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Wastewater surveillance suggests unreported Mpox cases in a low-prevalence area

Oghuan, J.; Chavarria, C.; Vanderwal, S. R.; Gitter, A.; Ojaruega, A. A.; Monserrat, C.; Bauer, C. X.; Brown, E. L.; Javornik, S.; Deegan, J.; Hanson, B. M.; Tisza, M.; Ocaranza, H. I.; Balliew, J.; Maresso, A. W.; Rios, J.; Boerwinkle, E.; Mena, K. D.; Wu, F.

2023-05-29 epidemiology
10.1101/2023.05.28.23290658 medRxiv
Show abstract

Wastewater surveillance has emerged as a valuable tool for monitoring infectious disease agents including SARS-CoV-2 and Mpox virus. However, detecting the Mpox virus in wastewater is particularly challenging due to its relatively low prevalence in the community. In this study, we detected Mpox virus in wastewater from a US-Mexico border city with a low prevalence of Mpox disease during February and March 2023 using real-time PCR assays targeting the C22L, F3L, and F8L genes. An increasing trend of viral concentration was observed 1[~]2 weeks earlier than when the Mpox case was reported. Further sequencing and epidemiological analysis provided supporting evidence for unreported Mpox infections in the city. This study showcases a combined approach with multiple molecular assays for efficient detection of the Mpox virus in wastewater in a low-prevalence area. The findings emphasize the value of wastewater surveillance as a timely identification tool for infectious diseases in low-prevalence areas, and the need for heightened vigilance to control the spread of infectious diseases in such settings.

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