Monkeypox outbreak: Wastewater and environmental surveillance perspective

Ananda Tiwari; Sangeet Adhikari; Devrim Kaya; Md Aminul Islam; Bikash Malla; Samendra P Sherchan; Ahmad I Al-Mustapha; Manish Kumar; Srijan Aggarwal; Prosun Bhattacharya; Kyle Bibby; Rolf U Halden; Aaron Bivins; Eiji Haramoto; Sami Oikarinen; Annamari Heikinheimo; Tarja Pitkänen

doi:10.1016/j.scitotenv.2022.159166

Monkeypox outbreak: Wastewater and environmental surveillance perspective

Sci Total Environ. 2023 Jan 15;856(Pt 2):159166. doi: 10.1016/j.scitotenv.2022.159166. Epub 2022 Oct 3.

Authors

Ananda Tiwari¹, Sangeet Adhikari², Devrim Kaya³, Md Aminul Islam⁴, Bikash Malla⁵, Samendra P Sherchan⁶, Ahmad I Al-Mustapha⁷, Manish Kumar⁸, Srijan Aggarwal⁹, Prosun Bhattacharya¹⁰, Kyle Bibby¹¹, Rolf U Halden², Aaron Bivins¹², Eiji Haramoto⁵, Sami Oikarinen¹³, Annamari Heikinheimo¹⁴, Tarja Pitkänen¹⁵

Affiliations

¹ Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Finland; Department of Health Security, Expert Microbiology Research Unit, Finnish Institute for Health and Welfare, Finland. Electronic address: Ananda.tiwari@helsinki.fi.
² Biodesign Center for Environmental Health Engineering, Biodesign Institute, Arizona State University, Tempe, AZ 85287, USA.
³ School of Chemical, Biological, and Environmental Engineering, Oregon State University (OSU), Corvallis, OR, USA.
⁴ COVID-19 Diagnostic Laboratory, Department of Microbiology, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh; Advanced Molecular Laboratory, Department of Microbiology, President Abdul Hamid Medical College, Karimganj, Kishoreganj, Bangladesh.
⁵ Interdisciplinary Center for River Basin Environment, University of Yamanashi, 4-3-11 Takeda, Kofu, Yamanashi 400-8511, Japan.
⁶ Department of Biology, Morgan State University, Baltimore, MD, USA; Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
⁷ Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Finland; Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Ibadan, Oyo State, Nigeria; Department of Veterinary Services, Kwara State Ministry of Agriculture and Rural Development, Ilorin, Kwara State, Nigeria.
⁸ Sustainability Cluster, School of Engineering, University of Petroleum & Energy Studies, Dehradun, Uttarakhand 248007, India.
⁹ Department of Civil, Geological and Environmental Engineering, College of Engineering and Mines, University of Alaska Fairbanks, PO Box 755900, Fairbanks, AK 99775, USA.
¹⁰ Department of Sustainable Development, Environmental Science and Engineering, KTH Royal Institute of Technology, SE-10044 Stockholm, Sweden.
¹¹ Department of Civil and Environmental Engineering and Earth Sciences, University of Notre Dame, IN 46556, USA.
¹² Department of Civil & Environmental Engineering, Louisiana State University, LA, USA.
¹³ Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
¹⁴ Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Finland; Finnish Food Authority, Seinäjoki, Finland.
¹⁵ Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Finland; Department of Health Security, Expert Microbiology Research Unit, Finnish Institute for Health and Welfare, Finland.

Abstract

Monkeypox disease (MPXD), a viral disease caused by the monkeypox virus (MPXV), is an emerging zoonotic disease endemic in some countries of Central and Western Africa but seldom reported outside the affected region. Since May 2022, MPXD has been reported at least in 74 countries globally, prompting the World Health Organization to declare the MPXD outbreak a Public Health Emergency of International Concern. As of July 24, 2022; 92 % (68/74) of the countries with reported MPXD cases had no historical MPXD case reports. From the One Health perspective, the spread of MPXV in the environment poses a risk not only to humans but also to small mammals and may, ultimately, spread to potent novel host populations. Wastewater-based surveillance (WBS) has been extensively utilized to monitor communicable diseases, particularly during the ongoing COVID-19 pandemic. It helped in monitoring infectious disease caseloads as well as specific viral variants circulating in communities. The detection of MPXV DNA in lesion materials (e.g. skin, vesicle fluid, crusts), skin rashes, and various body fluids, including respiratory and nasal secretions, saliva, urine, feces, and semen of infected individuals, supports the possibility of using WBS as an early proxy for the detection of MPXV infections. WBS of MPXV DNA can be used to monitor MPXV activity/trends in sewerage network areas even before detecting laboratory-confirmed clinical cases within a community. However, several factors affect the detection of MPXV in wastewater including, but not limited to, routes and duration time of virus shedding by infected individuals, infection rates in the relevant affected population, environmental persistence, the processes and analytical sensitivity of the used methods. Further research is needed to identify the key factors that impact the detection of MPXV biomarkers in wastewater and improve the utility of WBS of MPXV as an early warning and monitoring tool for safeguarding human health. In this review, we shortly summarize aspects of the MPXV outbreak relevant to wastewater monitoring and discuss the challenges associated with WBS.

Publication types

Review

MeSH terms

Animals
COVID-19* / epidemiology
DNA, Viral
Environmental Monitoring
Humans
Mammals
Monkeypox virus / genetics
Mpox (monkeypox)* / diagnosis
Mpox (monkeypox)* / epidemiology
Mpox (monkeypox)* / pathology
Pandemics
Wastewater

Substances

Waste Water
DNA, Viral