Monkeypox is in Bay Area sewage

Monkeypox is in Bay Area sewage

Recent data suggest that monkeypox DNA can also be detected in various body fluids of those infected. These include respiratory and nasal secretions, saliva, urine, faeces and seminal fluid – meaning that washed tissue from someone with monkeypox can pick up the virus in sewage.

If the genetic fingerprint of a pathogen can persist in wastewater for more than 24 hours, SCAN can probably detect it. The RNA of the Covid-19 virus persists in wastewater for more than 10 days. Although monkeypox DNA appears to pass the 24-hour threshold, there is no public research on how long it lasts.

The question remains how much monkeypox DNA needs to enter the wastewater for SCAN to actually detect. SCAN can smell covid from wastewater from only two infected people out of 100,000.

Even in a state like California, where sewers and drains are separate, the rain dilutes the amount of viral DNA in the wastewater. To account for this, SCAN normalizes its estimates using a virus with a well-established expected amount – pepper mild mottle virus. Healthy people shed the harmless virus after eating pepper and paprika-based products, making it the most abundant RNA virus in human feces (conveniently, it’s also very stable in water).

Scanning electron micrograph of monkeypox virus (orange) on infected cells (green).

NIAID

There is no evidence that you can get monkeypox from sewage itself. What triggers human-to-human transmission is prolonged, close contact with an infected person that exposes you directly to their rash, body fluids or respiratory droplets, according to World Health Organization. The bedding and clothing of people with monkeypox can also spread the virus.

Monkeypox has its own vaccine. The smallpox vaccine, which the US has in its national stockpile, also offers protection against it. But public access to monkeypox testing, treatment and vaccines remains limited. Testing wastewater can help public health officials spot monkeypox outbreaks without widespread testing and determine where to invest resources.

Wastewater monitoring can also detect new strains of monkeypox, two of which are currently circulating in the US. Almost all current outbreaks are driven by the West African strain of monkeypox, for which SCAN has a specific test. This strain is more contagious but far less lethal than another strain, known as the Congo Basin clade. In recent years, monkeypox has killed 3 to 6 percent of those infected, and is more deadly in young children. Monkeypox has killed three people worldwide this year.

SCAN is currently the only effort to publish data on monkeypox in wastewater. “The Bay Area is at the forefront of wastewater monitoring because we are, after all, Silicon Valley,” Boehm says. “But it’s not like California has monkeypox in the sewage and nowhere else.”



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