Mpox risk remains low in B.C. as concerns rise globally
World Health Organization (WHO) names mpox a global health emergency for 2nd time as virus surges in Africa
As concerns grow over a more contagious and deadlier strain of mpox, formerly known as monkeypox, public health officials say the risk to British Columbians remains low.
Last week, the World Health Organization (WHO) classified the mpox virus, which is surging across parts of Africa, as a "public health emergency of international concern."
Known for causing painful, pus-filled lesions and, in some cases, severe illness or death, mpox first exploded globally in 2022, prompting the WHO's first international emergency declaration, which lasted 10 months until mid-2023.
In a statement to CBC, the B.C. Centre for Disease Control (BCCDC) said the 2022 outbreak was caused by the spread of a variant known as clade II that spread through sexual networks, largely impacting gay and bisexual men.
The centre says that form of the virus is still circulating throughout much of the world, including B.C. The province recorded its first case of the 2022 outbreak in June of that year and has since confirmed 225 cases, with 21 this year as of July.
Kiffer Card, an assistant professor of health sciences at SFU, says while mpox is a "painful" and "unpleasant" condition, the fatality rate among those infected is low.
"About one per cent of people who acquire mpox, you know, are likely to die," he said.
According to the SFU epidemiologist, mpox, unlike respiratory disease, is transmitted through direct contact and sexual intercourse, which is why outbreaks have typically been confined to closely linked sexual networks and environments where physical contact is extended, such as nightclubs.
"So it's unlikely to mirror exactly what we saw with COVID," he said. "It can largely be handled by controlling physical contact."
A more deadly variant
However, an evolving new lineage of the mpox virus, known as clade I, has been recorded in several African countries, showing that some of these characteristics are changing.
Card says the strain is more deadly, with mortality rates of between three and five per cent.
More than 15,000 mpox cases and nearly 500 deaths have been identified on the African continent so far this year, representing a 160 per cent increase from the same period in 2023.
"The more virulent nature of this strain is a cause for public health concerns," Card added. "Now, with this new strain, the sexual contact isn't really required."
Just a day after the WHO's warning, Swedish health officials announced a patient who had recently travelled to Africa was recently diagnosed with a form of mpox originating in the Congo — the first known case ever recorded outside the African continent.
But while the latest outbreak has understandably sparked concern, Card says the WHO's global health emergency announcement should cause caution and not raise panic.
He says the announcement is largely to "mobilize resources" in prioritizing the availability of vaccines in Africa to bring viral transmission under control.
The BCCDC says there have been no cases in the province of the more serious type of the mpox virus.
While higher-income countries, Canada included, stamped out high case counts of clade II through vaccination programs, Africa hasn't had the same resources.
"Fortunately, we do have a vaccine," said Card. "The vaccine does significantly lower the severity of illness."
A supply of vaccine that protects against mpox has been provided to B.C. by the federal government. Since June 2022, vaccinations have been offered to at-risk populations, including gay and bisexual men.
The BCCDC says it strongly recommends people who are eligible to get two doses of the Imvavune mpox vaccine, adding that most cases in the province have been among people who are unvaccinated or under-vaccinated.
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With files from Anaïs Elboujdaïni and Lauren Pelley