The University of Toronto and its partner hospitals, including Sunnybrook Research Institute, Unity Health Toronto and the University Health Network, are leading a rapid research response to the global monkeypox outbreak to better understand disease symptoms, genetic evolution of the virus, and transmission risks, among other factors. .
The research effort is centered in the Emerging and Pandemic Infections Consortium (EPIC), which includes Toronto Hospital’s university, high-containment lab and five research institutes.
Monkeypox has infected 300 people in Canada and more than 5,000 worldwide since May.
“We’ve worked hard to tie together Toronto’s broad expertise and research capacity so that our community can respond effectively to infectious challenges,” says Natasha Christie Holmes, director, partnerships and strategy at EPIC. “It was exciting to see how quickly the partners came together to respond to this unexpected rise of monkeypox in Canada.”
The research response leverages the university’s Combined Containment Level 3 unit — a lab equipped to study infectious pathogens safely and securely — and partnerships between Toronto hospitals and community groups.
- An observational cohort study to understand the range of symptoms associated with monkeypox infection, viral spread and transmission risks, as well as the social, economic and psychosocial effects of infection
- An immunological study to understand how the immune system responds to infection
- A genetic study to investigate how the virus evolves and how changes in the virus’s genetic code correspond to changes in its ability to cause disease
- Transmission studies to understand the potential and risks of surface and aerosol transmission, and transmission from people who are presymptomatic or asymptomatic
Monkeypox is caused by a smallpox virus that is closely related to the smallpox virus. Until recently, monkeypox infections were limited to people living in Central and West Africa and travelers visiting those regions. As of June 30, Public Health Ontario reported a total of 77 cases in Ontario, including 63 in Toronto. Although the virus can infect anyone, so far in Ontario, men have been involved in all cases.
“One of the most important lessons from the history of infectious disease outbreaks is that community involvement from the very beginning is critical,” says Darrell Tana co-principal investigator and operational co-lead with Sharmistha Mishra of EPIC’s rapid response efforts for monkeypox. “That’s why we participate in community gatherings where we work with various local groups to respond. There has already been some great advocacy, action, knowledge sharing and collaboration that has come out of these meetings that have shaped the research questions we hope to answer.”
Tan and Mishra are both associate professors in the Temerty Faculty of Medicine and infectious disease physicians at St. Michael’s Hospital, a Unity Health Toronto site, where some of the first monkey pox patients in Toronto were identified and cared for.
The joint effort is the first coordinated response by Canadian researchers to address the current monkeypox outbreak and paves the way for future collaborations with other Canadian and international groups. The data generated from the projects over the coming months will help inform the province and country’s public health response to the outbreak, and may also inform and support efforts in other countries where the virus is endemic.
“The speed with which this research initiative came about is a testament to the strength of EPIC and its partnerships and their ability to pivot and respond quickly to emerging infectious threats such as monkeypox,” says Leah CowenU of T’s vice president, research and innovation, and strategic initiatives.
The rapid research response to monkeypox is led by EPIC in partnership with the Toronto Academic Health Science Network.
EPIC is a U of T Institutional Strategic Initiative that brings together infectious disease experts from the university and five hospital research partners – the Hospital for Sick Children (SickKids) Research Institute, the Lunenfeld-Tanenbaum Research Institute of Sinai Health, Sunnybrook Research Institute , Unity Health Toronto and University Health Network – to enable an integrated and innovative response to infectious diseases in an effort to help prevent future pandemics.