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. 2023 Mar 1:231:119621.
doi: 10.1016/j.watres.2023.119621. Epub 2023 Jan 18.

Spanish wastewater reveals the current spread of Monkeypox virus

Inés Girón-Guzmán  1 , Azahara Díaz-Reolid  1 , Pilar Truchado  2 , Albert Carcereny  3 , David García-Pedemonte  3 , Bruno Hernáez  4 , Albert Bosch  3 , Rosa María Pintó  3 , Susana Guix  3 , Ana Allende  2 , Antonio Alcamí  4 , Alba Pérez-Cataluña  5 , Gloria Sánchez  6
Affiliations

Spanish wastewater reveals the current spread of Monkeypox virus

Inés Girón-Guzmán et al. Water Res. .

Abstract

Besides nasopharyngeal swabs, monkeypox virus (MPXV) DNA has been detected in a variety of samples such as saliva, semen, urine and fecal samples. Using the environmental surveillance network previously developed in Spain for the routine wastewater surveillance of SARS-CoV-2 (VATar COVID-19), we have analyzed the presence of MPXV DNA in wastewater from different areas of Spain. Samples (n = 312) from 24 different wastewater treatment plants were obtained between May 9 (week 19 of 2022) and August 4 (week 31 of 2022). Following concentration of viral particles by a validated aluminum adsorption-precipitation method, a qPCR procedure allowed us to detect MPXV DNA in 56 wastewater samples collected from May 16 to August 4, 2022, with values ranging between 2.2 × 103 to 8.7 × 104 genome copies (gc)/L. This study shows that MPXV DNA can be reproducibly detected by qPCR in longitudinal samples collected from different Spanish wastewater treatment plants. According to data from the National Epidemiological Surveillance Network (RENAVE) in Spain a total of 6,119 cases have been confirmed as of August 19, 2022. However, and based on the wastewater data, the reported clinical cases seem to be underestimated and asymptomatic infections may be more frequent than expected.

Keywords: Epidemiology; Monkeypox; WBE; Wastewater.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Image, graphical abstract
Graphical abstract
Fig. 1
Fig. 1
(A) Evolution of MPXV DNA prevalence over time, as measured by qPCR in wastewater samples from 20 wastewater treatment plants with positive detection (B) Number of cases of monkeypox per week (Spanish Ministry of Health) (C) Geographical localization of wastewater treatment plants, dark blue (Autonomous Community with positive detection in the analyzed wastewater samples), light blue (no detection in wastewater samples) and gray (regions not covered in the study). (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
Fig. 2
Fig. 2
Monkeypox virus recovery (%) in wastewater samples using the aluminum-based adsorption-precipitation method. MPXV detection was performed using the West Africa (G2R_WA) assay (Li et al., 2010) of undiluted and ten-fold diluted DNA.
Fig. 3
Fig. 3
Comparison of MPXV DNA estimates from wastewater testing (left panels) and confirmed cases of monkeypox by Autonomous Community reported by the Health Ministry authorities (right panels). For wastewater samples, highest level within the same Autonomous Community are depicted. ND: No MPXV detection (light purple); NP: regions without WWTP analyzed in the study (gray). (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
See this image and copyright information in PMC

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