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Part of Disease prevention and surveillance

Mpox virus

Learn about the mpox virus (previously known as the monkeypox virus) in Alberta.

Current situation

Alberta is closely monitoring the spread of mpox along with federal and provincial partners as it continues to evolve in Central Africa and internationally. The Public Health Agency of Canada (PHAC) regularly assesses public health risks to Canadians to:

  • identify potential public health threats
  • develop recommended actions
  • explore possible outcomes

For more information on the current mpox situation in Canada, including the risk of mpox clade Ia or Ib entering Canada and spreading further, visit the PHAC’s mpox update page.

Overview

On August 14, 2024, the World Health Organization (WHO) declared the spread of mpox virus clade I on the African continent a Public Health Emergency of International Concern (PHEIC). Additional cases of the newer subclade, clade Ib, have been reported in Europe, Asia and North America.

In 2022, the WHO declared a PHEIC due to the global spread of mpox clade IIb. The PHEIC was declared over in May of 2023 after a sustained decline in global cases. However, mpox clade IIb cases continue to be reported in Canada and across the world in smaller numbers.

Strains

  • There are 2 different strains of the virus known as clades (clade I and clade II).
    • Each clade is further divided into 2 subclades (clade Ia, clade Ib, clade lla, and llb).

Clade I

  • Clade I subclade Ia is endemic in the Democratic Republic of the Congo (DRC), where there is an ongoing mpox outbreak.
    • Subclade Ib emerged from the DRC in September of 2023.
  • Current reports suggest that clade Ia may cause more severe illness and death, compared to clade Ib and clade II.
  • At this time, in Africa:
    • children under 15 years of age appear to be most affected by clade Ia
    • clade Ib is more evident in youth and adults over 15 years old
  • Clade I mpox cases have been reported in very limited numbers outside of Africa.

Clade II

  • Since 2022, cases of clade II mpox have been reported globally, including across Canada. 
  • In Alberta, these cases have been reported:
    • 44 cases in 2022
    • 3 cases in 2023
    • additional cases in 2024 

Signs and symptoms

Mpox infection is usually a mild illness that resolves without treatment. Most people recover within several weeks; however, severe illness can occur in some individuals.

Signs and symptoms, and the progression of illness, can vary from person-to-person.

At this time, the risk to the general public, including children, is low.

Children presenting with rash illness:

  • would not be considered to be at risk for mpox unless they have known exposure to a mpox case, such as a household member
  • should be investigated for more common causes of rash

Symptoms

Symptoms can develop 3 to 21 days after exposure to the virus and generally begin with:

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

Rash

Within 1 to 4 days after the fever starts, a rash may begin on the face and then spread elsewhere on the body. In some cases, the rash may occur without flu-like symptoms or flu-like symptoms may occur after the rash appears.

The rash can be painful and may affect any part of the body, including:

  • mucous membranes in the mouth, tongue and genital area
  • face
  • palms of hands
  • soles of the feet
  • arms and legs

The rash can last for 2 to 4 weeks and goes through different stages – from skin discoloration to sores to scabs – before the scabs fall off.

How it spreads

Mpox spreads through exposure to an infected individual, including:

  • direct physical contact and contact with mpox skin lesions or scabs
  • contact with body fluids, such as:
    • blood
    • saliva
    • semen
  • prolonged exposure to respiratory droplets
  • sexual activity, including oral and skin-to-skin contact
  • direct contact with contaminated materials, such as:
    • clothing
    • bedding
    • towels
    • sex toys
    • toothbrushes

Mpox can spread to others from the time symptoms start until the scabs fall off and new skin can be seen, usually 2 to 4 weeks.

It may also be possible for some people to spread mpox from 1 to 4 days before their symptoms start.

Mpox scabs contain virus that can spread the illness to others and care should be taken in their disposal.

If you think you have mpox

  • Testing for mpox is available in Alberta for those who have mpox symptoms.
  • Call HealthLink at 811 or your healthcare provider for advice.
  • Many Sexual and Reproductive Health Clinics can provide testing for mpox, along with testing for more common sexually transmitted infections. Visit Alberta Health Services to find a clinic near you.
  • If you would like to visit a health care provider, let them know in advance of your arrival so they can put precautions in place.
  • Take steps to avoid spreading mpox:
    • isolate and avoid direct physical contact with others until all sores/skin rashes have healed and new skin has formed
    • practice good hand hygiene – clean your hands properly and frequently by washing your hands with soap and water for at least 20 seconds or use hand sanitizer if your hands are not visibly soiled
    • wear a mask if you have to be around others
    • avoid sharing personal items that may be contaminated from lesions or body fluids (for example, razors, clothes, utensils, toothbrushes, linens, sex toys, needles, etc.)
    • avoid contact with animals (including pets)
    • use gauze or bandages to cover the rash
    • avoid popping, scratching or shaving the area with the rash 

Treatment and prevention

Most people recover from mpox without treatment. Some people with more serious illness may require hospitalization and supportive care.

Treatment

Treatment options may be available to those at risk of severe illness. Call Health Link at 811 or your health care provider if you think you were exposed to a case of mpox.

  • A limited supply of an antiviral drug is available for severe cases and requires consultation with a specialist before it is prescribed.

Prevention

To protect yourself and prevent mpox:

  • avoid skin-to-skin or face-to-face contact with anyone who has symptoms
  • practice safer sex, including barrier protection like condoms and dental dams, and limit the number of sexual partners you have, especially those who are anonymous
  • practice regular hand hygiene
  • clean and disinfect objects and surfaces that have been touched regularly
  • don’t share personal items with others
  • wear a mask if you are in close proximity with someone who has symptoms
  • while travelling – especially to areas where mpox transmission is ongoing – exercise caution if you plan to attend gatherings or events that include close, prolonged and frequent interactions among people, particularly sexual activity
  • avoid contact with wild animals
  • find out if you are eligible to receive mpox vaccine:
    • Imvamune vaccine is indicated for Albertans 18 years of age and older who are at high risk of mpox exposure (see vaccine eligibility).
    • The vaccine is available at no cost to eligible individuals and contains a modified version of a related virus that cannot multiply or make you sick with mpox.

Vaccine eligibility

Pre-exposure

The Imvamune vaccine is available as a 2-dose series, where eligible individuals should receive their second dose at least 28 days after their first dose.

The following individuals are eligible for the Imvamune vaccine before exposure to mpox:

  • men who have sex with men (MSM) and who meet at least one of the following criteria:
    • have more than one sexual partner
    • are in a relationship where at least one of the partners has other sexual partners
  • have had a confirmed sexually transmitted infection acquired in the last year
  • have engaged in sexual contact in sex-on-premises venues
  • sexual partners of any of the above
  • sex workers regardless of gender, sex assigned at birth or sexual orientation
  • staff or volunteers in sex-on-premises venues, where workers may have contact with objects or materials potentially contaminated with mpox
  • individuals who engage in sex tourism (regardless of gender, sex assigned at birth or sexual orientation)
  • individuals who anticipate experiencing any of the above scenarios
  • research laboratory employees working directly with replicating orthopox viruses and who are at higher risk of occupational exposure

MSM definition

MSM (men who have sex with men) are defined as any man or Two-Spirit identifying individual who has sex with another person who identifies as a man, including but not limited to individuals who self-identify as trans-gender, cis-gender, 2-Spirit, gender-queer, intersex, and non-binary.

Pre-exposure immunization

Pre-exposure immunization is not recommended at this time for healthcare workers and clinical diagnostic laboratory workers who both:

  • may be in contact with patients or their clinical diagnostic specimens
  • work in environments with training and control measures in place to mitigate the risk of unprotected exposures or infections in the healthcare setting

Post-exposure

If given shortly after exposure to mpox, Imvamune vaccine may prevent infection or reduce the severity of illness if infection does occur. If you believe you have been in close prolonged contact with someone with mpox, self-isolate and call Health Link at 811 or your health care provider.

Book an appointment

Eligible individuals who are interested in receiving the mpox vaccine can call Health Link at 1-866-301-2668 to review eligibility and book an appointment.

International travel

Public Health Agency of Canada issued a level 2 travel health notice for mpox for affected countries.

Check for active advisories for your travel destination before you travel outside of Alberta or Canada.

Resources

Government of Alberta

Alberta Health Services

Public Health Agency of Canada (PHAC)

International