Mpox: Self-Isolation Guidance

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

You should self-isolate immediately if:

  • Your rash or sores cannot be covered with bandages, dressings, clothing such as long sleeves or pants, gloves or medical mask (if your rash or sores are inside your mouth) OR
  • You have respiratory symptoms such as a cough or sore throat and you are unable to wear a medical mask OR
  • You initially have mild symptoms but later develop symptoms such as rash or sores that cannot be covered.

If the above criteria do not apply to you (e.g., your rash or sores can be covered), you are not required to self-isolate. However, you should follow precaution measures (see precaution measures for additional information).

Self-isolation means stay home, do not attend work, school or public areas:

  • If you live with other people, isolate in your own room, avoid common areas with other people, eat in your own room/area and use a separate bathroom if possible.
  • Avoid close physical contact, including sexual contact, with other people, especially those at a higher risk of severe mpox illness including people who are immunocompromised, pregnant or children 12 years of age or younger.
  • Cover your rash or sores with bandages, dressings, clothing such as long sleeves or pants, gloves and/or medical mask (if your rash or sores are inside your mouth).
  • Wear a medical mask if you have respiratory symptoms such as a cough or sore throat.
  • Wash hands often with soap and water, especially after changing bandages and dressings.
  • Surfaces/objects in common spaces should be cleaned and disinfected after use.
  • Avoid sharing household items including dishes, drinking glasses, cups, eating utensils, towels, and bedding.
  • If possible, have your own separate items for use.
  • Items that are shared should be washed with soap or detergent in warm water after use. No special soap is needed.
  • Dishwashers and washing machines can be used.
  • Cover upholstered furniture (e.g., couches, chairs, mattresses) with a sheet, waterproof mattress cover, blanket that can be washed (see safe washing of laundry for additional information).
  • Avoid close and unprotected contact with household pets, if possible, as well as contact with wild animals (see safe handling of pets for additional information).
  • 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.
  • Stay home unless you are seeking essential emergency medical care. Tell your health care provider of your mpox status before your appointment. When leaving ensure to cover your rash or sores, wear a medical mask if the rash or sores are inside your mouth or if you have respiratory symptoms such as a cough or sore throat, and gloves if the rash or sores are on your hands. Avoid public transportation. If travelling in a shared vehicle keep windows open.

Disposal of contaminated materials including bandages and dressings used to cover a rash or sores, as well as tissues or other items that came into contact with droplets from the nose or mouth should be disposed of as follows:

  • Dispose contaminated materials directly into a dedicated waste container and do not touch the outside of the container.
  • Food waste, tissues, bandages and gauze must be double-bagged using strong bags and 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.
    • Wear gloves if handling bags and wash hands after removing gloves.
    • Animal waste such as straw, feces, left over food, should be handled in the same way as human waste as per above.
    • Keep waste away from animals/rodents.
  • Avoid direct contact when handling contaminated laundry/linens (i.e., wear disposable gloves, disposable gowns or long-sleeved clothing if gowns are not available).
  • 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.
  • If someone helps you with the laundry, they should take precautions and wear gloves, disposable gowns or long-sleeved clothing if gowns are not available and immediately wash their hands with soap and water after removing their gloves and/or gown.
  • If you are washing laundry in a shared laundry room:
    • Cover your rash or sores.
    • Wear a medical mask if you have respiratory symptoms such as a cough or sore throat or have a rash or sores inside your mouth
    • Go at off peak hours
    • Wash your hands
    • Use a household disinfectant to wipe shared objects e.g., laundry machine
    • Avoid sitting on shared chairs/benches
  • Check for symptoms every day.
  • If you initially have mild symptoms but later develop symptoms such as rash or sores that cannot be covered, self-isolate.
  • 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 health care provider that you have tested positive for mpox, are under investigation for mpox or have symptoms of mpox. When leaving, ensure to cover your rash or sores, wear a medical mask if the rash or sores are inside your mouth or if you have respiratory symptoms such as a cough or sore throat, and gloves if the rash or sores are on your hands. Avoid public transportation. If travelling in a shared vehicle, keep windows open.
  • 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 even if they have previously received one or two doses of Imvamune® vaccine.
  • Inform your contacts that if they develop symptoms, they should notify Toronto Public Health and contact their health care provider for assessment and testing.
  • Inform your close contacts that public health can assess their eligibility for post-exposure prophylaxis (i.e., Imvamune® vaccine).

Who are close contacts?

  • People living in the same household.
  • People having direct physical contact, including sexual contact.
  • People having direct contact with rashes or sores and/or bodily fluids without personal protective equipment.
  • People having direct contact with surfaces or objects contaminated by a rash or sores and/or bodily fluids.

The risk of a pet getting mpox 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 in the home who is not sick with mpox to take care of your pet.
  • For dogs that need to go outside periodically, keep them on a leash and avoid contact with other people and animals.
  • Anyone who is immunocompromised and/or pregnant, and children under 12 years of age should not care for an ill animal or an animal that was exposed to a mpox positive individual.
  • If you are caring for your pet, cover your rash or sores (use bandages, wear a long sleeve shirt and long pants, gloves and mask), and wash your hands before and after touching your pet, their food, or other pet supplies.
  • Avoid close or prolonged unprotected contact (e.g., not wearing clothing or bandages covering rash or sores) with pets, including touching, snuggling, and kissing. It is important to prevent direct contact to pets with any unhealed rashes or sores.
  • Contact your veterinarian if your pet gets sick (e.g., fever, depression, not eating, respiratory signs, diarrhea, oral ulcers, skin lesions).
  • Dispose of animal waste (see safe disposal of contaminated materials for additional information).

If you are not required to self-isolate (e.g., your rash or sores can be covered and you have mild and/or no respiratory symptoms), you may engage in daily living activities with the following precautions:

  • Cover rash or sores (this may include wearing long sleeves/pants, bandages, gloves, mask).
  • Wear a medical mask if you have a rash or sores inside your mouth and/or respiratory symptoms such as a cough or sore throat.
  • If the mask needs to be removed to eat, consider going outside, eating in your private vehicle or closing the door of a room and opening a window.
  • Wash hands often with soap and water, especially after changing bandages and dressings.
  • Avoid close or direct interactions, especially with those who are immunocompromised, pregnant or children 12 years of age or younger.
  • Avoid prolonged close, direct skin-to-skin contact with others (e.g., sexual contact, large crowds, participation in contact sports such as wresting).
  • Avoid crowds and congregate settings (e.g., visiting long-term care home, shelter).
  • Non-essential medical and dental visits should be avoided. If you think you need to attend, first notify your health care provider or dentist of your current mpox diagnosis so that they can determine if the visit is essential or should be rescheduled.
  • Postpone all non-essential (elective) medical and dental appointments/procedures (e.g., cleanings) until you have recovered (see recovery for additional information).
  • Do not use shared recreational water facilities (e.g., pool, hot tub).
  • Avoid sharing items and having items laundered by someone else (e.g., towels at gym).
      • If you work with a population at higher risk of severe mpox illness (e.g., people who are immunocompromised, pregnant or children 12 years of age or younger), with animals or in a setting with an increased risk of spread of infection, contact your Toronto Public Health (TPH) Communicable Disease Investigator (CDI) who can help determine how and when it is safe for you to return to work.
      • You may be able to return to work and other essential activities such as school if you are able to:
        • Follow precaution measures.
        • You are not interacting with those at higher risk of severe mpox illness (e.g., people who are immunocompromised, elderly, pregnant, or children 12 years of age or younger).
        • The setting is not high risk (e.g., a long term care home, hospital, child care centre)

      If you meet the criteria above, re-testing (e.g., clearance testing) or getting a doctor’s note is not required to return to work/activity.

      • Consult your occupational health and safety department if applicable.
      • If you develop a fever, respiratory symptoms and/or rashes or sores that cannot be covered, you must self-isolate.
      • You are considered recovered when you have no symptoms and your rash or sores have scabbed over and fallen off with a fresh layer of skin formed underneath.
      • You should use barrier methods (i.e., condoms, dental dams) for sexual activities after recovery. A barrier method may decrease the risk of exposure to mpox from genital excretions (i.e., seminal or vaginal fluids) to sexual partner(s).
      • There is little evidence to support a length of time that a recovered individual should use barrier methods during sexual activity. Some countries and the World Health Organization (WHO) recommend a minimum of 12 weeks.
      • There is currently no available evidence that an individual who recovered from a mpox infection can transmit the virus via genital excretions. Guidance will be updated as additional evidence becomes available.
      • It is recommended to consult your health care provider prior to donating bodily fluids (e.g., blood, semen, breast milk), human cells, or tissues.

      At this time, based on provincial guidance, those who have been diagnosed with mpox are not recommended to receive the mpox vaccine.

      • If you encounter challenges with self-isolation, reach out to family or friends to help you with essentials (e.g., grocery delivery, picking up medications).
      • If you have limited or no supports, contact your Toronto Public Health Communicable Disease Investigator (CDI) or call 416-338-7600.

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