What Scientists Found on Surfaces in Monkeypox Patient Hospital Rooms

Scientists have detected the monkeypox virus lying on surfaces of two hospital rooms, according to a new study.

Lead author Dominik Nörz swabbed the surfaces of two rooms holding hospitalized monkeypox patients in Germany, and the adjacent anterooms, where staff would change in and out of personal protective equipment (PPE). The findings showed that all surfaces "directly touched" by the patients' hands had viral contamination. The scientists found the highest viral loads on the surfaces of the patients' bathrooms.

Monkeypox cases have continued to spread across at least 52 nations. Before the latest outbreak, monkeypox was only usually recorded in West and Central Africa. The infectious disease's symptoms include fever, swollen lymph nodes, and a body rash.

The virus was also detected on chairs, which both patients used frequently, the mobile phone of one patient, and both patients' fabrics. Contamination detected on the surfaces of the rooms is believed to primarily be from medical staff treating the patients. The highest level in the rooms was found on cabinet door handles, in the room of the first patient.

It was also found in all contact points in the anteroom. However, "only traces" of viral DNA were found on the door of the patient's room.

Scientists are trying to determine what is causing the virus to spread so rapidly during this outbreak. It is understood that monkeypox mainly transmits through direct physical contact with an infected person. Amid the recent outbreak, scientists are researching other possible transmission routes.

The study notes that secondary infections of the virus have occurred before. The study from Eurosurveillance highlights a previous monkeypox outbreak in Africa, where a nurse became infected with the virus after removing a patient's clothing, taking blood and checking the patient's temperature without adequate PPE.

Another case reported in the United Kingdom saw a healthcare worker become ill after changing "potentially contaminated bed linen" without adequate PPE.

The authors of the study caution that there is no "definite data" on what viral load is needed to infect a human with monkeypox. However, it is assumed that it requires a significantly higher dose than other diseases, such as smallpox.

Even though the virus was found on surfaces, it does not mean that infection can occur from touching them, according to the study.

"Despite high contamination with up to 105 cp/cm2 as well as the successful recovery of monkeypox virus from samples with a total of > 106 copies, our findings do not prove that infection can occur from contact with these surfaces. No secondary case in the context of clinical care of the two patients in our study has been observed so far," the study says.

It adds that contaminated surfaces have the potential to be infectious, and "it cannot be ruled out that their contact with especially damaged skin or mucous membranes, could result in transmission."

Dr. Hugh Adler from the Department of Clinical Sciences at the Liverpool School of Tropical Medicine told Newsweek that this is "absolutely an expected development."

"Patients with extensive skin lesions admitted to hospital are likely to spread the highest amount of virus to the environment. Patients with milder disease might shed less; we don't know yet," Adler said.

"As the authors mention, one instance of monkeypox transmission was previously linked to a hospital patient's infected bed linen," he continued. "Monkeypox viral persistence on surfaces is already well known in public health circles, and current public health guidelines for people self-isolating at home include recommendations for how to do laundry and steps to be taken to prevent transmission to household contacts.

Outside of very heavily contaminated areas (someone's hospital room, someone's bedroom at home, etc), surfaces in the community are not likely to be high risk for transmission, in my opinion," Adler said. "Reports like this one in Eurosurveillance are really useful and may allow us to refine/expand these guidelines over time. Many other labs in other countries are doing similar research to confirm/expand these findings.

Adler said that these findings are not a cause for concern, merely they "reinforce the importance of following public health guidelines."

"This data refers to a hospital room, and may translate to the home environment (e.g. someone's bedroom while they're self-isolating) but this paper does not mean that monkeypox patients shed infectious virus into the wider environment/surfaces around the town."