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. 2025 Apr 16;12(5):ofaf225.
doi: 10.1093/ofid/ofaf225. eCollection 2025 May.

Stability of Monkeypox Virus on Commonly Contacted Surfaces in Clinical Settings

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Stability of Monkeypox Virus on Commonly Contacted Surfaces in Clinical Settings

Andra Banete et al. Open Forum Infect Dis. .

Abstract

Monkeypox virus (MPXV), the etiologic agent of mpox, is an enveloped DNA virus that may persist on various surfaces, contributing to fomite-mediated transmission. The ongoing global outbreak of mpox has highlighted an urgent need to understand the environmental stability of MPXV. This study investigates the stability of MPXV on surfaces encountered in clinical settings. The persistence of viable MPXV and viral DNA was evaluated using porous (gauze, cotton, and scrubs), and nonporous (stainless steel, polypropylene plastic, intravenous tubing, N95 masks, and nitrile gloves) materials. Surfaces were inoculated with 105, 106, and 107 TCID50 (50% Tissue Culture Infectious Dose) MPXV and incubated at room temperature (22 °C) and 4 °C for up to 21 days to determine the effect of temperature and inoculum titre on virus viability. We show that MPXV stability is influenced by both surface type and temperature, with nonporous surfaces and lower temperatures supporting longer virus viability. Infectious MPXV was detected for up to 21 days on intravenous tubing and nitrile gloves at 4 °C, whereas porous materials like cotton showed rapid loss of infectivity, especially at room temperature. Notably, we found that viral DNA did not correlate with the presence of infectious virus, suggesting that molecular assays may overestimate fomite-mediated transmission risks. Our findings provide novel insights into MPXV persistence in clinical environments, extending prior knowledge by systematically quantifying virus viability across multiple surface types and temperature conditions. These findings underscore the importance of stringent decontamination protocols in clinical settings and highlight the need for comprehensive methods for risk assessment to evaluate the potential for MPXV transmission from contaminated surfaces.

Keywords: mpox; mpox virus; stability; surface; transmission.

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Figures

Figure 1.
Figure 1.
Stability of infectious monkeypox virus (MPXV) on porous surfaces at room temperature and 4 °C. Inocula of 50 μL containing 105, 106, or 107 TCID50 of MPXV were evenly applied to the circular pieces of porous materials on 12-well plates in triplicate and incubated at room temperature (RT, 22 °C) or 4°C. A, Infectious MPXV titers and (B) MPXV DNA were measured up to 21 d after inoculation. A, The mean and standard deviation and area between error bands shaded is shown. B, The dashed horizontal line indicates a Ct value of 36, representing clearance of MPXV DNA.
Figure 2.
Figure 2.
Stability of infectious monkeypox virus (MPXV) on nonporous surfaces at room temperature and 4 °C. Inocula of 50 μL containing 105, 106, or 107 TCID50 of MPXV were evenly applied to the circular pieces of porous materials on 12-well plates in triplicate and incubated at room temperature (RT, 22 °C) or 4°C. A, Infectious MPXV titers and (B) MPXV DNA were measured up to 21 d after inoculation. A, The mean and standard deviation and area between error bands shaded is shown. B, The dashed horizontal line indicates a Ct value of 36, representing clearance of MPXV DNA.

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