'Potentially' infectious monkeypox viral loads detected on high-touch hospital room surfaces, study finds

Researchers have found monkeypox virus lingering throughout the surfaces in patients’ hospital rooms, bathrooms and, to a lesser degree, adjoining rooms used by medical staff, underscoring the need for facilities treating these patients to maintain infection control and sanitation protocol.

The findings, published recently in the European infectious disease journal Eurosurveillance, come from two patients receiving care for monkeypox in a German hospital’s isolation rooms during late June.

Researchers who swabbed the rooms for environmental samples found varying degrees of contamination across each surface.

Monkeypox viral loads were highest in the patients’ bathrooms, particularly on high-touch surfaces such as toilet seats or the control levers of their sink or soap dispenser.

Door handles, chair surfaces and fabrics within the patients’ rooms were heavily contaminated as well, with some degree of viral DNA found “on all other investigated surfaces in the patients’ rooms, although it was not known at the time of testing whether and to what extent the patients had also touched these surfaces,” researchers wrote.

The researchers also detected “traces” of monkeypox viral DNA on all hand-contact points in an anteroom used by staff to don and doff personal protective equipment (PPE). They also found a small quantity of viral DNA on the handle of the door leading into the anteroom from the ward corridor.

Human transmission of monkeypox virus has primarily been attributed to direct person-to-person contact, the researchers wrote, although some cases of transmission within a healthcare setting have been reported when healthcare workers did not have adequate PPE.

While the jury is still out on just how much monkeypox virus is required to trigger an infection in humans, nonhuman primate findings suggest the quantity detected on some of these surfaces “could potentially be infectious and it cannot be ruled out that [the contaminated surfaces’] contact with especially damaged skin or mucous membranes could result in transmission.”

Still, researchers said their findings should be a reminder for hospital staff to follow recommended monkeypox protection measures: careful use of PPE, regular disinfection of frequently touched surfaces, proper hand hygiene and, potentially, vaccination.

As of a July 6 update from the World Health Organization (WHO), more than 6,000 cases of monkeypox have been reported across 58 countries during the current outbreak. Roughly 80% of those have been reported in Europe.

The global public health organization’s emergency committee declined to classify the outbreak as a public health emergency of international concern, its highest level of alert, although WHO Director-General Tedros Adhanom Ghebreyesus said Wednesday the organization will be reconvening the committee in the coming weeks.

There have been 605 cases confirmed in the U.S. as of July 6, according to the Centers for Disease Control and Prevention. The Biden administration said it had shipped nearly 20,000 doses of a monkeypox vaccine as of July 1 and has ordered millions more from manufacturers.