TORONTO — The Toronto Blue Jays lost yet another game and yet another player to injury Sunday, as starter J.A. Happ exited in the fifth inning with left elbow soreness before the Baltimore Orioles slugged their way to a dominant 11-4 win.

It's another discouraging blow for the Blue Jays (2-10), whose awful April represents the worst start in franchise history.

Happ (0-3) will undergo an MRI on Monday. More bad news had arrived prior to the game with the announcement that Aaron Sanchez was going on the 10-day disabled list with a blister on his right middle finger. And Josh Donaldson missed his third straight game with a calf strain that has him languishing to the disabled list.

Donaldson's sorely missed in Toronto's listless lineup, which looked feeble again Sunday as Baltimore starter Dylan Bundy (2-1) struck out six over six shutout innings in front of 38,188 increasingly dispirited fans at Rogers Centre. Trey Mancini clubbed a three-run homer and a solo shot for the Orioles (8-3), who took three of four this weekend.

Jays manager John Gibbons retained an air of optimism but acknowledged his team's potentially precarious situation.

"Today was the first time all year that felt like a sloppy game," Gibbons said.

"It's part of a baseball season. Every team goes through it. You just learn to deal with it," he added of the Jays' woes.

"You just roll with the punches — the pain, whatever you want to call it."

This loss was perhaps especially painful given how Happ was rolling prior to hearing a "pop" in his elbow in the fourth inning. He returned for the fifth and after J.J. Hardy drove a ground-rule double past a sprawling Kevin Pillar, Happ threw one pitch to Adam Jones before heading to the clubhouse.

"(It's) disappointing because I felt … I was establishing myself again, bouncing back from the game before," said Happ, who tied the team record for left-handers with 20 wins in 2016. "It's a little concerning and definitely frustrating."

Added Gibbons: "I was sitting there thinking he had at least seven innings tonight. He was on."

Without Happ, the Blue Jays came undone. With reliever Joe Biagini in, Jones singled and after some defensive confusion and an ill-advised rundown, Hardy scored.

The next inning, the Orioles took flight. With Ryan Tepera on the mound, Mark Trumbo singled and Chris Davis walked before Mancini drove a sinker into the seats in left. Hardy added an RBI double and scored on a sacrifice fly to give the Orioles a 6-0 lead.

The Jays briefly threatened a rally in the seventh after Chris Coghlan drove in Troy Tulowitzki with a sacrifice fly. But Stefan Crichton struck out Pillar with two on to end the frame.

An inning later, Mancini added a solo shot while Craig Gentry and Manny Machado smacked two-run homers off debuting Jays reliever Matt Dermody, now the owner of an unfortunate 135.0 ERA, to give the Orioles a 10-run lead.

Even after Tulowitzki hit an RBI single in the eighth and Pillar drove his first homer of the year to centre in the ninth, Toronto finished the game with a major league-worst 34 runs scored on the season.

Bundy, once a top prospect who returned to the major leagues last year after a years-long recovery from Tommy John surgery, shut down the Jays' bats for a second time this year. And Gibbons acknowledged later that eventually Toronto's anaemic offence will need to find life.

"We're all concerned. We all expected to no doubt play better," said Gibbons, still noting that the Jays had at least been close in many of their other losses.

"I'm holding out hope," he added. "I still believe our bats will get going. They've got to. They always have. But we've gotta start playing better baseball soon, that's for sure."