Mpox: Advice for travellers

Original publication date: June 7, 2022

Updated: October 2, 2024

Current situation

Mpox (formerly monkeypox) is a viral infectious disease caused by monkeypox virus. There are two distinct subtypes of monkeypox virus (called clades): clade I and clade II.

There is currently an outbreak of clade I mpox in the Democratic Republic of Congo (DRC). While clade I mpox is endemic (usually found) in the DRC, the current outbreak is larger than expected, and new areas are reporting cases. Countries that border the DRC are considered at risk for further spread. The Central African Republic, Republic of Congo, Burundi, Rwanda and Uganda have also reported person-to-person transmission of clade I mpox.

On August 14, 2024, the World Health Organization (WHO) declared that the increase in cases in the Democratic Republic of the Congo and in other African countries is a public health emergency of international concern (PHEIC). PHAC is working closely with international, provincial and territorial health partners to gather information on this evolving situation. 

Learn more:

WHO Director-General declares mpox outbreak a public health emergency of international concern

About mpox 

Mpox is a viral infection with a rash that may be painful. It is usually self-limited, meaning most people recover on their own after a few weeks. However, in some situations, people may become very sick and death may occur. It is regularly found in parts of Central and West Africa, where it has been re-emerging in recent years. Current information suggests that infection with clade I monkeypox virus may pose a higher risk of severe illness or death compared to clade II. Since 2022, mpox has been reported in over 100 countries around the world.

Mpox virus can spread in three ways:

• from person to person
• through direct contact with contaminated objects
• from infected animals to humans

Person to person

Mpox can spread from person to person through contact with an infected person’s:

• lesions or scabs that may be found on the skin or mucosal surfaces (such as eyes, mouth, throat, genitalia, rectum). These lesions may resemble chickenpox.
• blood or body fluids
• contaminated clothing or linens, such as bedding and towels, or by sharing personal objects used by an infected person (such as razors, utensils, needles, sex toys, toothbrushes)
• respiratory droplets (for example, from coughs and sneezes)
  • While respiratory droplets may transmit mpox virus, this is likely limited.

The risk of transmission increases when coming into close contact with someone who is infected, such as:

• during sexual contact (including oral and non-penetrative sexual contact)
• when providing care
• when living in the same household

An infected pregnant person may also pass on the virus to their developing fetus.

The majority of recent cases have spread from person-to-person, including through sexual contact and within health care settings. 

Having multiple sexual partners may increase your overall risk of infection.

Animal to human

Mpox can spread from an infected animal to a human through direct contact. Humans may also become infected if they:

• prepare or eat undercooked meat of infected animals
• come into contact with an infected animal's body fluids

In the wild, African rodents are thought to be the main carriers of the virus, however, other carriers include primates, such as monkeys.

Symptoms

Symptoms of mpox usually develop 7 to 10 days after being exposed, but can begin 3 to 21 days after exposure. Symptoms can include: 

• onset of a rash or lesions
• fever
• exhaustion
• swelling of the lymph nodes
• headache
• muscle pain
• joint pain
• chills
• back pain

It is possible that a rash may be the only presenting symptom. The rash is similar in appearance to chickenpox or sexually transmitted infections (such as herpes or gonorrhea). It can be painful and could affect any part of the body, such as the mouth, genitals, perianal area, face, arms and legs, feet, and hands. The rash usually lasts between 14 and 28 days and changes through different stages before finally forming a scab, which later falls off. 

Symptoms of mpox typically last from 2 to 4 weeks. Treatment is mainly supportive. 

Learn more: 

Mpox: How it spreads, prevention and risks
Mpox: Symptoms

Recommendations

Consult a health care provider or visit a travel health clinic preferably at least 6 weeks before you travel to get personalized health advice and recommendations for your trip. 

The Imvamune® vaccine is authorized for use against mpox infections in adults 18 years of age and older who are at high risk of exposure. Check with your local public health authority pre-travel to determine your eligibility for the mpox vaccine. The vaccine requires a minimum of 4 weeks between the two doses. Currently, the mpox vaccine is not routinely recommended for travellers without known exposure to mpox, unless they meet the high risk criteria.  When travelling abroad, individuals should take measures to reduce their risk, including avoiding contact with someone who has symptoms of mpox or who may have been exposed to mpox.

Learn more:

Interim guidance on the use of Imvamune® in the context of a routine immunization program

You should delay your travel if you have any symptoms of mpox, or have been diagnosed with mpox.

You can help lower your risk of getting mpox by avoiding:

• close physical contact with someone who has mpox, including sexual contact
• sexual contact with someone who may have had a high-risk exposure to mpox
  • For example, a sexual partner or household member of someone with mpox.
• contact with personal items or objects used by someone with mpox

You can also lower your risk by:

• getting vaccinated against mpox, if eligible
• having fewer sexual partners
• using barrier protection during sexual activity, including:
  • condoms
  • dental dams
  • gloves
  • clothing
• practising regular hand hygiene
  • Wash your hands frequently with soap and water for at least 20 seconds or use a hand sanitizer containing at least 60% alcohol.
  • If your hands look dirty, you should wash them with soap and water instead of using hand sanitizer.
  • It's a good idea to always keep hand sanitizer with you when you travel.
• cleaning and disinfecting high-touch surfaces and objects in your home, especially after having visitors

Learn more:

Preventing the spread of mpox

Monitor your health

Be aware of the symptoms of mpox and report any concerns, particularly a new rash or lesions with or without other symptoms, to a health care professional. Individuals engaging with new or multiple sexual partners should be particularly vigilant.

• If you’ve been exposed, watch for symptoms for 21 days and avoid taking medications that are known to lower fever, such as acetaminophen, ibuprofen and acetylsalicylic acid. They may mask an early symptom of mpox infection.
• If you develop symptoms that could be due to mpox when you are travelling or after your return, isolate immediately and contact a health care professional or your local public health authority and avoid contact with others. Tell them where you have been travelling or living and follow their instructions.
• If you have symptoms that could be due to mpox during the flight, tell the flight attendant before you land or the border services officer as you enter the country. They will notify a quarantine officer who can assess your symptoms.

Learn more: 

If you become sick or injured while travelling outside Canada or after your return
If you have mpox

Information for health care professionals

Mpox information for health professionals can be found on the Government of Canada’s Mpox (Monkeypox): For health professionals website. 

Guidance on the use of Imvamune® for travel is available from the National Advisory Committee on Immunization (NACI). Healthcare providers should consider a traveller’s responsibility to prevent the introduction and spread of mpox internationally in their recommendation to vaccinate.

Learn more: 

Mpox (monkeypox): For health professionals
National Advisory Committee on Immunization (NACI): Interim guidance on the use of Imvamune in the context of a routine immunization program

Registration of Canadians Abroad

Sign up with the Registration of Canadians Abroad service to stay connected with the Government of Canada in case of an emergency abroad or an emergency at home.

Learn more: 

Registration of Canadians Abroad