Emergence and Global Spread of Mpox Clade Ib: Challenges and the Role of Wastewater and Environmental Surveillance.

Several African countries, mainly the Democratic Republic of Congo, Burundi, and Uganda, are facing highly transmissible mpox clade Ib epidemics, prompting the World Health Organization to declare a Public Health Emergency of International Concern. It has spread to key travel hubs like Kinshasa, Bujumbura, and Kampala, increasing international spread risks. Current mitigation efforts focus mainly on medical care, diagnostics, vaccination, and infection prevention, but overlook wastewater and environmental surveillance (WES). WES can be effective in detecting hotspots and enabling rapid response through enhanced data collection and genomic sequencing. This perspective article reviews the latest outbreak situation and advocates integrating WES into response strategies.