mylène Drouin stressed on Thursday that all cases so far had been minor and said there is no cause for alarm, as widespread transmission is unlikely. Most patients recover within a few weeks.
Countries including the United States and Spain have been acquiring vaccines and medications to ward off the disease.
Quebec health authorities are looking into the possibility of ordering smallpox vaccines with their federal counterparts.
“There have been exchanges between Quebec's public health department and the Public Health Agency of Canada to clarify crucial elements, such as which vaccines to prioritize and the recommendations and risks involved with them,” said Quebec Health Ministry spokesperson Marjorie Larouche.
Monkeypox can cause painful pustules, scabs and skin lesions, and is spread primarily through close, sustained contact. It can be transmitted via respiratory droplets, as well as contact with open sores or bodily fluids. People considered at risk are those who live in the same household with an infected person, or who have had sexual relations with someone who has had the disease.
The infected in the Montreal area are mainly men who had sexual relations with other men, between the ages of 30 and 55, although it's not thought to be a sexually transmitted disease. Montreal's initial cases were believed to be linked to a traveller from Boston, and cases spread in the gay community because there happened to be a chain of transmission among some members.
Drouin warned against stigmatizing a particular segment of the community, as anyone can catch the virus.
Unlike typical cases of monkeypox that present with lesions and blisters covering the whole body, patients in Montreal have had lesions mainly in the genital area, causing doctors to first diagnose the cause as a sexually transmitted disease. The fact that the disease was likely first transmitted in Montreal by a traveller but then spread through contact in the community is “strange and intriguing,” said Dr. Réjean Thomas, medical director at L'actuel clinic downtown, which specializes in treating sexually transmitted diseases and where some of the city's first suspected cases of monkeypox were identified.
Drouin counselled Montrealers not to panic, but members of the gay community are concerned and asking a lot of questions, Thomas said. His staff advises patients to see a health professional if skin lesions or blisters appear, preferably at a clinic like L'actuel that can do tests.
“If you have ulcerations or blisters that aren't normal, avoid sexual relations and go get tested quickly,” Thomas said.
Counsellors at Rézo, a community-based organization for gay and bisexual men that focuses on health promotion, have not reported an uptick in concerns from clients, director Alexandre Dumont Blais said, but he added that news of the disease is still very fresh. The organization is posting an informational flyer on its social media pages, with links to Montreal's public health website for more details.
“At this point, we're just trying to remain vigilant, to give out the best information possible, and to prevent transmission as best we can,” he said.