Doctors warn cases of new mpox strain likely inevitable in Alberta

Alberta infectious disease experts say vigilance is key as concerns grow, internationally, about mpox.

A surge of cases in Africa prompted the World Health Organization to declare a public health emergency of international concern last month.

The upswing was sparked by a new strain of mpox, known as clade Ib.

No cases of the latest strain have been identified in Alberta, or across the country, according to Alberta Health Services (AHS) and the Pubic Health Agency of Canada (PHAC).

But Dr. John Gill, a Calgary-based infectious diseases specialist, said it's only a matter of time.

"Inevitably, viruses get around. They travel. And we will see it," said Gill, a professor at the University of Calgary.

"It's more easily transmitted with a higher fatality rate. And that's why everyone has woken up — [asking] what can we do, what's going on, how should we prepare?"

AHS has updated guidance for physicians in the province, which includes information on testing, infection prevention and immunization.

"Locally, there's been an excellent effort by the labs to make people aware of how to diagnose this," said Gill.

"We're fortunate that the last epidemic led people of the highest risk to be immunized so that the belief is that they are immune to the new clade. Or if they catch it , it won't be anywhere near as severe."

AHS said 54 cases of the earlier strain of mpox (clade IIb) have been confirmed in Alberta since 2022, including seven this year. Two of the cases were identified in July. 

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Dr. Stephanie Smith, who has treated cases of the earlier strain in Edmonton, is watching for signs of the latest clade, too.

"The risk right now to Canadians is low," said Smith, an infectious diseases specialist at the University of Alberta Hospital.

"I think we need to make sure our health system is aware of looking for cases in those who have travelled." 

According to Smith, awareness among front-line health-care workers is important moving forward.

"What we're looking for right now … is particular symptoms in people who have travelled to areas where the clade I mpox is circulating."

Vaccination program continues

A vaccine, which is delivered in two doses at least 28 days apart, is available to some groups of Albertans, including men who have sex with men who meet certain criteria, sex workers, people involved in sex tourism and those who work in locations where there is sex on the premises.

Since 2022, the province has given out 4,848 doses: 4,090 that year, 607 last year and 151 so far this year.

AHS said people interested in receiving the mpox vaccine can call  Health Link at 1-866-301-2668.

According to the Public Health Agency of Canada, the vaccine is expected to protect against both clade I and II.

"As part of its preparedness activities, the Government of Canada has secured sufficient supply of mpox vaccines to support provincial and territorial programs for the prevention and control of mpox in Canada," a spokesperson said in an email.

PHAC issued an mpox travel notice, which offers advice on how to minimize risk. 

The agency said people planning to travel abroad should consult their health-care provider or visit a travel health clinic six weeks before travelling.

"Currently, the mpox vaccine is not routinely recommended for travellers without known exposure to mpox, unless they meet the high-risk criteria," the emailed statement reads in part.

"PHAC continues to monitor the global mpox situation closely and will update travel health advice as the situation evolves."

The agency said it is working with federal scientists and academic researchers to identify information gaps and the research needed to respond to future cases.

According to the statement, border services officers from the Canada Border Services Agency watch for symptoms and can refer to PHAC quarantine officers either in person or virtually.

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Meanwhile, AHS said travel is not considered a "high risk" activity for acquiring the virus. 

But, according to the health authority, people who are concerned about potential exposure while travelling can take a number of steps:

• Avoid direct contact with individuals showing symptoms of mpox.
• Regularly clean hands, objects and surfaces.
• Refrain from sharing personal items.
• Wear a mask if in close proximity to someone with symptoms.
• Avoid wild animals.

"If you believe you have been in close, prolonged contact with someone with mpox or are experiencing mpox symptoms such as fever, rash and swollen lymph nodes, please self-isolate and call 811 or your primary care physician," an AHS spokesperson said in an email.

Testing is available through most sexual and reproductive health clinics and primary care clinics, the health authority said.