Mpox is now a global public health emergency. Do I need to worry?

The declaration of mpox as a public health emergency of international concern following years of precautions against COVID-19 has many people worried. 

Here are some answers from Canadian infectious disease specialists and public health authorities on what this all means. 

On Aug. 14, Dr. Tedros Adhanom Ghebreyesus, the director general of the World Health Organization, made the declaration. He said a coordinated international response is essential to stop the outbreak in Congo, and to save lives, after the mpox virus surged across several African countries.

For governments around the world, the declaration represents a rallying cry to better monitor and respond to the threat by preventing, diagnosing and treating the infection.

But an individual's risk of contracting mpox, which causes painful rashes, varies. People with mpox can also experience fever, enlarged lymph nodes, muscle aches, headaches, and respiratory symptoms. 

Mpox is caused by a virus in the same family as smallpox, a virus that was declared eradicated in 1980. 

Am I at risk of getting mpox?

Dr. Lynora Saxinger, an infectious diseases physician at the University of Alberta, said so far a lot of the spread of mpox has been through close physical contact, skin to skin, including through sexual activities. 

"This wouldn't be something like walking past someone on the subway," Saxinger said.

How is the virus transmitted?

When an infected person has a lot of skin lesions, enough of the virus can get on bed sheets and pillows that someone changing the linens could be at risk.

That's why wearing gloves is recommended when changing the bed of someone who has an active infection of mpox, said Dr. Isaac Bogoch, an infectious diseases specialist based at Toronto General Hospital.

"With no moralization and no stigmatization ... the epidemiology of mpox in Canada is largely, almost exclusively in the men who have sex with men community," Bogoch said. "Really, it's among men who have sex with men who are having multiple sexual partners."

Sex workers are also at risk for the infection, according to local public health units across Canada.

"In some of the sexual cases, there might be a lag even up to three weeks before the symptoms become apparent," Saxinger said.

It's important to identify the communities at risk for a meaningful and effective public health response and to gear communication and vaccinations to them, Bogoch said.

Experts advise avoiding close physical contact with someone who has lesions resembling mpox, not sharing their utensils, clothing or bedsheets and maintaining good hygiene like regular hand-washing.

WATCH | African health officials call for 10 million mpox vaccine doses: 

Canada must step up to ensure mpox ‘vaccine equity,’ doctor says

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Before the World Health Organization earlier this week declared mpox a public health emergency of international concern for the second time, African health officials called for 10 million vaccine doses to help the crisis. Dr. Joanne Liu, the director of the Pandemic Emergency Readiness Lab at McGill University, says Canada can play a crucial role, as there are more vaccines in the country than people.

Based on the COVID-19 pandemic, Saxinger said people may worry about respiratory transmission, which hasn't been flagged as a major route for mpox.

"On the other hand, it is also known that the virus can be found in saliva and respiratory secretions, and so it's not impossible. It just is much, much less likely."

What does close contact mean?

Bogoch said for mpox, close contact usually refers to people who not only live under the same roof as somebody infected, but who have very close contact with the individual for prolonged periods of time.

Saxinger said that includes skin-to-skin contact of mucosa, which are found in areas including the genitals and mouth.

It also includes direct handling of an infected animal.

Do I need to get vaccinated?

Currently in Canada, vaccines are offered to people who have risk factors for infection, namely men who have sex with men who have multiple sexual contacts and sex workers.

In general, for people who fall outside of those risk categories, there's no reason to be vaccinated, Bogoch advised.

Vaccination of household contacts is another way to limit spread, Saxinger added.

Will this trigger another pandemic?

In infectious disease circles, a pandemic is the widespread occurrence of an infectious disease over a whole country or the world at a particular time.

Saxinger said people now link the term with the notion of high risk across the population at large with very high rates of transmission.

"I think the actual risk of it ever reaching the kind of point that we reached with the COVID-19 pandemic is extremely unlikely," she said.

Scientists say the risk to the general population in countries without ongoing mpox outbreaks is low.