Ontario isn’t seeing a rapid increase in monkeypox cases and its vaccination strategy appears to be working, says the province’s top doctor.
The Chief Medical Officer of Health Dr.  Kieran Moore said monkeypox will likely be around for “many, many months” because of the long incubation period of up to 21 days, but Ontario is not seeing exponential growth of the virus.
“Right now the number (of cases) is not escalating rapidly, but it is increasing,” Moore said in a recent interview.  “We think it’s stabilizing in Ontario, in terms of not rapid growth.”
Moore said 133 cases had been identified in Ontario as of July 6, with the vast majority in Toronto and most others with a connection to the city.  Ontario Public Health had reported 33 cases two weeks earlier.
All cases reported since July 6 have been in men between the ages of 20 and 65.
Monkeypox generally does not spread easily between humans and is transmitted through prolonged close contact via respiratory droplets, direct contact with skin lesions or body fluids, or through contaminated clothing or bedding.  Symptoms may include rash, oral and genital lesions, swollen lymph nodes, headache, fever, chills, myalgia and fatigue.
Public health says most cases are among men who report close contact with men, but says anyone can get monkeypox.
Monkeypox disease comes from the same family of viruses that cause smallpox, which the World Health Organization declared to have been eradicated worldwide in 1980. Smallpox vaccines have been shown to be effective in fighting monkeypox. .
Moore said the province is working “diligently” to vaccinate those who have contracted the virus, as well as close contacts or anyone at risk of contact.
“More than 8,000 people have been given the smallpox vaccine, which we believe has good protection against monkeypox,” he said.
“We were also able to provide treatments, so five Ontarians were treated with a drug called TPoxx, (which is for those) who had severe complications associated with monkeypox.”
The province is not looking to expand its vaccination strategy at this time, Moore said, adding that it “seems to be working.”
“Normally this vaccine dose has two doses 28 days apart,” Moore said.  “We are looking at whether we should go back to those 8,000 people and provide a second dose.”
Dr.  Allison McGreer, an infectious disease specialist at Mount Sinai Hospital in Toronto, said the increase in cases in the province is “not cause for alarm” but the situation is still “relatively fragile.”
“We don’t know what it will take to get the epidemic under control,” McGreer said.  “We’re not absolutely sure that the virus hasn’t changed enough to allow for some more sustained transmission in populations.”
McGreer said there is no immediate danger to most of the population from monkeypox.
“This is really still very much an intervention for the populations where we have defined risk, and they’re really watching closely to see if there’s been any spread outside of those high-risk populations,” McGreer said.
The province’s current vaccination strategy is “the best that can be done right now with the limited supplies we have,” he said.
“The fine line that all jurisdictions are trying to walk is to make sure that people who are at significant risk of monkeypox have access to the vaccine,” McGreer said.
“And that the rest of us who are not, right now, at significant risk of monkeypox, are not depleting the limited supplies we have, and are not potentially exposed to some tiny risk that we just don’t know about yet.”