“The evolution of cases every day is not dramatic,” Montreal’s director of public health, Dr. Mylène Drouin, together with the interim director of public health of Quebec, Dr. Luc Boileau. “We see some (new cases) a day.” Photo by John Mahoney / Montreal Gazette
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Montreal is the epicenter of the North American smallpox epidemic, public health officials said Tuesday. Globally, the 126 cases of the disease detected in the city since the beginning of May represent 7.9 percent of the 1,600 cases reported this year by the World Health Organization (WHO). Quebec’s 132 cases bring the rate to 8.25.
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However, the authorities assure that there is no reason for concern. “The evolution of cases every day is not dramatic,” said Dr. Mylène Drouin, Montreal’s director of public health. “We see some (new cases) a day.” But with the arrival of summer and the tourists who flock to our city in the coming months, both the city and the province want to bring the situation under control as soon as possible. Quebec has announced a vaccination campaign aimed at those most at risk of contracting monkey pox. “There is a group that is specifically affected – men who have sex with other men,” said Dr. Luc Boileau, interim director of public health of the province. The WHO said the high number of cases in this group could be, as before, a product of “positive health-seeking behavior in this demographic”.
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Drouen said public health officials believe there was a superspreader event in Montreal in late April. He did not provide details about the event, but said it was linked to other events in the UK, Belgium and elsewhere in Europe. All cases in Montreal so far are between men. Health officials “do not see new transmission chains linked to other segments of the population,” Drouin said. The county has received 40,000 doses of vaccine from the federal government. More than 3,000 people have been vaccinated in Montreal with the smallpox vaccine since late May, most of whom have been in close contact with infected people. “We believe we have enough installments to cover people at risk in Montreal and Quebec,” Boileau said.
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“We will continue (vaccination) in the coming days, here in Montreal and also in other parts of Quebec, for people who are at greater risk.” Because monkeypox is closely linked to the virus that causes smallpox, giving a smallpox vaccine can prevent people from becoming infected or make it much less serious, officials say. Vaccination is now being stepped up. Previously, the campaign in both the city and the countryside focused on people who had been exposed to people who had been infected or who had attended events where cases had occurred. The vaccine is being expanded to include people at risk who have not yet been exposed to the virus, Drouin explained, hoping to protect themselves before dealing with dangerous situations.
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“We ask men who plan or have sex with men in Montreal during the summer – we offer them the vaccination,” he said. Those wishing to be vaccinated can make an appointment through the Clic Santé and Santé Montréal websites or go to a clinic. Three people were treated at the start of the epidemic, but no one is being treated now, Drouen said, adding that most cases are not serious. The virus appears to be transmitted through close, prolonged physical contact, Quebec says. The disease can be transmitted five days before the onset of symptoms and until all skin lesions have a crust. The incubation period – the time between exposure to an infectious pathogen and the onset of symptoms – is usually five to seven days, but can be up to 21 days.
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In most cases, the disease goes away on its own in two to four weeks, but in “very rare cases, serious complications can occur,” Quebec says. Also Tuesday, the WHO said it would convene an emergency committee next week to assess whether the monkey pox outbreak represents a public health emergency of international concern. This is the highest level of warning issued by the United Nations agency, which currently only applies to the COVID-19 pandemic and polio. There have been 1,600 confirmed and 1,500 suspected cases of smallpox this year, according to the WHO, and 72 deaths in 39 countries, including those where the virus usually spreads. Reuters contributed to this report.
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