Persistence of Monkeypox Virus on Healthcare Surfaces: Impact of Material and Temperature
Overview
This study demonstrates that monkeypox virus (MPXV) viability on surfaces in healthcare settings is influenced by surface type and temperature, with nonporous materials and lower temperatures supporting longer virus survival. Infectious MPXV was detected up to 21 days on intravenous tubing and nitrile gloves at 4 °C, while porous materials like cotton showed rapid loss of infectivity at room temperature. Viral DNA detection did not correlate with infectious virus presence, indicating molecular assays may overestimate fomite transmission risk.
Background
Monkeypox virus (MPXV) is an enveloped DNA virus responsible for the mpox disease, which has caused a global outbreak since 2022. Transmission primarily occurs through direct contact with infectious lesions or bodily fluids, but environmental stability raises concerns about fomite-mediated spread, especially in healthcare environments. Previous studies have shown poxviruses can remain viable on surfaces for extended periods, with stability influenced by temperature and humidity. However, data on MPXV persistence on clinical materials and the associated transmission risk to healthcare workers remain limited.
Data Highlights
Surface Type
Temperature
MPXV Viability Duration
Intravenous tubing (nonporous)
4 °C
Up to 21 days
Nitrile gloves (nonporous)
4 °C
Up to 21 days
Cotton (porous)
Room temperature (22 °C)
Rapid loss of infectivity (short duration)
Key Findings
MPXV stability is greater on nonporous surfaces such as stainless steel, polypropylene plastic, intravenous tubing, N95 masks, and nitrile gloves compared to porous materials like gauze, cotton, and scrubs.
Lower temperatures (4 °C) significantly prolong MPXV viability, with infectious virus detected up to 21 days on certain nonporous surfaces.
Porous materials, especially cotton, show rapid loss of MPXV infectivity at room temperature.
Detection of viral DNA by molecular assays does not reliably indicate the presence of infectious virus, potentially overestimating transmission risk from fomites.
These findings highlight the importance of stringent decontamination protocols in healthcare settings to prevent fomite-mediated MPXV transmission.
Clinical Implications
Healthcare facilities should prioritize rigorous cleaning and disinfection of nonporous surfaces, especially those frequently touched such as intravenous tubing and gloves, to reduce MPXV transmission risk. Reliance solely on molecular detection of viral DNA for infection control decisions may be misleading, underscoring the need for methods that assess viral infectivity. Temperature control during specimen handling and storage is also critical to limit virus persistence.
Conclusion
This study provides critical insights into the persistence of infectious MPXV on various clinical surfaces, emphasizing that both surface type and environmental temperature influence virus viability. These findings support enhanced infection prevention strategies to mitigate fomite-mediated transmission in healthcare environments.
