Ontario’s chief public health official has issued an order to health care providers requiring them to report any possible or suspected cases of monkeypox to local authorities.

In a copy of the order, which was issued under section 77.6 of the Health Protection and Promotion Act, it states that health care providers must provide Public Health Ontario with information about any patient who meets the “definitions cases” of monkeypox.

The information will be used for research purposes, as well as to carry out case and contact management.

The Ministry of Health confirmed to CTV News Toronto that the order was issued on May 20, a day before the first suspected case was identified in Ontario.

On Saturday, Toronto Public Health (TPH) said an infection was suspected in a man in his 40s who had recently been in contact with a person who had traveled to Montreal.

The man is in stable condition and recovering at the hospital, authorities said. Anyone who attended the Axis Club (located at 722 College Street) on May 14 or Woody’s Bar (located at 467 Church Street) on May 13 or 14 may have been exposed and is asked to self-monitor to detect symptoms.

Speaking to CP24 the next day, TPH Associate Medical Director for Health Dr. Rita Shahin said that monkeypox usually starts with a fever and a general feeling of being unwell – the lymph nodes may be swollen and the patient may experience muscle pains.

“A couple of days later it can progress to a rash that starts on the face first. The lesions look a bit like chickenpox. They start with small red bumps and then fill with a clear fluid and then the rash will spread to the rest of the body.”

At the same time, Shahin said monkeypox is not easily spread and usually requires prolonged face-to-face or skin-to-skin contact with lesions.

“The risk is really low. It doesn’t spread easily like COVID, which is reassuring, but we ask anyone who has been exposed to keep an eye out for any unusual injuries he may have.”

Anyone with symptoms is asked to seek medical attention.


According to the section 77.6 order, a suspected case of monkeypox is defined as a new rash and at least one other acute sign or symptom of the disease. It also means that an alternative diagnosis cannot fully explain the patient’s ailments.

A “probable case” is defined as a patient who meets the definition of a suspected case but also has a high-risk exposure to a probable or confirmed human case of monkeypox, has a history of travel to a region with a confirmed case or has a “relevant zoonotic exposure”.

A case is confirmed when a laboratory test is performed and monkeypox virus DNA is detected.

The incubation period can range from 5 to 21 days, officials say.

An internal memo sent to health care providers and public health units along with the order, obtained by CTV News, the chief medical officer of health asks doctors to consider monkeypox as a diagnosis “in persons presenting with signs and symptoms that may be compatible, especially with those with a history of travel to affected countries or other risk factors.

“Please do not limit concerns or suspicions about the diagnosis to men who report having sex with men, as anyone who has close personal contact with a person infected with monkeypox virus could be at risk. of contracting the disease,” Moore wrote. “I urge all health care providers to be vigilant for patients presenting with symptoms consistent with monkeypox virus infection, especially if they have traveled or been in contact with a known case.”

The memo also says that close contacts of patients with suspected or confirmed monkeypox should self-monitor for symptoms for 21 days after exposure. If symptoms begin to occur, those individuals should seek care, get tested, and isolate.

The World Health Organization has confirmed 92 cases of monkeypox worldwide, along with up to 28 suspected cases, including up to 25 across Canada.


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