{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T21:33:55Z","timestamp":1791495235943,"version":"4.3.4"},"reference-count":34,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T00:00:00Z","timestamp":1724889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infectious Disease Reports"],"abstract":"<jats:p>Since COVID-19, mpox was the first emerging pathogen to have spread globally in 2022. Wastewater-based surveillance (WBS) has proven to be an efficient early warning system for detecting potential resurgences. This report aims to provide insight into the development and implementation of WBS of mpox in Slovenia and to incorporate the surveillance results into the development of public health interventions. WBS of mpox was conducted during the period from 1 June 2023 to 30 September 2023 at the wastewater treatment plant (WWTP) Ljubljana and WWTP Koper. The selected detection method of the monkeypox virus (MPXV) in the wastewater sample was based on PCR analysis. The implemented laboratory method showed that the sample preparation and concentration method enables a stable procedure for MPXV detection in wastewater samples. The laboratory analysis of wastewater samples from the selected WWTPs did not detect the MPXV during the monitoring period. In the event of MPXV detection in a wastewater sample, targeted public health interventions would be implemented, focusing on increasing awareness among the groups of men who have sex with other men and searching for positive mpox cases. We recommend that the developed system be retained in the case of an emergency epidemiological situation.<\/jats:p>","DOI":"10.3390\/idr16050065","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T03:40:39Z","timestamp":1724902839000},"page":"836-845","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Wastewater Surveillance of Mpox during the Summer Season of 2023 in Slovenia"],"prefix":"10.3390","volume":"16","author":[{"given":"Jan","family":"Ro\u017eanec","sequence":"first","affiliation":[{"name":"National Institute of Public Health, Trubarjeva ulica 2, SI-1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8358-0490","authenticated-orcid":false,"given":"Natalija","family":"Kranjec","sequence":"additional","affiliation":[{"name":"National Institute of Public Health, Trubarjeva ulica 2, SI-1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana","family":"Obid","sequence":"additional","affiliation":[{"name":"National Institute of Public Health, Trubarjeva ulica 2, SI-1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6819-2406","authenticated-orcid":false,"given":"Andrej","family":"Steyer","sequence":"additional","affiliation":[{"name":"National Laboratory of Health, Environment and Food, Prvomajska ulica 1, SI-2000 Maribor, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4053-5590","authenticated-orcid":false,"given":"Tja\u0161a","family":"Cerar Ki\u0161ek","sequence":"additional","affiliation":[{"name":"National Laboratory of Health, Environment and Food, Prvomajska ulica 1, SI-2000 Maribor, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Koritnik","sequence":"additional","affiliation":[{"name":"National Laboratory of Health, Environment and Food, Prvomajska ulica 1, SI-2000 Maribor, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Fafangel","sequence":"additional","affiliation":[{"name":"National Institute of Public Health, Trubarjeva ulica 2, SI-1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3639-9817","authenticated-orcid":false,"given":"An","family":"Gali\u010di\u010d","sequence":"additional","affiliation":[{"name":"National Institute of Public Health, Trubarjeva ulica 2, SI-1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,29]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2024, August 16). Multi-Country Outbreak of Mpox, External Situation Report #35\u201412 August 2024. Available online: https:\/\/reliefweb.int\/report\/world\/multi-country-outbreak-mpox-external-situation-report-35-12-august-2024."},{"key":"ref_2","unstructured":"National Institute of Public Health (2023). Communicable Disease Registry\u2014NIJZ48, National Institute of Public Health."},{"key":"ref_3","unstructured":"World Health Organization (2023, December 11). 2022-23 Mpox (Monkeypox) Outbreak: Global Trends. Available online: https:\/\/worldhealthorg.shinyapps.io\/mpx_global\/#section-fns2."},{"key":"ref_4","first-page":"2200471","article-title":"Monkeypox Outbreak Predominantly Affecting Men Who Have Sex with Men, Madrid, Spain, 26 April to 16 June 2022","volume":"27","year":"2022","journal-title":"Eurosurveillance"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e28250","DOI":"10.1002\/jmv.28250","article-title":"Monkeypox Viral Detection in Semen Specimens of Confirmed Cases: A Systematic Review and Meta-Analysis","volume":"95","author":"Reda","year":"2023","journal-title":"J. Med. Virol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1056\/NEJMoa2207323","article-title":"Monkeypox Virus Infection in Humans across 16 Countries\u2014April\u2013June 2022","volume":"387","author":"Thornhill","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"319","DOI":"10.3390\/idr15030032","article-title":"Mpox: Fifty-Nine Consecutive Cases from a Mexican Public Hospital; Just the Tip of the STIs Iceberg","volume":"15","year":"2023","journal-title":"Infect. Dis. Rep."},{"key":"ref_8","first-page":"2200503","article-title":"Frequent Detection of Monkeypox Virus DNA in Saliva, Semen, and Other Clinical Samples from 12 Patients, Barcelona, Spain, May to June 2022","volume":"27","author":"Fuertes","year":"2022","journal-title":"Eurosurveillance"},{"key":"ref_9","unstructured":"World Health Organization (2023, December 20). Surveillance, Case Investigation and Contact Tracing for Mpox (Monkeypox): Interim Guidance, 22 December 2022. Available online: https:\/\/iris.who.int\/handle\/10665\/365398."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"159816","DOI":"10.1016\/j.scitotenv.2022.159816","article-title":"Multiple Traces of Monkeypox Detected in Non-Sewered Wastewater with Sparse Sampling from a Densely Populated Metropolitan Area in Asia","volume":"858","author":"Wannigama","year":"2023","journal-title":"Sci. Total Environ."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Wolfe, M.K., Duong, D., Hughes, B., Chan-Herur, V., White, B.J., and Boehm, A.B. (2022). Detection of Monkeypox Viral DNA in a Routine Wastewater Monitoring Program. medRxiv, 22278043.","DOI":"10.1101\/2022.07.25.22278043"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1021\/acs.estlett.2c00693","article-title":"First Detection of Monkeypox Virus Genome in Sewersheds in France: The Potential of Wastewater-Based Epidemiology for Monitoring Emerging Disease","volume":"9","author":"Wurtzer","year":"2022","journal-title":"Environ. Sci. Technol. Lett."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"158265","DOI":"10.1016\/j.scitotenv.2022.158265","article-title":"The Detection of Monkeypox Virus DNA in Wastewater Samples in The Netherlands","volume":"852","author":"Peterse","year":"2022","journal-title":"Sci. Total Environ."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"164414","DOI":"10.1016\/j.scitotenv.2023.164414","article-title":"Wastewater Surveillance of Mpox Virus in Baltimore","volume":"891","author":"Sherchan","year":"2023","journal-title":"Sci. Total Environ."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"119621","DOI":"10.1016\/j.watres.2023.119621","article-title":"Spanish Wastewater Reveals the Current Spread of Monkeypox Virus","volume":"231","author":"Truchado","year":"2023","journal-title":"Water Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"193","DOI":"10.3201\/eid2901.221311","article-title":"Detection of Monkeypox Virus DNA in Airport Wastewater, Rome, Italy","volume":"29","author":"Mancini","year":"2023","journal-title":"Emerg. Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.ijid.2023.05.014","article-title":"Mpox Virus Detection in the Wastewater and the Number of Hospitalized Patients in the Poznan Metropolitan Area, Poland","volume":"133","author":"Gazecka","year":"2023","journal-title":"Int. J. Infect. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"164289","DOI":"10.1016\/j.scitotenv.2023.164289","article-title":"Monkeypox Viral Nucleic Acids Detected Using Both DNA and RNA Extraction Workflows","volume":"890","author":"Sharkey","year":"2023","journal-title":"Sci. Total Environ."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Mejia, E.M., Hizon, N.A., Dueck, C.E., Lidder, R., Daigle, J., Wonitowy, Q., Medina, N.G., Mohammed, U.P., Cox, G.W., and Safronetz, D. (2022). Exploration of Wastewater Surveillance for Monkeypox Virus. medRxiv, 22282091.","DOI":"10.1101\/2022.11.10.22282091"},{"key":"ref_20","unstructured":"World Health Organization (2024, January 15). Considerations for the Control and Elimination of Mpox in the WHO European Region Update 25 April 2023: The Need for Integrated National Operational Plans. Available online: https:\/\/iris.who.int\/handle\/10665\/367265."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"106896","DOI":"10.1016\/j.ijsu.2022.106896","article-title":"FDA Approved Vaccines for Monkeypox: Current Eminence","volume":"105","author":"Chopra","year":"2022","journal-title":"Int. J. Surg."},{"key":"ref_22","unstructured":"National Institute of Public Health (2023). Electronic Register of Vaccinated Persons and Adverse Reactions\u2014eRCO (NIJZ49), National Institute of Public Health."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Bragazzi, N.L., Woldegerima, W.A., Iyaniwura, S.A., Han, Q., Wang, X., Shausan, A., Badu, K., Okwen, P., Prescod, C., and Westin, M. (2022). Knowing the Unknown: The Underestimation of Monkeypox Cases. Insights and Implications from an Integrative Review of the Literature. Front. Microbiol., 13.","DOI":"10.3389\/fmicb.2022.1011049"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2200448","DOI":"10.2807\/1560-7917.ES.2022.27.24.2200448","article-title":"Estimated Incubation Period for Monkeypox Cases Confirmed in the Netherlands, May 2022","volume":"27","author":"Miura","year":"2022","journal-title":"Eurosurveillance"},{"key":"ref_25","unstructured":"Slovenian Tourist Board (2024, January 19). Events. (In Slovenian)."},{"key":"ref_26","unstructured":"Statistical Office of the Republic of Slovenia (2024, January 22). Database Si-STAT: Tourism. (In Slovenian)."},{"key":"ref_27","unstructured":"Statistical Office of the Republic of Slovenia (2024, July 03). Population Number and Structure. (In Slovenian)."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2200816","DOI":"10.2807\/1560-7917.ES.2022.27.45.2200816","article-title":"Evaluation of 11 Commercially Available PCR Kits for the Detection of Monkeypox Virus DNA, Berlin, July to September 2022","volume":"27","author":"Michel","year":"2022","journal-title":"Eurosurveillance"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/0166-0934(95)00025-P","article-title":"Methods to Remove Inhibitors in Sewage and Other Fecal Wastes for Enterovirus Detection by the Polymerase Chain Reaction","volume":"54","author":"Shieh","year":"1995","journal-title":"J. Virol. Methods"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"37","DOI":"10.15585\/mmwr.mm7302a3","article-title":"Detecting Mpox Cases Through Wastewater Surveillance\u2014United States, August 2022\u2013May 2023","volume":"73","author":"Adams","year":"2024","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"159166","DOI":"10.1016\/j.scitotenv.2022.159166","article-title":"Monkeypox Outbreak: Wastewater and Environmental Surveillance Perspective","volume":"856","author":"Tiwari","year":"2023","journal-title":"Sci. Total Environ."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Alakunle, E., Moens, U., Nchinda, G., and Okeke, M.I. (2020). Monkeypox Virus in Nigeria: Infection Biology, Epidemiology, and Evolution. Viruses, 12.","DOI":"10.3390\/v12111257"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1089\/lgbt.2022.0281","article-title":"Mpox Stigma, Online Homophobia, and the Mental Health of Gay, Bisexual, and Other Men Who Have Sex with Men","volume":"10","author":"Keum","year":"2023","journal-title":"LGBT Health"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1021\/acs.estlett.2c00496","article-title":"Model-Based Theoretical Evaluation of the Feasibility of Using Wastewater-Based Epidemiology to Monitor Monkeypox","volume":"9","author":"Chen","year":"2022","journal-title":"Environ. Sci. Technol. Lett."}],"container-title":["Infectious Disease Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2036-7449\/16\/5\/65\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:44:45Z","timestamp":1760111085000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2036-7449\/16\/5\/65"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,29]]},"references-count":34,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,10]]}},"alternative-id":["idr16050065"],"URL":"https:\/\/doi.org\/10.3390\/idr16050065","relation":{},"ISSN":["2036-7449"],"issn-type":[{"value":"2036-7449","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,29]]}}}