Monkeypox

Monkeypox can spread through:

• Direct skin-to-skin contact with lesions, blisters, rashes or bodily fluids such as saliva.
• Prolonged close contact with respiratory droplets from breathing, talking, coughing or sneezing.
• Direct contact with contaminated fabrics such as bedding or by sharing personal items such as toothbrushes.

Monkeypox is most often spread through direct contact with the skin rash or lesions of an infected person. The virus enters the body through breaks in the skin or mucosal surfaces, such as the eyes, nose and mouth. Most transmission of Monkeypox in Canada has occurred between close contacts, such as household members or intimate partners.

Monkeypox can also be transmitted from contact with infected animals through bites and scratches.

Signs & Symptoms

Monkeypox is usually mild and most individuals recover within a few weeks. However, some people can become very sick with the virus, and require treatment.

Symptoms can start anywhere from 5 to 21 days after being exposed to Monkeypox, but usually start within 7 to 14 days.

If you think that you may have Monkeypox, self-isolate and contact your health care provider as soon as possible.

Think you may have been exposed?

People who have been in contact with a person who has Monkeypox should monitor themselves for signs and symptoms of monkeypox for 21 days. If symptoms develop, you should self-isolate right away and contact your healthcare provider and local Public Health Unit. If no symptoms appear you can continue with normal activities.

If you have been identified as a contact of a monkeypox case, a Public Health Nurse will contact you to provide you with further guidance and speak to you about vaccine eligibility.

What to do if you have been tested

If you are experiencing symptoms or have been tested for Monkeypox, you will need to self-isolate until you have spoken to your health care provider.

How to self-isolate:

• Stay in a separate room or area away from other household members and use a separate bathroom if available
• If unable to separate from household members, you should:
• Wear a medical mask, especially if respiratory symptoms are present
• Cover skin lesions as much as possible (e.g., long sleeves, long pants)
• Avoid leaving the home unless seeking urgent medical care
• Avoid household visitors
• Avoid contact with animals, including household pets as the virus can be spread to animals.
  • Keep your pets in the home and if possible, ask someone else in the home who is not sick to care for the pet.
  • Avoid close contact or prolonged contact with pets including touching, snuggling and kissing.
  • If having to care for the pet, you should wear a mask and wash hands with soap and water immediately before and after touching pets, their food, or supplies. If lesions are present on the hands, wear disposable gloves.

If you test positive for Monkeypox you must self-isolate at home until lesion scabs have fallen off and new intact skin has formed below. This recovery period typically takes 2 to 4 weeks. A Public Health Nurse will contact you and support you throughout your illness.

Reduce your chances

• Practice good hand hygiene. Wash your hands with soap and water or use an alcohol-based hand sanitizer.
• Do not kiss, hug, cuddle or have sex with someone who has or may have Monkeypox. 
• Avoid skin to skin contact with Monkeypox rashes or lesions.
• Reduce or limit the number of people you have close contact with, including sexual partners.
• Talk to sexual partners about sexual health and use barriers such as gloves and condoms.
• Avoid sharing objects such as toothbrushes, sex toys and drug use supplies.
• Clean and disinfect high touch surfaces (such as door handles and phones).
• Avoid touching bedding and laundry that has been in contact with someone who has the virus.
• Use personal protective equipment (PPE) when caring for someone at home who has the virus, including a medical mask and disposable gloves for direct contact with lesions. 

Vaccine information & eligibility

What is the Monkeypox vaccine (Imvamune®)?
Imvamune® vaccine is approved by Health Canada for protection against monkeypox. The vaccine contains weakened virus and cannot make you sick.

The vaccine can be used in two ways:

1. Before being exposed to monkeypox virus: The vaccine can be used for protection against Monkeypox before getting exposed to the virus (this is known as Pre-Exposure Prophylaxis

2. After being exposed to monkeypox virus, before you have symptoms: The vaccine is given after being exposed to prevent illness or severe outcomes (this is known as Post-Exposure Prophylaxis).

People who are identified as being at increased risk of exposure to monkeypox are encouraged to receive two doses (0.5ml) of the Imvamune® vaccine by injection given at least 28 days apart. Individuals with signs or symptoms of monkeypox infection should not receive the vaccine as the vaccine is not indicated in the treatment of monkeypox infection.

Please see the Monkeypox Vaccine Information Sheet for more information about the monkeypox vaccine.

Who is eligible for Imvamune® vaccine prior to exposure?

Hamilton Public Health continues to follow federal and provincial guidance on the administration of the Imvamune® vaccine to protect at-risk populations against the monkeypox virus. The vaccine is free and available to all eligible people.

Based on the Ontario Ministry of Health guidelines, the following individuals are eligible for Imvamune® vaccine prior to exposure,

a.) Two-spirit, non-binary, transgender cisgender, intersex, or gender-queer individuals who self-identify or have sexual partners who self-identify as belonging to the gay, bisexual, pansexual and other men who have sex with men (gbMSM) community AND at least one of the following:

• Had a confirmed sexually transmitted infection within the last year
• Have or are planning to have two or more sexual partners or are in a relationship where at least one of the partners has other sexual partners
• Have attended venues for sexual contact (i.e., bathhouses, sex clubs) recently or may be planning to, or who work/volunteer in these settings?
• Have had anonymous sex (e.g., using hookup apps) recently or may be planning to
• Are a sexual contact of an individual who engages in sex work.

b.) Individuals who self-identify as engaging in sex work or are planning to, regardless of self-identified sex or gender.

*Household and/or sexual contacts of those identified as eligible for pre-exposure vaccination eligibility in parts a) or b) above who are moderately to severely immunocompromised OR pregnant may be at higher risk for severe illness from a monkeypox infection and should contact their healthcare provider to help determine eligibility for pre-exposure monkeypox vaccination.

If you meet the above eligibility criteria and are interested in pre-exposure vaccination, please call our Sexual Health Information Line 905-528-5894 - Mon to Fri from 8:30 am to 4:30 pm to book an appointment.  This clinic is by appointment only, no walk-ins will be accepted.

Hamilton Public Health will be offering monkeypox vaccination for at-risk populations at our Sexual Health Clinic.

People who meet the provincial criteria for vaccination to prevent monkeypox infection can book an appointment by calling our Sexual Health Info Line at 905-528-5894 - Mon to Fri from 8:30 am to 4:30 pm.

An OHIP card is not required. The vaccine is free and available to all eligible people. These clinics require booked appointments. Walk-ins cannot be accommodated.

Hamilton Sexual Health Clinic

Accessibility: This clinic location is accessible. Please bring all required mobility devices with you. From the main floor of David Braley Health Sciences Centre, clinic access is via an elevator.

Imvamune® vaccine eligibility after being exposed to the monkeypox virus:

Individuals who have been identified by their local public health unit as having a high or intermediate-risk exposure with someone who has the monkeypox virus may be eligible to receive Imvamune®. These individuals will be contacted directly by their local public health unit. 

When the vaccine is used as Post-Exposure Prophylaxis (receiving the vaccine after exposure to the monkeypox virus), it should be given within 4 days, but can be given up to 14 days after the last exposure. Contact your healthcare provider or Hamilton Public Health to find out if you are eligible for Post-Exposure Prophylaxis.