Mpox (formerly known as monkeypox) is an infectious disease that is caused by the monkeypox virus. It can cause:

  • a painful rash
  • fever
  • swollen lymph nodes

While most people get better quickly, some people can become very sick.

Although the risk for mpox is low, anyone who has had close physical contact with someone who has mpox or a contaminated surface or is concerned about symptoms they are experiencing should self-isolate and contact a health care provider.

Key facts about mpox

Early symptoms of mpox may include:

  • headache
  • fever
  • chills
  • sweats
  • swollen lymph nodes
  • muscle pain
  • fatigue
  • sore throat

Symptoms that usually appear 1 to 3 days later are:

  • rash or sores on the palms of the hands or on the soles of the feet
  • rash or sores inside the mouth
  • rash or sores on the genitals or inside or around the anus or rectum
  • pain or bleeding from the anus or rectum

In some cases, the rash is the first symptom. Illness from mpox is usually mild and it typically goes away on its own within 2 to 4 weeks. Severe cases are more common among newborns, children, pregnant people and people who are immunocompromised. You can reduce your risk of getting mpox by avoiding close contact with people who have confirmed mpox or people with symptoms that might be due to mpox infection.

How mpox is spread

Mpox can spread from person to person through:

  • direct close contact (skin-to-skin)
  • direct contact with skin lesions, scabs and bodily fluids, particularly through sexual contact
  • respiratory secretions (such as when a person coughs or sneezes)
  • contact with materials that have been contaminated with the virus (such as bedding, linens, towels, lesion dressings, needles, eating utensils, and dishes)

Mpox can also spread from someone who is pregnant to the fetus or from a parent to a child during or after birth.

If you have come in contact with a suspected or confirmed case of mpox

Monitor for signs and symptoms for 21 days from the day you may have been exposed to someone with mpox. Consider wearing a mask (medical mask preferred) when you are in indoors with other people.

Local public health units will work to identify and notify close contacts of a person with mpox and may:

  • advise you to avoid non-essential interactions with people at higher risk of severe mpox illness (including people who are pregnant, immunocompromised, and children under the age of 12 years)
  • advise you to avoid sexual contact with others during the 21-day monitoring period to minimize the risk of onward transmission
  • advise you on whether Imvamune® vaccine may help prevent mpox infection or reduce the risk of severe illness 

What to do if you have symptoms of mpox

If you develop symptoms of mpox, you should contact a health care provider to get advice on testing and medical care. Tell them if you think you have had contact with a person with mpox. You should also follow the recommendations below:

  • Self-isolate at home if possible and avoid close contact with others, until you receive information from your local public health unit about when to end isolation. Stay in a separate room or area away from other people in the home and use a separate bathroom.
  • Wear a medical mask.
  • Cover any rashes or sores as best as possible when you are unable to avoid close contact with other people.
  • People should not visit a person with mpox symptoms unless it is for an essential purpose.
  • People with mpox symptoms should avoid contact with those at higher risk of severe illness including people who are pregnant, immunocompromised, and children under the age of 12 years.
  • Clean your hands and the environment:
    • Clean your hands often with soap and water or an alcohol-based hand sanitizer, including after touching the rash or sores, clothing, or objects and surfaces that may have had contact with the rash or sores
    • Clean and disinfect contaminated surfaces (such as the bathroom, if shared) after use with regular household cleaning products and disinfectants according to the manufacturer’s instructions
    • Discard contaminated items directly into a waste container and avoid touching the outside of the waste container or other surfaces. Hands should be cleaned immediately after handling the waste.
    • Do not share dishes or utensils when eating, however, dishes and utensils can be used by others in the home if these are properly washed between uses either in a dishwasher or in a sink using warm water and soap.
    • Have dedicated clothing, bed linens, and towels that are not shared with others. Handle laundry and linens with care and avoid shaking. Laundry can be cleaned in a washing machine with warm water and detergent.

What to do if you’ve been tested or test positive for mpox

If you have been tested for mpox, self-isolate at home until your test results are known. If your test results are negative, you can stop self-isolating.

If you test positive, continue to self-isolate at home until a staff person from your local public health unit contacts you to provide further information about mpox, including how to prevent spreading mpox to others and when you can end your self-isolation.

If you need to seek medical care:

  • call a health care provider ahead of time to inform them of your health status, that you are being tested for mpox, and about any contact you had with a person with suspected or confirmed mpox
  • wear a medical mask when seeking medical care

Vaccination for mpox

Ontario provides the Imvamune® vaccine for protection against mpox. Imvamune® should be given as a two-dose series, 28 days apart. Imvamune® is not a treatment for mpox and must be given before you have symptoms of mpox.

Imvamune® should be considered for the following:

  • Pre-exposure vaccination — when Imvamune® is administered before known exposure to the virus
  • Post-exposure vaccination — when Imvamune® is administered for individuals who have had a high-risk exposure to a probable or confirmed case of mpox, or within a setting where transmission is happening

Individuals who are eligible to get Imvamune® for pre-exposure vaccination

  • two-spirit, non-binary, transgender, cisgender, intersex, or gender-queer individuals who self-identify or have sexual partners who self-identify as belonging to the gay, bisexual, pansexual and other men who have sex with men (gbMSM) community and at least one of the following:
    • had a confirmed sexually transmitted infection (STI) within the last year
    • have or are planning to have 2 or more sexual partners or are in a relationship where at least one of the partners may have other sexual partners
    • have attended venues for sexual contact (such as bathhouses, sex clubs) recently or may be planning to, or who work or volunteer in these settings
    • have had anonymous sex (such as using hookup apps) or may be planning to or are a sexual contact of an individual who engages in sex work
  • individuals who self-identify as engaging in sex work or are planning to, regardless of self-identified sex or gender

Household and/or sexual contacts of those identified for pre-exposure vaccination eligibility in parts A and B above and who are moderately to severely immunocompromised or pregnant.

Individuals who are eligible to get Imvamune® for post-exposure vaccination

Imvamune® given for post-exposure vaccination requires an assessment of the risk of exposure by the public health unit. The first dose should be offered ideally within 4 days (up to 14 days) from the date of the last exposure to individuals who are a high-risk contact of a confirmed or probable case of mpox. The second dose should be offered at least 28 days after the first dose. Anyone who self-identifies as a high-risk contact of a confirmed or probable case of mpox should contact their local public health unit for further assessment to see if post-exposure vaccination would be recommended.

If you have previously received a vaccine against smallpox, this will give you some protection, but you will still need to receive 1 dose of Imvamune®. Individuals should ensure to receive both doses of Imvamune® to be best protected. Booster doses are not recommended at this time.

Research laboratory employees

Research laboratory employees working directly with replicating orthopoxviruses are eligible to receive two doses of Imvamune®, 28 days apart as post-exposure vaccination or pre-exposure vaccination if there is an ongoing risk of exposure.

Treatment for mpox

Symptoms usually go away on their own without the need for any treatment. In rare situations for individuals who are exceptionally high risk or suffering from severe disease, your healthcare provider may recommend a medication for mpox.

You can manage your symptoms by:

  • letting the rash dry or covering the rash with a moist dressing to protect the area, if needed
  • avoiding touching any sores in the mouth or eyes and if needed, mouth rinse or eye drops can be used (but products containing cortisone should be avoided)

For individuals who are severely ill due to mpox, there is an antiviral medication, Tecovirmat (TPoxx®), that prevents the virus’ ability to multiply and therefore slows down its spread throughout the body. This allows your body to build up its defences to fight off the infection. There is a very limited supply of TPoxx® is available in Ontario and it is currently only being used to treat individuals who are severely ill/disabled due to mpox infection or at high risk for severe disease. If you think you have symptoms of mpox, contact your health care provide who will help determine what is best for you.

Caring for someone with mpox or with symptoms that may be due to mpox infection

If you need to provide care to someone with mpox symptoms or confirmed to have mpox, you should:

  • encourage the person to cover their rash and sores as best as they can (for example, wearing a long sleeve shirt and long pants)
  • wear a medical mask and encourage the person to wear a medical mask when you are physically close to them
  • avoid skin-to-skin contact
  • if you provide care that may involve touching the rash and sores, wear a medical mask and use disposable gloves (these should be disposed of after you use them once)
  • perform hand hygiene regularly, including after touching the rash or sores, before putting on and after removing gloves, or after handling clothing, linens, or environmental surfaces that may have come into contact with fluid from lesions
  • not shake soiled laundry in a way that could disperse infectious particles
  • wash laundry in a standard washing machine with warm water and detergent is acceptable

Mpox in animals

Some animals can become infected with mpox, including:

  • rodents (such as rats, mice, hamsters, gerbils, squirrels, chipmunks)
  • rabbits
  • hedgehogs
  • opossums
  • non-human primates (such as monkeys)

Mpox has been reported in a dog that had close contact with its infected owners. As such, precautions should be taken to prevent exposure of the virus to domestic and wild animals.

Pets in your home

As the risk of infection in different animal species is unclear, it is best to find someone else to take care of your pet until you are no longer infectious.

Precautions to help reduce the risk of mpox transmission to your pets or to other people via your pets:

  • avoid close or prolonged contact with pets (such as touching, snuggling, kissing animals or having animals sleep in your bed) and their belongings
  • individuals with underlying health conditions and children under the age of 5 should avoid being caregivers to exposed or infected animals
  • while infectious, keep your pets in the home, if possible. For dogs that need to go outside periodically, keep them on leash and avoid contact with other people and animals
  • while infectious, wear a well-fitting medical mask and gloves, cover all skin rashes or sores with clothing or bandages and perform hygiene measures as recommended to reduce the risk of transmission to other people, when interacting with animals, their food and supplies

If you have any questions about the health or care of your animals when you are exposed or infected with mpox, please contact your veterinarian.

If your pet becomes sick while you have mpox

Seek care from a veterinary telemedicine service, to assess if the animal’s condition can be managed at home.

If your animal must be examined directly by a veterinarian or requires other procedures that cannot be reasonably delayed until your own infection is resolved, your veterinarian should be advised that your pet may have been exposed to mpox.

If you own or work with livestock or poultry and think you may have been exposed to mpox

As a precaution, any person who has, or may have been exposed to, mpox should not work with livestock or poultry until they are advised by their healthcare provider that they are no longer able to pass on the virus.

Animal owners are responsible for providing basic care for their animals including food, water and shelter. Livestock and poultry producers should always have a plan in place for others to provide care for their animals in case of emergencies, including the need to self-isolate due to illness or to avoid contact with animals if exposed.

Ministry of Health resources for the public

Document TitleDescription
Mpox Vaccine Information SheetInformation for patients and the public about the vaccine for mpox
Mpox Antiviral Information SheetInformation for patients and the public about treatment for mpox

Additional resources