Please review the following steps you are required to take if your health care provider has indicated that your test results are positive for Monkeypox or you are under investigation for the virus or you are unwell with signs and symptoms of the virus:

Please review the following next steps that you are required to complete:

  1. Immediately self-isolate
  2. Safe disposal of contaminated materials, including animal waste
  3. Safe washing of laundry
  4. Check daily for symptoms
  5. Inform close contacts
  6. Leaving self-isolation
  7. Return to work/activities through phased approach
  8. Safe handling of pets
  9. Vaccine eligibility for recovered cases

1. Immediately Self-Isolate

  • Do not attend work, school or public areas.
  • Immediately self-isolate from the day your symptoms start. This means stay home. If you live with other people, isolate in your own room, eat in your own room/area and use a separate bathroom if possible.
  • If possible avoid areas commonly used by others in your home. Surfaces/objects in common spaces that you may use should be cleaned and disinfected after use.
  • You should remain in isolation, and. avoid contact with other people until the rash has healed and scabs have fallen off, and a fresh layer of skin has formed or your test results show that you do not have Monkeypox.
  • Cover lesions with bandages and dressings or long sleeves or pants. If you need to be around others, a surgical mask should be worn in addition to covering lesions.
  • Wash hands often with soap and water, especially after changing bandages and dressings.
  • Avoid sharing household items including dishes, drinking glasses, cups, eating utensils, towels, and bedding.
    • Items should be washed with soap or detergent in warm water after use. No special soap is needed.
    • If possible, have your own separate items for use.
    • Dishwashers and washing machines can be used.
  • Avoid contact with household pets if possible, as well as contact with wild animals (see number 8 for additional information).
  • Avoid contact with those at higher risk of severe Monkeypox illness including people who have an underlying illness, weakened immune system, pregnant women, and children under 12 years of age.
  • Avoid sexual contact
  • As much as possible, have necessities delivered to your home (e.g. medication, groceries). Items should be left outside and picked up after the delivery person has left.
  • Do not leave your home unless you are seeking essential medical care. Tell your healthcare provider of your Monkeypox status before your appointment. If possible, avoid public transportation. If this is not possible, cover all lesions and wear a medical mask. Keep windows open if you are travelling in a vehicle. Do not have visitors to your home unless it is an essential visit.

2. Safe Disposal of Contaminated Materials

Be careful when handling waste. Disposal of contaminated materials including bandages and dressings, as well as tissues or other items that came in to contact with droplets from nose or mouth of a Monkeypox positive or person under investigation should be disposed of as follows:

  • Dispose contaminated materials directly into waste container and do not touch the outside of the container.
  • Food waste, tissues, bandages and gauze must be double-bagged using strong bags, securely tied before disposing.
    • Multi-residential (e.g. condo, apartment buildings):
      • Food waste and tissues should be disposed of in the Green Bin (if applicable), or garbage without organics/green bin collection.
    • Single dwelling (e.g. house):
      • Bandages and gauze should be disposed of in the garbage. Store waste in secure bin before municipal pick up.
      • Food waste and tissues should be disposed of in the Green Bin. Ensure the Green Bin is set out for collection in the locked position.
  • Animal waste such as straw, feces, left over food, should be handled in the same way as human waste as per above.
  • Wear gloved if handling bags and wash hands after removing gloves.
  • Keep waste away from animals/rodents.

3. Safe Washing of Laundry

  • Avoid direct contact when handling contaminated laundry/linens (i.e., wear disposable gloves).
  • Do not shake soiled laundry in a way that could spread virus particles.
  • You can wash laundry in a standard washing machine with warm water and detergent.
  • Hand launder at home.
  • Have someone help with the laundry. The person doing your laundry should take precautions and wear gloves and immediately wash their hands with soap and water after removing their gloves
  • If you are washing laundry in a shared laundry room:
    • Wear a medical mask
    • Cover all lesions
    • Go at off peak hours
    • Maintain 2 metres distance form others at all times
    • Perform hand-hygiene
    • Use a household disinfectant to wipe shared objects e.g. laundry machine
    • Avoid sitting on shared chairs/benches

4. Check for Symptoms

  • While self-isolating, check for symptoms every day.
  • If symptoms get worse, call your family physician or Health Connect Ontario at 811.
  • If symptoms are severe such as difficulty breathing or chest pain, call 911.
  • Before getting in-person medical care, tell the provider that you have tested positive for Monkeypox, are under investigation for Monkeypox or have symptoms of Monkeypox.

5. Inform Close Contacts

  • Tell people you live with (household members) or any close contacts, including sexual contacts that they need to self-monitor for symptoms for 21 days from last contact.
  • Inform your contact that if they develop symptoms, they must self-isolate immediately and contact their health care provider.
  • Inform your close contacts that public health can assess their eligibility of a preventative vaccine (i.e. post-exposure prophylaxis [PEP].

Who are close contacts?

  • People living in the same household.
  • People having direct physical contact, including sexual contact.
  • People having direct contact with skin lesions and/or bodily fluids without personal protective equipment.
  • People having direct contact with surfaces or objects contaminated by skin lesion(s) and/or bodily fluids.

6. Leaving Self-Isolation

  • You may leave self-isolation for outdoor exercise and getting fresh air. Speak to your Toronto Public Health Communicable Disease Investigator (CDI) for more information.
  • If you no longer have your CDI’s direct number, please call 416-338-7600 and let the operator know you are looking to speak with your CDI and provide their name. A message will be taken and a member of the team will call you back.

Do not attend work/school/public spaces while you remain under self-isolation.

7. Return to Work or Activities Through Phased Approach

  • You may return to work/activities when:
    • All rash/lesions have healed and scabs have fallen off, and
    • Toronto Public Health has indicated your self-isolation period has ended (see phased approach below) or
    • Your test results show that you do not have Monkeypox.

Phased Approach to Ending Self-Isolation

Phase 1: Must meet all of the criteria in Phase 1 to leave isolation.
  • Your lesions on face/arms/hands have scabbed & fallen off, new fresh layer of skin, AND
  • All non-face/arms/hand lesions have scabbed over (but scab has not fallen off), AND
  • You no longer has any respiratory symptoms (absence of sore throat, cough), AND
  • You remain fever free for at least 72 hours, AND
  • You have not developed any new lesions for at least 48 hours, AND
  • You have no lesions in your mouth.

If all the above criteria are met, you can leave isolation but follow all the precautions below until all non-face/arms/hand lesions lesions have scabbed over and fallen off with a fresh layer of skin formed underneath:

  • Wear a medical mask when leaving your place of self-isolation, AND
  • Continue to cover any remaining scabbed lesions when leaving self-isolation or having close-contact with others (genital or truncal lesions would be covered by clothing), AND
  • Continue to avoid close contact with those at high risk for severe illness (young children, pregnant and/or immunosuppressed individuals), AND
  • Avoid sharing linens and towels (e.g. gym), AND
  • Avoid shared water facilities (e.g. pool, hot tub).
  • Medical and Dental Visits: Before attending any medical or dental visits notify your healthcare provider or dentist of your current Monkeypox diagnosis so that they can determine if the visit is essential or should be rescheduled.
Phase 2:  You can resume normal activities:
  • If all lesions have scabbed over and fallen off with a fresh layer of skin formed underneath, or you never had any visible lesions AND
  • It is recommended to use a barrier method (i.e. condoms) for at least 12 weeks for sexual activities after resolution of symptoms.
  • If you work in a high-risk setting (e.g. hospital, long-term care home), follow your employer’s directions about when to return to work.
  • Re-testing (e.g., clearance testing) or getting a doctor’s note is not required to return to work and other activities.

8. Safe Handling of Pets

The risk of a pet getting Monkeypox is unclear. Avoid contact with household pets if possible, as well as contact with wild animals. If you have pet(s) at home, take these extra precautions:

  • If possible, get someone else to take care of your pet until you are out of isolation. This can also be someone in your home who is not sick or has not been exposed to Monkeypox.
  • If possible, keep pets in your home and physically distanced from others. The virus can be carried on an animal’s fur or feathers.
  • Avoid close or prolonged contact with pets, including touching, snuggling, and kissing (especially if you have an unhealed rash or blisters).
  • If you are caring for your pet, wear a mask if you are in the same room, cover your sores as much as possible (use bandages, wear a long sleeve shirt and long pants), and wash your hands before and after touching your pet, their food, or other pet supplies.
  • If your pet gets sick, contact your vet.
  • Dispose of animal waste as per number 2 above.

 9. Vaccine eligibility for recovered cases

  • At this time, based on provincial guidance, those who have had a monkeypox infection are not eligible to receive the Imvamune vaccine.
  • There is very little information about how long immunity from monkeypox infection lasts or if you can be re-infected with the monkeypox virus.
  • If you currently have any symptoms of monkeypox, do not come to the vaccine clinics.

More Information