23 May 2022 | 11:03 PM UTC
North America: Monkeypox cases reported in Quebec and Toronto, Canada, and in some US states as of late May
Monkeypox cases reported in Toronto and Quebec, Canada, and selected US states as of late May. Maintain basic health precautions.
Event
Public health officials have reported cases of monkeypox in some areas of Canada and the US in late May; ongoing disease transmission within these countries has not yet been confirmed.
According to data through May 23, Canadian authorities have reported 23 suspected cases in Toronto and Montreal, including five confirmed cases. Five suspected cases have been reported in the US, including two confirmed cases, in New York, New York; Boston, Massachusetts; Broward County, Florida; and Salt Lake County, Utah.
Additional cases within these and other new locations in Canada and the US will likely be identified in the coming weeks as disease surveillance and contact tracing continue.
Context
In contrast to sporadic cases reported in the past linked to travel to endemic countries, health officials have not confirmed the source of infection for the current spike in cases. However, suspected human-to-human transmission occurs among people in close physical contact, with clusters of cases reported among men having sex with men (MSM). The current outbreak highlights the importance of vigilant safe sexual practices and suggests monkeypox can be sexually transmitted while the infected person displays few or no symptoms; however, risk is currently assessed as low for individuals not routinely engaging with multiple or anonymous sexual partners.
Monkeypox does not naturally occur in North America; most cases are reported in West and Central Africa, primarily in the DRC, Nigeria, and Cameroon, among individuals who report contact with wild primates or other mammals that may harbor the disease.
Monkeypox is caused by a virus that belongs to the same family as the virus that causes smallpox. However, monkeypox is not the same as smallpox, and it does not have the same capacity for rapid human-to-human transmission. Monkeypox is mainly transmitted to humans through direct contact with the bodily fluids of infected rodents or primates. Human-to-human transmission primarily occurs through close personal contact with an infected individual via respiratory droplets, direct contact with bodily fluids, or indirect contact with lesion material (e.g., contaminated clothing or bedding). Symptoms typically appear 6-16 days after exposure but can develop up to 21 days after exposure. Symptoms generally include fever, headache, muscle aches and backaches, swollen lymph nodes, chills, exhaustion, and a distinctive rash characterized by lesions that progress through several stages before falling off.
Advice
Practice basic health precautions, including frequent handwashing with soap and water, covering the nose and mouth when coughing, and avoiding obviously ill individuals. Avoid overcrowded areas, such as nightclubs, and consider exercising safe sexual practices, such as physical barriers (condoms) in countries reporting monkeypox transmission. Seek medical attention if symptoms develop within two weeks of being in affected areas, especially if you have had one or more new sexual partners.
