Stability of monkeypox virus on commonly contacted surfaces in clinical settings

Monkeypox virus (MPXV), the etiologic agent of mpox, is an enveloped DNA virus that may persist on various surfaces, contributing to fomite-mediated transmission. The ongoing global outbreak of mpox has highlighted an urgent need to understand the environmental stability of MPXV.

This study investigates the stability of MPXV on surfaces encountered in clinical settings. The persistence of viable MPXV and viral DNA was evaluated using porous (gauze, cotton, and scrubs), and non-porous (stainless steel, polypropylene plastic, IV tubing, N95 masks, and nitrile gloves) materials. Surfaces were inoculated with 10⁵, 10⁶, and 10⁷ TCID50 MPXV and incubated at room temperature (22°C) and 4°C for up to 21 days to determine the effect of temperature and inoculum titre on virus viability.

We show that MPXV stability is influenced by both surface type and temperature, with non-porous surfaces and lower temperatures supporting longer virus viability. Infectious MPXV was detected for up to 21 days on IV tubing and nitrile gloves at 4°C, while porous materials like cotton showed rapid loss of infectivity, especially at room temperature. Notably, we found that viral DNA did not correlate with the presence of infectious virus, suggesting that molecular assays may overestimate fomite-mediated transmission risks.

Our findings provide novel insights into MPXV persistence in clinical environments, extending prior knowledge by systematically quantifying virus viability across multiple surface types and temperature conditions. These findings underscore the importance of stringent decontamination protocols in clinical settings, and highlight the need for comprehensive methods for risk assessment to evaluate the potential for MPXV transmission from contaminated surfaces.