MPox (Monkeypox)

Mpox symptoms usually appear 6 to 13 days after being exposed to the virus but can also range from 5 to 21 days. Infection usually has two phases:

Phase One: A prodromal (early) illness that lasts between 1 to 5 days, including:

• Fever
• Headache
• Muscle aches
• Swollen lymph nodes
• Backache
• Chills
• Exhaustion
• Sore throat and/or cough
• Runny nose

Phase Two: A skin rash that begins 1 to 3 days after fever and usually lasts two to four weeks. The rash often begins on the face and then spreads to other places on the body, including the palms of the hands, soles of the feet, and mouth. The rash turns into blisters that then scab over.

The Mpox virus enters the body through breaks in the skin, or through the eyes, nose, and mouth.

The virus is spread by:

• Touching the sores, scabs, or bodily fluids of an infected person (including hugging, kissing, and sexual contact).
• Prolonged face-to-face contact with an infected person, such as an in-person conversation.
• Touching objects that are contaminated with the virus, such as clothing or bedding.

Mpox may be contagious up to 4 days before symptoms first appear and until all scabs from the sores have fallen off and new skin is present - about 3 weeks after onset of rash.

Anyone who has been exposed to a person infected with Mpox should monitor themselves for symptoms for 21 days and contact your healthcare provider by phone to see if you are eligible to receive Post-Exposure Prophylaxis (PEP).

If you or a family member are showing signs and symptoms of Mpox, it is important to: 

• Isolate immediately by staying home and do not attend work, school, childcare, or any other public spaces.
• Contact your healthcare provider by phone to discuss your symptoms, get tested, and to see if treatment is recommended.
• Before attending a healthcare setting for medical care or testing including a clinic, hospital, medical lab, radiologic facility, you must call the facility and notify them that you may have Mpox, so that they can prepare for your arrival and prevent virus spread.
• Wear a well-fitting, high-quality mask when seeking medical assessment.

The Mpox vaccine (Imvamune) can now be given to eligible persons, as per the Ontario Ministry of Health guidelines. A single dose will provide protection two weeks after vaccination. A second dose can be given 28 days after receiving the first dose and may provide longer-lasting protection.

Imvamune® can be used to protect individuals before an exposure to the Mpox virus (this is called Pre-Exposure Prophylaxis or PrEP) or to protect individuals after being exposed to the Mpox virus (this is called Post-Exposure Prophylaxis or PEP).

Imvamune® vaccine eligibility for protection before an exposure to the Mpox virus (PrEP)

Based on the National Advisory Committee on Immunization (NACI) guidelines, the following individuals/groups are recommended to have PrEP:

1. 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 may have other sexual partners,
   • Have attended venues for sexual contact (i.e., bath houses, sex clubs) recently or may be planning to, or who work/volunteer in these settings; or
   • Have had anonymous sex (e.g., using hookup apps) recently or may be planning to; and/or
   • Are a sexual contact of an individual who engages in sex work.
2. Sexual partners of individuals who met the criteria above
3. Individuals who self-identify as engaging in sex work or are planning to, regardless of self-identified sex or gender.
4. Staff or volunteers in sex-on-premises venues where workers may have contact with items potentially contaminated with mpox.
5. Individuals who engage in sex tourism (regardless of gender, sex assigned at birth, or sexual orientation).
6. Individuals who anticipate experiencing any of the above scenarios.

Currently, people who have or have had Mpox are not eligible for the vaccine.

Based on the Ontario Ministry of Health guidelines, individuals who have been identified by their local public health unit as having a high exposure with someone who has the Mpox virus are eligible to receive Imvamune®. These individuals will be contacted directly by their local public health unit.