Publishing date: Jun 13, 2022  •  47 minutes ago  •  3 minute read  •  15 Comments Test tubes labelled “Monkeypox virus positive and negative” are seen in this illustration taken May 23, 2022. (REUTERS/Dado Ruvic)

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Public health officials have identified the first case of monkeypox in the London region, but say the risk to the broader community remains very low.

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The infected person, identified by a local health-care provider, has no close contacts who require post-exposure treatment for the viral disease or followup by case investigators, the Middlesex-London Health Unit said Monday. The patient, whose age and gender were not released, is doing well, the health unit said. “We have not been able to specifically link this case to another case in Canada. However, we do believe it was travel-associated and not from transmission here in the Middlesex-London region at this time,” medical officer of health Alex Summers said. “Right now, for the vast majority of people here, there is no risk.” The health unit has been sharing information about monkeypox, a viral illness endemic in parts of central and west Africa, with local health-care providers since the first Canadian cases were reported May 19.

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The case came to the health unit’s attention after it asked health-care providers to notify them if a patient showed signs and symptoms of the virus, including fever, headache, lethargy and a distinctive rash, Summers said Monday. Monkeypox is transmitted by direct contact with the bodily fluids or skin lesions of infected people or animals, he said. It can also be spread by contact with contaminated clothing or bedding and, rarely, by prolonged exposure to exhaled droplets from an infected person. While monkeypox’s spread shouldn’t be ignored or underestimated, the west African strain showing up in the U.S., Europe and Canada is much less deadly than the central African variant, said Sameer Elsayed, an infectious diseases doctor and professor of medicine, pathology and laboratory medicine at Western University.

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And on average, monkeypox is nowhere near as contagious as the Omicron strain of the virus that causes COVID-19. “If you have one individual with COVID-19 and you put them in a room with susceptible individuals, that one individual will pass on that infection to 10 people,” Elsayed said. “If you take 10 monkeypox people and put them in a room with susceptible individuals, they’ll only pass the infection along to one person at the most.” After two years of grappling with the COVID pandemic, the public is understandably anxious or hyper-vigilant about emerging viral threats, he said. But it’s not clear monkeypox has the right traits to make it the next pandemic virus. “Within certain populations, or perhaps high-risk exposures, it’s possible to sustain it in a small group,” he said. “But at a population level, it’s unlikely to happen.”

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There is no specific treatment for monkeypox, but antiviral medication used to treat smallpox – and post-exposure vaccination against the disease – can help. The first-generation smallpox vaccine – before the disease was declared eradicated in 1980 – offered about 85 per cent cross-protection for monkeypox, Elsayed said. Depending on monkeypox’s trajectory in North America, a newer smallpox vaccine may be offered to health-care providers dealing directly with monkeypox patients or lab workers as a pre-exposure precaution, he said, but a widespread public vaccination drive seems less likely. “We have to be very careful about . . . funnelling too many health-care resources into something that is not going to pan out into a big public health issue,” Elsayed said. “We have to have a good balance.”

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Over the weekend, public health officials in Toronto ran smallpox vaccine clinics targeting populations at high risk of monkeypox exposure. If a similar need for vaccinations should arise in London, the health unit can mobilize quickly, Summers said. “We would rapidly be able to get those clinics up and running. I’d imagine we would take advantage of our current COVID-19 vaccine operations and infrastructure to provide vaccine either through mobile clinics or . . . mass vaccination sites,” he said. “I don’t know if we’ve ever been in as good of a position to rapidly provide a post-exposure prophylaxis clinic as we are right now.” [email protected] Twitter.com/JenatLFPress

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