Detection of Monkeypox Virus DNA in Airport Wastewater, Rome, Italy

ily Poxviridae, causes monkeypox, a viral zoonosis detected in north Africa in the 1970s (1). MPXV can be transmitted between humans through contact with lesions, body fluids, respiratory droplets, and contaminated materials (1). In May 2022, an epidemic of monkeypox in nonendemic regions outside Africa began receiving worldwide attention. On July 23, 2022, the World Health Organization declared monkeypox a public health emergency of international concern (2), and 24,973 monkeypox cases had been recognized in 45 countries throughout Europe by October 12, 2022 (3). Rapid identification of outbreaks and clusters is critical for infection control. Sewage surveillance has been recognized as a powerful tool for assessing the circulation of pathogens. After the European Union issued Recommendation 2021/472 (http://data.europa. eu/eli/reco/2021/472/oj), wastewater surveillance was successfully used to track SARS-CoV-2 and its variants across EU countries (4). Studies have demonstrated MPXV DNA sheds from saliva, feces, urine, semen, and skin lesions (5–7), suggesting that the viral genome could occur in wastewater. Various research groups involved in SARS-CoV-2 environmental surveillance extended their efforts to investigate MPXV DNA in wastewater. Studies from the Netherlands and western California, USA, have documented successful detection of MPXV DNA in sewage (8; M.K. Wolfe et al., unpub. data, https://doi.org/10.1101/2022.07.2 5.22278043). We investigated whether we could detect MPXV in wastewater in Italy.