MEDICAL ADVISORY: Monkeypox Designated a Disease of Public Health Significance and Updated Reporting Requirements Issued by: Azim Kasmani, MD FRCPC, Associate Medical Officer of Health On June 16, 2022, Ontario’s Chief Medical Officer of Health issued a Memorandum to Health Care Providers and Public Health Units notifying that monkeypox has been designated a Disease of Public Health Significance (DOPHS) as “Smallpox and other Orthopoxviruses including Monkeypox” under the Health Protection and Promotion Act (HPPA). It has also been designated as both a communicable and virulent disease. Now that monkeypox is a DOPHS under the HPPA, the monkeypox Order issued by Ontario’s Chief Medical Officer of Health under Section 77.6 on May 20, 2022 is no longer in effect. Updates to reporting requirements for health care providers - Persons required to report DOPHS and/or communicable diseases under the HPPA are now required to report directly to the local Medical Officer of Health in accordance with the reporting requirements in the Act, as per routine disease processes
- To report confirmed, probable or suspect cases of monkeypox for patients residing in Niagara call the Infectious Disease Program at 905-688-8248 ext. 7330, toll free 1-888-505-6074 (Monday to Friday, 8:30 a.m. to 4:30 p.m.)
- After hours, please call 905-984-3690
- For current case definitions, please refer to the Infectious Disease Protocol for Smallpox and other Orthopoxviruses, including Monkeypox
- Confirmed, probable or suspect cases of monkeypox are required to be reported within one business day
- Note smallpox continues to require immediate
reporting
Key messages for health care providers - Consider the diagnosis of monkeypox in individuals with signs and symptoms that may be compatible with the disease such as: rash, fever, lymphadenopathy, chills and/or sweats, headache, myalgia, or back pain.
- Testing for monkeypox should occur in outpatient clinics. Please refer to Infection Prevention and Control (IPAC) Recommendations for Monkeypox in Health Care Settings – Public Health Ontario to ensure appropriate IPAC protocols are followed when seeing potential cases.
- Laboratory testing is helpful for reporting and case/contact management purposes for any individual with
rash/symptoms similar to monkeypox. Please refer to Monkeypox Test Information Index – Public Health Ontario for further information about testing, recommendations on which samples to submit and requirements for submission and transport, prior to testing patients.
- It is possible for patients to be co-infected with monkeypox and a sexually transmitted and blood borne infection (STBBI). Testing for both may be warranted for some patients.
- Monkeypox cases outside endemic
countries have usually been linked to travel. Anyone can get monkeypox. During this outbreak, a number of gay, bisexual and men who have sex with men have been affected in multiple countries.
- At this time, Niagara Region Public Health will follow up with all reported cases. Cases must isolate at a minimum until test results are available and if positive until all rash has resolved. Contacts should monitor for symptoms for 21 days after their last exposure. If they develop symptoms, they should immediately self-isolate, contact Public Health, and see their primary health care provider.
- Based on Public Health assessment, post exposure prophylaxis with a single dose of the Imvamune vaccine may be recommended to people who have been identified by Public Health as a
high-risk exposure of a probable or confirmed case of monkeypox, or within a setting where transmission is happening. Public Health will contact those individuals who have been identified as a high-risk exposure.
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