Quebec health officials are investigating more than a dozen cases of suspected monkeypox in Canada after US and European health officials confirmed growing cases of the rare infectious disease – suggesting a wider outbreak could occur worldwide.
Radio Canada said Wednesday that public health officials in Montreal are investigating at least 13 cases marked by doctors in the city after diagnoses made at three clinics specializing in sexually transmitted and blood-borne infections. Laboratory confirmation of the cases is pending and a report is expected in the coming days.
The United States has confirmed its first case of monkeypox in a man who recently traveled to Canada, after European health officials confirmed more than two dozen cases of the rare infectious disease this week, suggesting it could happen more widely worldwide hearth.
A man in the case of the United States travels to Canada
Massachusetts Department of Public Health confirmed a single case of monkeypox infection on Wednesday in an elderly man who was in Canada and returned to the state – but did not specify which province the man traveled to. STAT news reported on Wednesday that the man had traveled to Quebec.
The Public Health Agency of Canada (PHAC) said in a statement to CBC News on Wednesday that no cases of monkeypox have been reported in the agency.
“PHAC is aware of and closely monitors the current situation regarding the reporting of monkeypox cases in Europe. No cases of PHAC have been reported so far, “a spokesman said in an email.
“PHAC has warned provincial and territorial public health authorities and laboratory partners in Canada to be vigilant and investigate all potential cases. As the situation progresses, we will continue to keep Canadians informed. ”
The agency said it was also “cooperating closely” with international partners, including the World Health Organization (WHO), the US Centers for Disease Control (CDC) and Prevention, and the UK’s Health Security Agency (UKHSA).
Britain reported its first case of monkeypox on May 7, and a total of nine have been found since Portuguese health officials have confirmed five cases Wednesday and Spain are investigating more than 20 possible infections.
“This again underscores the threat of viruses like this,” Dr. Maria Van Kerkhove, an epidemiologist on infectious diseases and technical director of COVID-19 and emerging diseases at the WHO, told a news conference this week.
“We really need to better understand the extent of smallpox in endemic countries like the DRC and Nigeria, the Central African Republic and others to really understand how much circulates and the risk it poses to people living there – as well as the risk from exports. ”
During a monkeypox epidemic in the Democratic Republic of the Congo, a young man shows his hands that have the characteristic monkeypox rash during the recovery phase. Record (CDC)
Cases in the United Kingdom may involve community surrender
It is unusual to see monkeypox in Europe and North America, but there are thousands of cases annually across West and Central Africa, WHO officials said this week.
The earliest known case in the UK involved a trip to Nigeria, according to the UK Health Security Agency. But the last two infections reported on Wednesday were not related to travel or other previously confirmed cases.
“So it is possible that they became infected through community transmission,” said the agency.
Angela Rasmussen, a virologist and researcher at the University of Saskatchewan’s Organization for Vaccines and Infectious Diseases (VIDO), said the spread of cases in Europe and North America was surprising compared to previous outbreaks of monkeypox.
“It seems to be spread, at least from the information we have so far, through contact between people,” she told CBC News.
“Which means it’s either a more portable version of monkeypox than any we’ve seen before between humans, or there are behaviors that are associated with increased transmission.”
Possible sexual transmission
UKHSA said four of the cases found in the UK identified themselves as gay, bisexual or other men who have sex with men, and called on men who are gay and bisexual to be aware of any unusual rashes or lesions and immediately contact a sexual health service.
The virus is known to be spread through superficial transmission or close contact, but has not previously been characterized as a sexually transmitted infection, although it can be transmitted through direct contact during sex.
“We didn’t think the Ebola virus was sexually transmitted, and of course it was found in semen. The same thing with the Zika virus, “said Dr. Isaac Bogoch, an infectious disease doctor at Toronto General Hospital.
“The question is whether it is sexually transmitted? The answer is unknown. But, of course, we know that it is transmitted by people who are close to each other. So it is not surprising that it can spread among sexual networks of people. ”
Monkeypox was first identified in the 1950s, when two outbreaks occurred in colonies of monkeys used for research purposes, the first human case being reported in 1970 in the Democratic Republic of the Congo.
The disease is often likened to a mild form of smallpox, a disease that has been eradicated worldwide through widespread vaccination against the smallpox virus.
An effective smallpox vaccine
The smallpox vaccine is also very effective against monkeypox, but routine immunization programs ended in Canada in the early 1970s, leaving Canadians under the age of 50 vulnerable to infection.
“There are certainly generations of people who have not been vaccinated against smallpox and would not have protection against monkeypox infection if exposed,” Bogoch said.
Symptoms of monkeypox infection may include fever, headache, swollen lymph nodes, chills and exhaustion, along with lesions all over the body.
There is no proven cure and infections can be fatal for at least one in 10 people who become infected. A vaccine developed against smallpox has been approved for monkeypox, and several antivirals also appear to be somewhat effective.
“It is possible that although supplies of this vaccine are somewhat limited by the country, a ring vaccination strategy can be used to prevent the infection of people who have been exposed,” Rasmussen said.
“There is also a drug that can also be used to treat measles virus infections. So it’s not like we don’t have any tools to control this outbreak. “
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