GREY-BRUCE – Dr. Ian Arra, medical officer of health for Grey-Bruce, gave a presentation on monkeypox at the May 27 meeting of the board.
He said he doesn’t anticipate the recent outbreak in Canada (26 people affected as of May 26) to become “a burden on the health-care system.”
Monkeypox was discovered in 1958, and typically has symptoms that are mild and self-limiting, with recovery in 2-4 weeks, he said. However, it can cause severe illness in certain people. The World Health Organization states historical data gives a fatality rate of 0-11 per cent, with more recent data giving a 3-6 per cent fatality rate.
In response to a question, Arra said the people who are likely to be seriously affected are those whose immune system is already compromised – people on chemotherapy, pregnant women, and those with cancer, he said.
The initial presentation of monkeypox is similar to smallpox – headache, fever, intense fatigue, sweating, joint pain and a rash that develops within one to three days. After that, skin lesions can develop, especially around the mouth and genital area.
Transmission is by direct contact with fluid from a skin lesion, or with contaminated bedding. A person is contagious as long as there are lesions. Anyone with lesions must self-isolate.
The disease has been endemic in Central and West Africa, but in May 2022 outbreaks occurred in several non-endemic countries including Canada.
Arra noted that at the provincial level, surveillance has been expanding, and notice has been sent out to emergency departments. Locally, the response would focus on contact tracing, working with local health-care providers and communications, communications and working with community partners.
Treatment for the most part is supportive, with use of antivirals in certain cases.
The smallpox vaccine is effective against monkeypox. Arra told the board that the vaccine in use in Canada is “non-replicating,” in that it can generate immunity without generating the disease. There are vaccines in use in other countries that can generate the disease. Arra said NACI (National Advisory Committee on Immunization) will issue vaccine guidelines beginning in June.
He stressed that for most people, the risk from the disease “is far greater than the risk from the vaccine.” The disease has a fatality rate of 3-6 per cent, while the vaccine would cause fatal complications in one or two people in a million.
“Most people getting the vaccine will have only minor reactions,” he said.
Board member Helen-Claire Tingling asked if the smallpox vaccine many older people received years ago offers any protection.
Dr. Rim Zayed, physician consultant, answered that the smallpox vaccine is 85 per cent effective against monkeypox, and appears to offer lifelong protection unless someone is immunocompromised.
She added that the first outbreak of monkeypox reported in humans outside the continent of Africa affected 47 people in six states in the central U.S. All were linked with people who had been in contact with pet prairie dogs.
Tingling also noted that to date, the monkeypox cases in Canada have been associated with men who have sex with men; it was the same with AIDS when it first appeared. However, it soon became apparent AIDS was not a homosexual disease but one that affected everyone.
Board member Luke Charbonneau said he wanted to ask how worried we should be about monkeypox, but his question had pretty much been answered – this disease is not one that will be “debilitating for society.”
Board gets update on environmental health
Andrew Barton, public health manager, updated the board on environmental health.
This includes food safety, safe recreational water, safe drinking water, rabies and healthy environments.
One point of interest to board members was private drinking water system testing, to be exact, where people can drop off samples.
Barton explained that prior to COVID, the pick-up and drop-off locations were at hospitals. That ended with the pandemic. He said he’s grateful for the grocery stores in Kincardine, Wiarton and Markdale that provided temporary locations – for the past two years.
“Now we’re returning to pre-COVID service,” he said, “but we will not be going back to hospitals.”
There’s an ongoing discussion taking place with municipalities, in the hope of having the same number of locations in similar buildings.
He anticipates the new locations will be up and running my mid-summer or sooner.
Pauline Kerr, Local Journalism Initiative Reporter, The Walkerton Herald Times