Smallpox Vaccines Reviewed for Use Against Monkeypox: Canada’s Chief Medical Officer

Smallpox Vaccines Reviewed for Use Against Monkeypox: Canada’s Chief Medical Officer
Chief Public Health Officer Theresa Tam responds to a question during a news conference in Ottawa on Oct. 5, 2020. Adrian Wyld/The Canadian Press
Andrew Chen
Updated:

Canada’s top public health officials say they are looking at the possible use of smallpox vaccines against monkeypox, after the first two cases of monkeypox infections in the country were confirmed in Quebec this week.

Canada’s chief public health officer Theresa Tam told reporters at a press conference on May 20 that federal public health authorities are now “having discussions” with international and provincial counterparts around the potential use of the smallpox vaccine for monkeypox.
Tam said, however, that the several vaccines being reviewed were all originally developed for immunization against smallpox, and did not go through clinical trials for monkeypox. But she also cited the World Health Organization (WHO), which said a number of studies show smallpox vaccines are about 85 percent effective when used against monkeypox.

“Based on what we know globally, the smallpox vaccines can be applied to monkeypox. In particular, there is one [vaccine] that has monkeypox included in its labelling,” she said.

While smallpox was eradicated in the 1980s, Tam said Canada still has a “limited supply” of vaccines for the virus—as do many other countries—though she refused to disclose the exact number Canada has in stock, citing “security reasons.”

Monkeypox’s overall risk to the Canadian population is low, deputy chief public health officer Dr. Howard Njoo said on May 20, though he added that the public should remain vigilant about the virus and be informed about its symptoms and how it is transmitted.

Monkeypox is a zoonotic infectious disease that occasionally results in human infections, “usually associated with exposure to infected animals or contaminated materials,” according to a statement released by the Public Health Agency of Canada (PHAC) on May 19.

“Signs and symptoms of monkeypox can typically include fever, headache, muscle aches, exhaustion, and swollen lymph nodes, and a rash that often appears within a few days after symptoms such as fever develop,” the statement reads.

“Person to person spread of monkeypox is uncommon. However, when spread does occur between people the mode of transmission is through close contact with an infected individual, such as through direct contact with their body fluids, respiratory droplets, or monkeypox sores, or by sharing clothing, bedding or common items that have been contaminated with the infected person’s fluids or sores.”

A 1971 photo from the Center For Disease Control handout shows monkeypox-like lesions on the arm and leg of a female child in Bondua, Liberia. (CDC/Getty Images)
A 1971 photo from the Center For Disease Control handout shows monkeypox-like lesions on the arm and leg of a female child in Bondua, Liberia. CDC/Getty Images

On May 19, PHAC confirmed that two people in Quebec have tested positive for monkeypox, and that they were the first-ever reported in the country. The agency said about 20 others in the province are also under investigation for being potentially infected with the disease.

PHAC is also working with U.S. public health authorities to investigate potential contacts of an infected U.S. citizen who recently travelled to Canada. The man travelled by private transportation, and may have been infected before or during his visit to Montreal.

Tam said the cases in Quebec and the recent reports of cases around the world are unusual, as the disease is mostly found in parts of central and western Africa.

“So far, we do know that not many of these individuals are connected to travel to Africa where the disease is normally seen. So this is unusual. It’s unusual for the world, to see this many cases reported in different countries outside of Africa,” she said.

“We don’t understand enough. There’s probably been some hidden chains of transmission that could have occurred for quite a number of weeks, given the sort of global situation that we’re seeing right now.”

Cases of monkeypox are being investigated in the United States, Australia, and several European countries, including Belgium, France, Germany, Italy, Portugal, Spain, Sweden, and the United Kingdom.