MONTREAL — Montreal’s monkeypox cases appear to be reaching a plateau, but officials say they’re worried that soaring infections in the United States and low vaccination rates could help the disease rise again in the city. dr
MONTREAL — Montreal’s monkeypox cases appear to be reaching a plateau, but officials say they’re worried that soaring infections in the United States and low vaccination rates could help the disease rise again in the city.
Dr. Genevieve Bergeron of Montreal Public Health says that while the situation in the city has stabilized in recent weeks, she fears that the busy travel and tourism season could compromise efforts to contain the disease.
“We are concerned that we may see an increase in the coming weeks because of the travel and how connected we are to different countries, so we are quite vigilant with the pattern of progress that we are seeing right now,” she said Monday in an interview.
Last month, public health officials described Montreal as the epicenter of the monkeypox epidemic in North America and expanded vaccination against the disease to all men who have sex with men.
Bergeron said the early initiation of vaccination has been helpful in efforts to control the disease, but the city “still has a lot of work to do” when it comes to promoting vaccination.
She said only between a third and half of those eligible to be vaccinated have received the vaccine. Demand for the vaccine has slowed somewhat, she said, although there has been an uptick since the World Health Organization declared the disease a global emergency on Saturday.
The provincial government described the province’s monkeypox outbreak as “relatively contained,” with 331 cases as of last week and no hospitalizations. Over 13,000 people have been vaccinated.
In contrast, the Public Health Agency of Canada says cases across the country have continued to rise to a total of 681. “Since July 1, we have seen a doubling of cases, the first case in a woman and the first cases in Saskatchewan,” it wrote the agency on Saturday.
Bergeron said the city is working with various levels of government and with community organizations to raise awareness about monkeypox and encourage vaccination. This includes pop-up notifications sent through dating apps, mobile vaccination clinics and enlisting the support of influencers, including a popular drag queen, to raise awareness.
Dr. Michael Liebman, an infectious and tropical disease specialist at McGill University Health Center, said his impression was that the number of monkeypox in the city “is under control and maybe turning around.”
For now, he says, the disease is mainly transmitted among a small subset of the population — men who report having intimate contact with men — making it manageable as long as health officials act quickly. But he notes that anyone can get monkeypox, which is spread through prolonged close contact through respiratory droplets, direct contact with skin lesions or body fluids, or through contaminated clothing or bedding.
If it is not brought under control, “it will inevitably go to other sexually active communities and eventually to households if we fail to control it,” he said.
Dr. Réjean Thomas, who works at l’Actuel medical clinic in Montreal, said he was “very surprised” by the number of sexually active patients who were not vaccinated. He believes that public health messages may need to be strengthened to better reflect the seriousness of the situation without being alarmist.
He believes that some people may have been unwittingly misled into believing that the disease is “benign” just because it is rarely fatal.
“But the cases we see are quite serious: large ulcers in the mouth, tongue, chin, genitals,” he said. People are suffering a lot.
A study published last week in the New England Journal of Medicine, which analyzed more than 500 cases in 16 countries, found that 98 percent of those infected were gay or bisexual, 75 percent were white and 41 percent had a previous HIV diagnosis. However, the study notes that while the current outbreak disproportionately affects men who have sex with men, monkeypox can affect anyone, and heterosexual transmission has also been reported.
Spread to other populations is “expected,” the study added.
Bergeron said the vaccine is available in Montreal for people who have had direct contact with someone who has monkeypox, or with potentially contaminated items or bedding. It is also available to men and members of the gay, bisexual and trans communities who have sex with at least one male partner in Montreal other than a regular partner.
This report by The Canadian Press was first published on July 26, 2022.
— With files from Frédéric Lacroix-Couture
Morgan Lowry, The Canadian Press
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