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Global participatory wastewater surveillance to understand Mpox clade diversity in war and conflict-affected countries

Wannigama, Dhammika Leshan; Amarasiri, Mohan; Phattharapornjaroen, Phatthranit; Hurst, Cameron; Modchang, Charin; Wang, Yangzhong; Miyanaga, Kazuhiko; Cui, Longzhu; Fernandez, Stefan; Huang, Angkana T.; Melhem, Nada M.; Singer, Andrew C. ORCID: https://orcid.org/0000-0003-4705-6063; Ragupathi, Naveen Kumar Devanga; Araujo, Juliana Calabria; Sei, Kazunari; Ndatuwong, Lazarus G.; Mahmood, Syed Faisal; Shimotai, Yoshitaka; Kanjanabuch, Talerngsak; Higgins, Paul G.; Aoyagi, Tetsuji; Kicic, Anthony; Nanbo, Asuka; Mori, Hirotake; Siow, Richard; Kurt, Özgür; Trowsdale, Sam; Hongsing, Parichart; Khatib, Aisha; Sano, Daisuke; Shibuya, Kenji; Abe, Shuichi; Hamamoto, Hiroshi. 2025 Global participatory wastewater surveillance to understand Mpox clade diversity in war and conflict-affected countries. Journal of Travel Medicine, 32 (5), taaf052. 10.1093/jtm/taaf052

Abstract
Community-led wastewater surveillance reveals widespread circulation of the mpox virus and clade diversity in conflict-affected countries. This low-cost approach fills critical surveillance gaps, uncovering regional clade variations, including the more severe Clade Ib, and highlighting the potential of decentralized genomic monitoring where traditional systems fail.
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