Monkeypox virus detection using wastewater surveillance during the Mpox outbreak in the Republic of Korea

Wastewater surveillance has emerged as a critical complementary approach for the early detection and monitoring of infectious disease outbreaks at the community level. This method is particularly effective for pathogens associated with socially stigmatized diseases, such as Mpox, which often remain underreported due to societal barriers. In this study, we aimed to detect the presence of the monkeypox virus (MPXV) in wastewater samples collected from four major wastewater treatment plants in Seoul during periods of increased Mpox transmission in South Korea (April to June and October 2023). We implemented a real-time polymerase chain reaction assay targeting specific MPXV genes ( F3L and A39R ) to identify viral presence in the samples. MPXV was detected in wastewater collected from regions with active “Men who have Sex with Men” communities, highlighting the potential of wastewater surveillance as a tool for capturing community-level infection trends that are not easily detected through clinical surveillance. This study suggests the feasibility of utilizing wastewater-based genomic surveillance to detect low-prevalence pathogens such as MPXV, providing valuable insights that can inform public health interventions. Our findings underscore the potential to integrate wastewater surveillance into broader monitoring frameworks to track pathogen spread in communities. • A real-time PCR assay was used to detect the monkeypox virus in Seoul. • Specific genes—F3L and A39R—were targeted in the wastewater samples. • The virus was detected in one sample from a wastewater treatment plant. • Wastewater surveillance facilitates pathogen detection.