Montreal has 17 suspected monkeypox cases; officials say it’s ‘not highly contagious’ or severe

Montreal Public Health said they’re asking health workers to be alert for monkeypox after seeing 17 suspected cases in the area over the last week.

But public health chief Dr. Mylene Drouin said the illness is not extremely contagious and is the milder of two strains.

The virus is transmitted by “close contact” and respiratory droplets and it’s not a sexually transmitted disease, she said, even though so far, those infected in the Montreal area happen to have been gay men.

It’s also not a disease that health officials believe will enter a phase of general community transmission, she said — it’s not infectious enough for that.

“It’s not something you can acquire when do you do your grocery store [shopping] or on public transportation,” she said.

So far in Montreal, “mainly those [17] cases are men that have had sexual relationships with other men, aged between 30 to 55 years old,” Drouin said.

“And the clinical presentation is mainly ulceration of oral and genital parts that are painful, and with a phase before the eruption with fever, sweating and headaches.”

She added that “most of our cases are not severe cases.”

Those symptoms tally with known descriptions of monkeypox, a rare illness that can present as fever, headache and fatigue.

After a few days, patients usually develop a rash that often starts on the face before spreading to other parts of the body. Most patients recover in a matter of weeks, although it can be potentially fatal in some cases.

A distinguishing feature of monkeypox, compared to smallpox, is that it causes the lymph nodes to swell, according to the CDC.

Montreal doesn’t yet have lab confirmation that the 17 cases are, in fact, monkeypox, but after learning of other outbreaks in Europe and a case in the U.S. with travel linked to Montreal, public health “changed the course” of their investigation, Drouin said.

The first case was reported in Montreal on May 12, last Thursday, she said, and that first infected person’s symptoms began in late April.

There are now 15 suspected cases in the city, one on the North Shore and one on the South Shore. Some of them are, in turn, linked to travel with other countries, including one person in Boston who visited Canada, as well as people who have travelled to Mexico and Belgium.

Drouin said all known local patients are in isolation and have been asked to cover their skin lesions with bandages.

The illness can be passed along by anyone in close contact with others, such as a family member, especially when they have exposure to the skin lesions or things that have touched them.

What’s considered a “significant contact” are “those in the same household and sexual partners,” Drouin explained.

In the 17 local cases, all the significant contacts of the infected people are not being asked to stay in isolation, but they have been asked to monitor themselves carefully for 21 days and report any symptoms.

Local doctors have also been asked to stay vigilant for suspected cases.

CHILDHOOD SMALLPOX VACCINE MAY OFFER SOME PROTECTION

As to whether a vaccine will be offered, that’s a decision that will be made at the provincial and federal levels. The first step is to know if a vaccine is available, Drouin said.

“There is a report of protection from having the smallpox vaccine,” said Medical Officer in Charge of Health Emergencies and Infectious Diseases Dr. Geneviève Bergeron.

But Montreal authorities don’t yet know how many Montrealers have the smallpox vaccine from their childhoods, she said.

While that vaccine was widespread in earlier decades, it hasn’t been in use in North America since smallpox was eradicated, meaning that only people roughly in their 50s and above are likely to have had it.

On Wednesday, the Massachusetts public health department in the U.S. said in a statement it had confirmed one case of the disease in an adult man “with recent travel to Canada.”

This comes after five cases were identified in Portugal, seven were confirmed in the U.K. and 23 were flagged in Spain.

Health officials are investigating whether the cases in North America are linked to the outbreaks in Europe.

Monkeypox is generally limited to Africa, with the few cases seen elsewhere in the world usually linked to travel to that region.

Monkeypox was first discovered in 1958 in colonies of monkeys that were kept for research.

The first human case was recorded in 1970 in the Democratic Republic of Congo, according to the CDC.