Monkeypox Cases Level Off in Montreal, But Rise in US

Monkeypox cases in Montreal appear to be reaching a plateau, but officials say they are concerned that rising infections in the United States and a low vaccination rate could help the disease resurface in the U.S. city.

Montreal Public Health Dr. Geneviève Bergeron says that while the situation in the city has stabilized in recent weeks, she fears the busy tourist and travel season could compromise efforts to contain the disease.

“We are concerned that we may see an increase in the coming weeks due to travel and how connected we are with different countries, so we are very attentive to the pattern of progress that we see at this time,” he said in an interview Monday.

Last month, public health officials described Montreal as the epicenter of the monkeypox outbreak in North America and expanded vaccination against the disease to all men who have sex with men.

Bergeron said starting vaccination early was 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 a third to half of those eligible to be vaccinated have received a shot. 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 has described the province’s monkeypox outbreak as “relatively contained,” with 331 cases as of last week and no hospitalizations. More than 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 also seen a doubling of cases to date, the first case in a woman and the first cases in Saskatchewan,” the agency wrote on Saturday.

Bergeron said the city is working with different levels of government and community organizations to raise awareness of monkeypox and promote vaccination. That includes push notifications sent through dating apps, mobile vaccine clinics, and enlisting the support of influencers, including a popular drag queen, to raise awareness.

Dr. Michael Libman, an infectious and tropical disease specialist at the McGill University Health Center, said his impression is that monkeypox numbers in the city “are under control and maybe reversing.”

Montreal monkeypox cases are leveling off, but officials are concerned about increases elsewhere. #Montreal #Viuela del mono

He says that, for now, the disease is spread primarily among a small segment of the population — men who report having intimate contact with men — making it controllable as long as health officials act quickly. But he points out that anyone can get monkeypox, which is spread through prolonged close contact via respiratory droplets, direct contact with broken skin or bodily fluids, or through contaminated clothing or bedding.

If left unchecked, “it will inevitably find its way into other sexually active communities and eventually into homes if we don’t get it under control,” he said.

Dr. Réjean Thomas, who works at the l’Actuel medical clinic in Montreal, said he is “very surprised” by the number of sexually active patients who are not vaccinated. He believes 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 inadvertently led to believe 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 that 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 diagnosis. previous HIV. However, the study noted 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 “anticipated,” 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 objects 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 single regular partner.

This report from The Canadian Press was first published on July 26, 2022.

— With archives of Frédéric Lacroix-Couture

Leave a Comment