Once the epicenter of Canada’s monkeypox epidemic, Montreal has nearly eliminated the virus from its territory, according to doctors in the city — but they warn it’s too soon to declare victory. Cases can still be imported by tourists and other visitors, they say, adding that it is not yet clear how long the vaccine will remain effective. Doctors and members of the city’s LGTBQ community credit the quick start of a vaccination campaign and cooperation between public health officials and community organizations for success in controlling the disease. Dr. Genevieve Bergeron, in charge 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,” she said in a recent interview. “At this point, the last cases we have started their illness in late September.” Dr. Rejean Thomas, president of a clinic in Montreal’s Village district that specializes in sexually transmitted and blood-borne infections, said that at the beginning of the outbreak, his clinic – l’Actuel – saw nearly a dozen people a day who thought they had the disease. Now, he said in a recent interview, “we hardly see any other cases. it has been completely reduced, it has almost been eliminated.’ In all, his clinic has treated 125 people with monkeypox — more than a quarter of all cases in Montreal since the city’s first case was identified on May 12. But Thomas said it remains 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 studies are continuing on how long the protection offered by Imvamune, a smallpox vaccine approved for use against the related monkeypox virus, is ongoing. The vaccine is offered to anyone who thinks they may have been exposed to the virus, as well as those whose sexual contacts may put them at higher risk for 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 one dose of 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 monkeypox cases are on the decline. In Ontario, where the trajectory of the disease has followed a similar pattern, the province’s chief medical officer said in mid-October that he was “actively considering” declaring the outbreak over. The World Health Organization reports that the number of new cases of monkeypox in several countries – including Canada, the United Kingdom and Italy – dropped by more than 50 percent in the last week of October compared to the previous week. Several other countries, including France and the United States, have seen smaller declines, but the number of new cases is still rising in other parts of Europe and parts of Central and South America. Bergeron said it’s not clear what’s driving the decline, but said vaccination and seasonality could play a role. “We saw a lower number of cases overall in Montreal 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 people being stigmatized and worked closely with the community to design messaging around vaccination. If people were worried that they would be judged or stigmatized for protecting themselves, that would be counterproductive, he said. Christian Tanguay, executive director of the Montreal LGBTQ+ Community Centre, said that while the experience at the vaccination clinic was like getting a flu shot, he was concerned that people would not get vaccinated for fear of being stigmatized for having multiple partners. Seeing three people he knows contract the virus motivated him to get vaccinated quickly and encourage others to do the same, he said. 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, the 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 are confident that the outbreak is largely behind them, adding that the number of questions his team receives about the disease has dropped significantly. “We feel a lot better than we did a few months ago,” he said in a recent interview.
