A monkey pox vaccination clinic in Montreal on June 6.CHRISTINNE MUSCHI/Reuters
Once the epicenter of Canada’s monkeypox outbreak, Montreal has nearly eradicated the virus from its territory, according to the city’s doctors, but they warn it is too soon to declare victory.
Tourists and other visitors can still import cases, they say, adding that it is not yet clear how long the vaccine will remain effective.
Doctors and members of the city’s LGBTQ community credit the rapid launch of a vaccination campaign and collaboration between public health officials and community organizations for the success in controlling the disease.
Dr. Genevieve Bergeron, head of health emergencies and infectious diseases at Montreal’s public health department, said she is “cautiously optimistic.”
“We’ve definitely seen a big decline in the last few weeks,” he said in a recent interview. “At this time, the last cases we have started their disease at the end of September.”
Dr. Rejean Thomas, president of a Montreal-area clinic that specializes in sexually transmitted and blood-borne infections, said that early in the outbreak, his clinic, Actuel, was seeing almost a dozen people a day who thought he had the disease.
Now, he said in a recent interview, “we hardly see any more cases; it has completely decreased, almost eradicated”.
In all, his clinic treated 125 people with smallpox, more than a quarter of all cases in Montreal since the city’s first case was detected on May 12.
But Thomas said it’s still unclear what the future holds; said he recently saw a patient with monkeypox who had been vaccinated in July. “So that’s the big question: How effective will the vaccine be, for how long.”
Bergeron said there are ongoing studies on how long protection is provided by Imvamune, a smallpox vaccine that was approved for use against the related monkeypox virus. The vaccine is offered to anyone who thinks they may have been exposed to the virus, as well as to those whose sexual contacts may put them at greater risk of contracting the disease.
Public health officials are now encouraging people who received an initial dose of monkeypox vaccine to get a second shot, he said. “We know that one dose gives good protection, a second dose gives even better protection.”
About 30,000 people have received a dose of the monkeypox vaccine in Quebec. Last week, the province’s director of public health, Dr. Luc Boileau, said about 6,000 had received a second.
“The situation is going well,” Boileau told reporters, adding that one case had been detected in the province in the past two weeks.
But Quebec isn’t the only place where cases of monkeypox are declining. In Ontario, where the trajectory of the disease has followed a similar pattern, the province’s chief medical officer of health said in mid-October that he was “actively looking” at declaring the outbreak over.
The World Health Organization says the number of new cases of monkeypox in several countries, including Canada, the United Kingdom and Italy, fell by more than 50 percent in the last week of October compared to with the previous week. Several other countries, including France and the United States, have seen smaller declines, but the number of new cases continues to rise in other parts of Europe and parts of Central and South America.
Bergeron said it’s unclear what’s driving the decline, but said vaccination and seasonality could play a role.
“We’ve seen generally in Montreal a lower number of cases compared to other countries and other jurisdictions, so I think the vaccination campaign helped,” he said.
Bergeron said public health officials knew there was a high risk of stigmatizing people and worked closely with the community to design the message around vaccination. If people were worried about being judged or stigmatized to protect themselves, that would be counterproductive, he said.
Christian Tanguay, the executive director of Montreal’s LGBTQ+ Community Centre, said that while the experience at the vaccination clinic felt like a flu shot, he was concerned that people were not getting vaccinated because they feared being stigmatized for having multiple partners.
He said seeing three people he knows contract the virus motivated him to quickly get vaccinated and encourage others to do the same.
Tanguay said the outbreak caused real fear and came at a difficult time, when life was returning to normal after the COVID-19 pandemic and people wanted to be around each other again.
Alexandre Dumont Blais, executive director of REZO, an organization that promotes sexual health among gay, bisexual and other men who have sex with men, said he believes people in the LGBTQ community trust that the outbreak is largely behind them, and added that the number of questions his group asks about the disease has decreased significantly.
“We feel a lot better than we did a couple of months ago,” he said in a recent interview.