Mpox Virus

Mpox is a rare disease caused by the mpox virus.

It is found mostly in areas of Africa but has been seen in other areas of the world. Recently, Mpox virus has been found in countries where it is not endemic (not usually found).

There is no proven treatment for mpox, although antiviral treatment is available for severe cases and there is also a vaccine (see below). Mpox usually goes away on its own.

NOTE: The Ontario outbreak was declared over on December 12, 2022. Ontario will continue to monitor the situation and will re-assess if numbers start to increase.

Mpox typically does not spread easily between people. Person-to-person spread may occur through:

• sexual or intimate contact with an infected person
• contact with clothing or linens (such as bedding or towels) used by an infected person
• direct contact with mpox skin lesions or scabs
• respiratory transmission from an individual with mpox.

The virus enters the body through broken skin (even if not visible), the respiratory tract or the mucous membranes (eyes, nose or mouth).

Anyone who has had close, prolonged contact with someone who is infected with mpox or who has touched contaminated objects (clothing, bedding, towels, eating utensil and dishes) is at risk of becoming infected.

Mpox is usually a mild illness, with most people recovering on their own after a few weeks; however, some may have severe illness and need to be hospitalized. People typically develop symptoms five to 21 days after being exposed to the mpox virus. Symptoms occur in two stages and typically last from two to four weeks.

In stage one, symptoms may include:

• fever
• chills
• swollen lymph nodes
• headache
• muscle pain
• joint pain
• back pain
• exhaustion

In stage two of the illness, a rash develops - usually within one to three days (sometimes longer) after the fever starts. The rash often starts on the face or extremities, however it can affect other parts of the body, such as the hands, feet, mouth and genitals.

The rash can last between 14 and 21 days and changes through different stages before finally forming a scab which later falls off.

• Imvamune® vaccine is approved in Canada for protection against mpox.
• The vaccine contains weakened virus. You cannot get mpox from the vaccine.
• For individuals at high risk of exposure to mpox, the vaccine can be used for protection against mpox before getting exposed to the virus (pre-exposure vaccination) or after being exposed (post-exposure vaccination).
• After getting the Imvamune vaccine, it is recommended to wait at least 2 weeks before getting another non-live vaccine (e.g. COVID-19, flu or meningococcal) and 4 weeks before getting another live vaccine (e.g. Shingles or MMR).
• Read more about the vaccine:
  • Ministry of Health Factsheet
  • Gay Men’s Sexual Health Alliance

Based on Ontario Ministry of Health guidelines, specific groups are people are eligible to receive pre-exposure vaccine as a two-dose series, with at least 28 days between first and second doses.

These groups include:

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 (STI) 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 (e.g. 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) or may be planning to; and/or
• 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.

NOTE: Household and/or sexual contacts of people who are eligible as listed above in parts (a) or (b) above AND who are moderately or severely immunocompromised (have a weak immune system) or are pregnant may be at risk for severe illness from a mpox infection. These individuals may be considered for this type of pre-exposure vaccination, and should contact their healthcare provider or TBDHU for more information.

First dose:

• Contact TBDHU (625-5900 or toll-free 1-866-294-6630) to discuss options, including making an appointment for an upcoming clinic.

Second dose:

• It is STRONGLY a second dose is received for improved protection.
• You are eligible to get a second dose when it has been at least 28 days after first dose. If it’s been more than 28 days since your first dose, you do not have to start again and it’s strongly recommended you finish this series of vaccines.

1. If you received a first dose through TBDHU or any other health unit in Ontario: contact TBDHU (625-5900 or toll-free 1-866-294-6630) to discuss options, including making an appointment for an upcoming clinic.
2. If you received a first dose outside of Ontario: contact TBDHU (625-5900 or toll-free 1-866-294-6630) to discuss options. Proof of the first dose is required and this can be reviewed with TBDHU staff. 

• Tecovirmat (TPoxx®) is an antiviral medication that prevents the virus’ ability to multiply and therefore slows down its spread throughout the body. This allows your body to build up its defences to fight off the infection.
• Tecovirmat (TPoxx®) is currently being used for severe cases of mpox and with individuals at risk for severe disease.
• Read more about Tecovirmat (TPoxx®) here.