Environmental Monitoring and Wastewater Analysis as Tools for Early Detection and Management of Mpox Outbreaks: A Scoping Review
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By
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Sizwe Nkambule
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Hanyani Lebese
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Yonela Mkunyana
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Edison Mavundza
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Mark E. Engel
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Renée Street
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December 29, 2025
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Clinical Scorecard: Environmental Monitoring and Wastewater Analysis as Tools for Early Detection and Management of Mpox Outbreaks: A Scoping Review
At a Glance
| Category | Detail |
|---|
| Condition | Mpox (Monkeypox) |
| Key Mechanisms | Detection of MPXV DNA in wastewater as an early warning system for outbreaks. |
| Target Population | Any human population/community at risk of MPXV exposure. |
| Care Setting | Public health surveillance in both urban and rural settings. |
Key Highlights
- MPXV detected in wastewater supports early outbreak detection.
- WES can identify infection trends prior to clinical reporting.
- Integration of WES enhances outbreak management, especially in LMICs.
- Stigma and surveillance fatigue hinder timely clinical testing.
- WES provides anonymous pooled sampling for large population screening.
Guideline-Based Recommendations
Diagnosis
- Utilize wastewater surveillance to complement clinical case reporting.
Management
- Implement WES as a tool for monitoring outbreaks and hotspots.
Monitoring & Follow-up
- Track MPXV concentrations in wastewater to predict clinical cases.
Risks
- Address stigma and resource limitations in LMICs affecting mpox surveillance.
Patient & Prescribing Data
Individuals in areas with reported mpox cases.
Focus on integrating wastewater analysis with clinical data for effective outbreak response.
Clinical Best Practices
- Combine clinical and environmental surveillance for comprehensive outbreak management.
- Educate communities to reduce stigma associated with mpox.
References
