Late last week, U.S. government officials declared the ongoing monkeypox outbreak to be a public health emergency. Meanwhile, the same wastewater surveillance techniques that emerged as a critical tool in early detection of COVID-19 outbreaks are being adapted for use in monitoring the spread of monkeypox across some U.S. communities.

The federal government’s declarations, which came from the Department of Health and Human Services and the Food and Drug Administration, follow similar ones made by some states and cities, including California and New York City. They pave the way for an increase in funding for tests, vaccines, and treatments. Included in the nation’s efforts to address the current outbreak is testing wastewater for the presence of monkeypox, as has been done for the coronavirus. The same research team that pioneered efforts to detect coronavirus in U.S. wastewater, the Sewer Coronavirus Alert Network (SCAN), is now a leader in expanding monitoring to detect monkeypox. Currently the SCAN website shows results from wastewater sampling for monkeypox in some communities in California, Colorado, Florida, Georgia, Idaho, Kansas, Kentucky, Michigan, Pennsylvania, and Texas. The number of wastewater systems testing for monkeypox is limited, and the CDC isn’t reporting results on its national wastewater surveillance system (currently only being used for COVID-19). SCAN hopes to scale up its efforts to 300 sites.

Researchers consider wastewater surveillance a complement to other public health tools, not a replacement. But it can serve as an early indicator of community health threats. The discovery of monkeypox in San Francisco's wastewater system in June, the first such finding in the nation, set off alarms in the city. Nationwide, the CDC reports there are nearly 9,000 confirmed cases of monkeypox, with every state having at least one case, with the exception of Wyoming.

Read more at the University of Minnesota Center for Infectious Disease Research and Policy and NPR.