North Carolina health officials urge vigilance after detecting Clade I mpox in Greenville wastewater samples, despite no reported cases.
RALEIGH, N.C. — North Carolina health officials are urging residents and healthcare providers to remain vigilant following the detection of mpox virus particles in wastewater samples from Greenville. The North Carolina Department of Health and Human Services (NCDHHS) reported Tuesday that testing revealed the presence of Clade I mpox, a strain not previously identified in the state.
“The detection of Clade I mpox virus in wastewater surveillance tells us the virus is potentially here in our state, even though no cases have been reported and confirmed,” NC Health and Human Services Secretary Dev Sangvai said in the department’s press release.
The concerning samples were collected on March 25, March 28, and April 8 from a treatment plant in Greenville. This discovery indicates there may have been at least one undiagnosed or unreported case of clade I mpox in the area during this period.
Dr. Emma Doran, medical director for vaccine preventable and respiratory diseases with NCDHHS, explained in an interview on WCNC+ that wastewater testing serves as an “early warning” system.
“Wastewater, is not the water that you’re drinking. So there’s no risk of infection from the wastewater,” Doran said on Live Impact News. “These are virus that we’re detecting is kind of broken down particles, and we can’t really say if there’s one case or more.”
Understanding the different mpox strains
The mpox virus, formerly known as monkeypox, can cause serious symptoms and primarily spreads through close contact, particularly skin-to-skin contact. Doran noted that there are “two strains of that. We call those clades, and so there’s clade I and clade II. They both spread the same way and they can be prevented the same way.”
The 2022 mpox outbreak in the United States was caused by clade II. The current detection in North Carolina is clade I, which is responsible for a significant outbreak in Central and Eastern Africa. To date, only four cases of clade I mpox have been reported in the United States.
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“There’s a very large outbreak occurring in central and eastern Africa at the moment of clade I, and so we’ve only seen four cases of clade I mpox so far in the United States and all of those cases were travel related,” Doran explained.
Risk factors and prevention
According to health officials, clade I mpox appears to be spreading primarily through heterosexual contact in Africa, with some transmission to household members, including children. This differs somewhat from the clade II outbreak pattern in 2022.
“The clade II risk factors were a little bit different and we saw that transmit more in the gay, bisexual men who have sex with men community,” Doran explained. “That might still be a risk factor, but those four clade i cases that we’ve seen elsewhere in the United States were travel related.”
NCDHHS advises that vaccines are available to protect against both clade types of mpox and can reduce illness severity if infection occurs. Information about vaccine recommendations and locations is available on the NCDHHS mpox page.
Symptoms to watch for
Health officials are asking people to be aware of mpox symptoms, which include a characteristic rash that can appear on any part of the body. The rash may initially look like pimples or blisters and can be painful or itchy. Some people experience flu-like symptoms before the rash appears, while others may develop the rash first followed by other symptoms. In some cases, a rash is the only symptom experienced.
Anyone who thinks they have mpox or has had close contact with someone infected should contact their healthcare provider or local health department.
Wastewater surveillance at risk
North Carolina’s wastewater monitoring network, established in 2021, has become an important tool for tracking virus spread across communities. The system currently tests for multiple viruses including coronavirus, influenza, RSV, and mpox.
“North Carolina’s wastewater testing is a center of excellence and so we’re kind of on the cutting edge of that,” Doran stated However, she warned that “the funding for that is at risk given the federal cuts that have been proposed and and that have happened recently.”
NCDHHS emphasizes that while this detection is concerning, the overall risk to the public remains low. Healthcare providers are being asked to consider mpox in patients with compatible symptoms and to inquire about recent international travel.
For more information about mpox symptoms, prevention, and vaccine availability, residents can visit the NCDHHS mpox page or contact their local health department.
