Monkeypox likely to be around for 'many months' but vaccine strategy working: Ontario's top doctor

Ontario is not seeing rapid growth in cases ofmonkeypoxand itsvaccination strategy appears to be working, the province's top doctor says.

Chief Medical Officer of Health Dr. Kieran Moore saidmonkeypox will likely be around for "many, many months" due to its lengthyincubation period of up to 21 days, but Ontario isn't seeing exponential growth of the virus.

"At present the numbers (of cases) are not escalating rapidly, but they are increasing," Moore said in a recent interview. "We dothink it's stabilizing in Ontario, in terms of not rapid growth."

Moore said 133 cases had been identified in Ontario as of July 6,with the vast majority being in Toronto and most others with aconnection to the city. Public Health Ontario had reported 33 casestwo weeks earlier.

All reported cases as of July 6 have been in men between the ages of 20 and 65.

Comes from same family of viruses causing smallpox

Monkeypoxgenerally does not spread easily between people and is transmitted through prolonged close contact via respiratory droplets, direct contact with skin lesions or bodily fluids, or through contaminated clothes or bedding.

Symptoms can include rash, oral and genital lesions, swollen lymph nodes, headache, fever, chills, myalgia and fatigue.

Public health says most cases are among men who report intimate contact with men but says anyone can getmonkeypox.

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Themonkeypoxdisease comes from the same family of viruses that cause smallpox, which the World Health Organization declared eradicated around the globe in 1980. Smallpox vaccines have proveneffective in combating themonkeypoxvirus.

Moore said the province has been working "diligently" to vaccinate those who have contracted the virus as well as close
contacts or anyone at risk of contact.

"Over 8,000 individuals have been provided the smallpox vaccine,which we think has good protection againstmonkeypox," he said.

"We've also been able to provide treatments, so five Ontarians have been treated with a medication called TPoxx, (which is forthose) who have had severe complications related tomonkeypox."

'Not causing alarm' but situation 'relatively fragile'

The province is not looking to expand its vaccination strategy at this time, Moore said, adding that "it appears to be working."

"Normally this dose of vaccine has two doses 28 days apart,"said Moore. "We're reviewing if we have to go back to those 8,000individuals and provide a second dose."

Dr. Allison McGeer, an infectious diseases specialist at Mount Sinai Hospital in Toronto, said the increase in cases in theprovince is "not causing alarm," but the situation is still"relatively fragile."

"We don't know what it's going to take to get the outbreak under control," said McGeer. "We aren't completely confident that the virus hasn't changed enough to allow some more sustained transmission to populations."

McGeer said there is no immediate risk to most of the population frommonkeypox.

"This is really still very much an intervene for the populationswhere we have a defined risk, and they're really carefully watching to identify whether there's been any spread outside those high riskpopulations," said McGeer.

The province's current vaccination strategy is "the best that can be done at the moment with the limited supplies that we have," she said.

"The fine line that all jurisdictions are trying to run is tomake sure that people who are at significant riskifmonkeypoxare getting access to the vaccine," said McGeer.

"And that the rest of us who are not, at the moment, at any significant risk ofmonkeypoxare not using up the limited suppliesthat we have, and are not potentially being exposed to some tinyrisk that we just don't know about yet."