Quebec will start vaccinating some people with a smallpox vaccine, in order to combat the spread of monkeypox in the Montreal area.
Quebec's public health director Dr. Luc Boileau said Thursday that 25 cases of monkeypox have now been confirmed in the province. Fourteen of them are in the city of Montreal, though all cases are tied to the greater Montreal area.
About 20 to 30 more cases are also under investigation, Boileau said.
Boileau underlined that the spread of monkeypox was "a serious situation," but said it is not sweeping through the population like COVID-19, for example.
"We aren't expecting a rapid, huge number of cases," he explained. "That's why we think it can be eradicated."
To that end, Boileau said that the smallpox vaccine — which hasn't been routinely offered in Canada for decades — will be offered to those at high risk of contracting the disease, such as those who have been in contact with confirmed cases.
Boileau said the province has access to hundreds of doses at the ready, but vaccination will only occur after a recommendation from public health. It will not be open to the general public.
Dr. Caroline Quach, chair of Quebec's immunization committee, told the news conference that the vaccine —_ which was approved in 2020 for the prevention of smallpox and other orthopox viruses — has been shown to prevent monkeypox in animal studies.
The vaccine, she said, will ideally be administered within four days of an exposure but could be administered up to two weeks after.
"Data have shown that if you give it within four days, you have a very good effectiveness in preventing the illness,'' Quach said. "If you administer it between Day 5 and 14, it might not prevent disease, but it might modify the evolution.''
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Currently, the "vast majority" of cases are adult men who have had sexual relations with men, Boileau said. There is one case affecting a minor, Boileau specified, who has been to school since exposure. By Friday, however, health officials said testing showed the minor did not have monkeypox.
But the virus needs close and prolonged contact to spread, Quach said, "so it's not like an entire classroom would suddenly be affected," like it would with more transmissible diseases like the coronavirus.
Boileau specified the government is "not in a community alert situation" when it comes to monkeypox.
Montreal's medical officer responsible for health emergencies and infectious diseases, Dr. Geneviève Bergeron, added that contact tracing and isolation are also being used to prevent the spread.
Dr. Sébastien Poulin, an infectious disease specialist at the Saint-Jérôme Hospital, near Montreal, said he thinks it makes sense for the vaccination campaign to target close contacts.
"I believe it's reasonable because we can't forget that at present, there haven't been any severe cases; there haven't been any deaths,'' he said in an interview Thursday. While the disease can be uncomfortable, Poulin said, "we're not talking about human smallpox; we're not talking about a deadly virus.''
Poulin, who practises at clinics in Montreal and Saint-Jérôme, said during past outbreaks of monkeypox in central and west Africa, patients had flu-like symptoms before developing a rash.
While some cases that have been reported during the current outbreak in the Montreal area and the United Kingdom have involved flu-like symptoms coupled with painful lesions on the penis, anus or mouth, other patients have had few symptoms, he said.
One of Poulin's patients, he said, had no symptoms other than a single lesion on his penis that was not painful and a somewhat painful swelling of one lymph node. Those "atypical'' symptoms could lead to further transmission, he said, as people may not realize they have the virus.