What happens if I get monkeypox? What are the symptoms? Your questions answered

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Amid growing concern about the spread of monkeypox infections, experts around the world are working to monitor the chains of transmission and try to stem the unusual outbreak.

As of July 27, the World Health Organization (WHO) says more than 18,000 cases of monkeypox have been reported globally from 78 countries, most in Europe.

Canada has 745 confirmed cases of monkeypox as of July 27, the vast majority of which are in Quebec and Ontario.

The WHO declared the monkeypox outbreak a global health emergency on July 23 — its highest level of alert. However, the designation does not necessarily mean a disease is particularly transmissible or lethal.

Due to the unexpected nature of the current outbreak, there are still many unknowns about the disease, including exactly how it's spreading and whether the suspension of mass smallpox immunization decades ago may somehow be speeding its transmission.

CTVNews.ca asked experts some of our readers' most commonly asked questions, to help separate facts from fiction when it comes to monkeypox.

WHO CAN GET MONKEYPOX? WHO CAN GET VACCINATED?

Anyone can contract or spread monkeypox.

However, the WHO says as of July 27, 98 per cent of cases — outside of countries in Africa, where the virus is endemic — have been reported in gay, bisexual, and other men who have sex with men.

In Canada, fewer than one per cent of confirmed cases in Canada are in females or people under 20, Chief Public Health Officer Dr. Theresa Tam said in a press briefing on July 27.

Health officials have recommended vaccinations for high-risk groups, including health-care workers, and men who have sex with men and have recently had multiple sexual partners. It can take several weeks after receiving a second dose of a vaccine to be fully protected. Canada currently is only offering first doses.

HOW DO HUMANS GET MONKEYPOX? CAN I GET IT FROM SURFACES?

Monkeypox often presents as a flu-like infection with a rash and spreads through close personal contact with those who have a symptomatic case.

The Public Health Agency of Canada says the virus may also spread through respiratory particles from talking, breathing, coughing or sneezing during close contact, but more information is being gathered to confirm this.

The virus can also be transmitted through skin-to-skin contact, as well as contact with infected material and surfaces. Transmission from an animal can happen through bites or scratches, contact with an animal's blood or body fluids.

Dr. Stephen Hoption Cann, a clinical professor at the University of British Columbia, noted monkeypox is "not an easily transmitted disease like COVID-19" and requires prolonged contact with an infected person or their material for transmission.

"If you were caring for an individual who had the illness, where the virus would be on their skin, clothing and bedding — in that situation it could be passed on by direct contact," he said.

If cases were to become more widespread in Canada, Toronto-based emergency physician Dr. Kashif Pirzada told CTVNews.ca in a telephone interview on June 1 that health officials may have to re-emphasize surface cleaning to help mitigate public risk, similar to the approach at the outset of the COVID-19 pandemic.

The WHO has said it does not expect the hundreds of cases reported to date to turn into another pandemic, but acknowledged there are still many unknowns about the disease, including method of transmission.

WHAT HAPPENS IF YOU GET MONKEYPOX? WHAT ARE THE SYMPTOMS?

Monkeypox symptoms are similar to those for the smallpox, but generally milder. The first signs are fever, headache, muscle aches, backaches, chills and exhaustion.

Tam said during a media briefing on July 27 that the inclubation period for monkeypox can range between seven and nine days, and potentially up to 21.

A rash usually begins on the face and spreads to other parts of the body, developing into distinct, raised bumps that then fill with fluid or pus.

DO THE LESIONS FROM MONKEYPOX LEAVE SCARS?

Hoption Cann noted it is possible scars can result from the lesions left by monkeypox, especially if they are picked at or have fluid inside them.

"The younger you are, the more likely your skin will heal without leaving a scar. For those with darker skin, the scabs may fall off leaving areas of hypopigmentation," he said.

However, Pirzada said the lesions may appear "very subtle" for some and warned to keep an eye out for even the smallest changes on one's skin. He said the lesions can also be painful for some patients.

"It may not be all over the body, it may only be in a few spots here and there," he said.

IF I HAD THE SMALLPOX VACCINE AS A KID, AM I PROTECTED AGAINST MONKEYPOX? WHAT ABOUT CHICKENPOX?

First discovered in 1958, monkeypox is a rare disease that comes from the orthopoxvirus genus of viruses that belongs to the same family as the one that causes smallpox.

Despite the similar-sounding name, Hoption Cann says chickenpox is a type of herpes virus not related to monkeypox.

"If you had chickenpox or the chickenpox vaccine, you are not protected against monkeypox," he told CTVNews.ca via email on May 31.

There is no proven treatment for the virus infection, but since they are related, the smallpox vaccine is known to also protect against monkeypox, with a greater than 85 per cent efficacy. But because the smallpox vaccine eradicated the disease, routine smallpox immunization for the general population ended in Canada in 1972.

Hoption Cann said this means that any Canadian who was vaccinated against smallpox was inoculated more than 50 years ago.

"It is likely that, after 50 or more years, that vaccination may not offer too much protection against this disease," he said.

HOW CAN PEOPLE PROTECT THEMSELVES?

WHO Director-General Dr. Tedros Adhanom Ghebreyesus is urging members of at-risk groups to consider reducing their number of new sexual partners and sharing contact details with any new partners.

"This is an outbreak that can be stopped... The best way to do that is to reduce the risk of exposure," Tedros told a news conference from Geneva on July 27. "That means making safe choices for yourself and others."

Tam said on July 27 that Canadian health authorities recommend practising safer sex, having fewer sexual partners and staying home when sick.

With files from CTV News, The Canadian Press and Reuters

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