ArticleEmerging infectious diseases2026
Monkeypox Virus Surveillance in Wastewater, North Carolina, USA, October 2023-May 2025.
Article in Emerging infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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11 authors.
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Abstract
In September 2023, the North Carolina Department of Health and Human Services identified a new case of mpox clade II 5 months after the last previous report. To assess possible unrecognized transmission, nonvariola orthopoxvirus testing was implemented at select wastewater sites. During October 29, 2023-May 2025, a total of 801 samples were collected across 16 treatment plants serving ≈2 million residents. We analyzed wastewater detections (n = 47) and clinical cases (n = 45) using a +17-day window. Overall sensitivity of identifying the presence of >1 temporally aligned mpox case within a sewershed was 10.6% (95% CI 6.5%-16.7%); specificity was 95.1% (95% CI 93.2%-96.5%), positive predictive value was 31.9% (95% CI 20.4%-46.2%), and negative predictive value was 83.2% (95% CI 80.3%-85.7%). Restricting detections above the limit of detection reduced sensitivity but increased specificity. Overall, wastewater surveillance showed low sensitivity but provided complementary awareness for public health response.
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