Article(id=1322607944517136988, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322607837742747790, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202501426, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1737820800000, receivedDateStr=2025-01-26, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793263906839, onlineDateStr=2026-10-29, pubDate=1761321600000, pubDateStr=2025-10-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793263906839, onlineIssueDateStr=2026-10-29, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793263906839, creator=13701087609, updateTime=1793263906839, updator=13701087609, issue=Issue{id=1322607837742747790, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='20', pageStart='3649', pageEnd='3840', issueExtLink='null', onlineDate='null', pubDate='1761321600000', pubDateStr='2025-10-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793263881383, creator='13701087609', updateTime=1793264238791, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322609336933794638, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322607837742747790, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322609336933794639, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322607837742747790, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=3820, endPage=3823, ext={EN=ArticleExt(id=1322607944739435101, articleId=1322607944517136988, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Research progress on environmental contamination monitoring of Monkeypox virus, columnId=1228016573156360233, journalTitle=Modern Preventive Medicine, columnName=Disease Control and Prevention, runingTitle=null, highlight=null, articleAbstract=

Monkeypox (MPX) is a significant global public health issue, characterized by high contagion and universal susceptibility among populations, thereby imposing a considerable economic burden on both society and individual patients. The Monkeypox (MPXV)virus has been circulating within the human population for several years and continues to evolve. However, there are currently no specific antiviral treatments available for MPX, making this disease a major concern. Current evidence indicates that the MPXV can survive and remain infectious in certain environments, with its survival time varying across different settings, influenced by environmental factors such as contaminated surfaces and temperature. This article provides a comprehensive review from various perspectives, including an introduction to the MPXV, environmental wastewater monitoring, surface environmental monitoring, virus persistence at varying temperatures, and air monitoring, thereby offering insights for the early detection and prevention of MPX.

, authors=Jia-sheng ZHANG1, Min ZHANG1, Jing YANG2, Ri-sheng ZHA1, authorsList=Jia-sheng ZHANG, Min ZHANG, Jing YANG, Ri-sheng ZHA, authorCompany=null, correspAuthors=Ri-sheng ZHA, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322607945154671198, articleId=1322607944517136988, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=环境中猴痘病毒污染监测研究进展, columnId=1228016573844226129, journalTitle=现代预防医学, columnName=疾病预防控制, runingTitle=null, highlight=null, articleAbstract=

猴痘(Monkeypox,MPX)作为一种全球性公共卫生问题,不仅传染性强,而且人群普遍易感,给社会和患者个人带来了沉重的经济负担。目前猴痘病毒已在人群中传播数年且不断演变,至今尚无特异性抗猴痘病毒药物,因此该病备受关注。现有证据表明,在特定环境中猴痘病毒(Monkeypox virus,MPXV)是可存活的,并具有传染性,同时受环境因素影响(如不同材料物表、温度等),不同环境中存活时间不同。本文从猴痘病毒简介、环境污水监测、物表环境监测、不同温度下病毒持久性、空气监测等方面进行综述,为猴痘早发现早预防提供借鉴。

, authors=张加生1, 张敏1, 杨静2, 查日胜1, authorsList=张加生, 张敏, 杨静, 查日胜, authorCompany=null, correspAuthors=查日胜, authorNote=

张加生(1992—),男,硕士,主管医师,研究方向:公共卫生和疾病控制相关工作

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查日胜,E-mail:
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张加生(1992—),男,硕士,主管医师,研究方向:公共卫生和疾病控制相关工作

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环境中猴痘病毒污染监测研究进展
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张加生 1 , 张敏 1 , 杨静 2 , 查日胜 1
现代预防医学 | 疾病预防控制 2025,52(20): 3820-3823
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现代预防医学 |疾病预防控制 2025 , 52 (20) : 3820 -3823
环境中猴痘病毒污染监测研究进展
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张加生1, 张敏1, 杨静2, 查日胜1
作者信息
  • 1.苏州高新区疾病预防控制中心,江苏 苏州 215010
  • 2.南京医科大学附属江苏盛泽医院
通讯作者:
查日胜,E-mail:
作者简介:

张加生(1992—),男,硕士,主管医师,研究方向:公共卫生和疾病控制相关工作

Research progress on environmental contamination monitoring of Monkeypox virus
Jia-sheng ZHANG1, Min ZHANG1, Jing YANG2, Ri-sheng ZHA1
Affiliations
  • Suzhou New District Center for Disease Control and Prevention, Suzhou, Jiangsu 215010, China
出版时间: 2025-10-25 doi: 10.20043/j.cnki.MPM.202501426
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猴痘(Monkeypox,MPX)作为一种全球性公共卫生问题,不仅传染性强,而且人群普遍易感,给社会和患者个人带来了沉重的经济负担。目前猴痘病毒已在人群中传播数年且不断演变,至今尚无特异性抗猴痘病毒药物,因此该病备受关注。现有证据表明,在特定环境中猴痘病毒(Monkeypox virus,MPXV)是可存活的,并具有传染性,同时受环境因素影响(如不同材料物表、温度等),不同环境中存活时间不同。本文从猴痘病毒简介、环境污水监测、物表环境监测、不同温度下病毒持久性、空气监测等方面进行综述,为猴痘早发现早预防提供借鉴。

猴痘病毒  /  环境监测  /  污水  /  综述

Monkeypox (MPX) is a significant global public health issue, characterized by high contagion and universal susceptibility among populations, thereby imposing a considerable economic burden on both society and individual patients. The Monkeypox (MPXV)virus has been circulating within the human population for several years and continues to evolve. However, there are currently no specific antiviral treatments available for MPX, making this disease a major concern. Current evidence indicates that the MPXV can survive and remain infectious in certain environments, with its survival time varying across different settings, influenced by environmental factors such as contaminated surfaces and temperature. This article provides a comprehensive review from various perspectives, including an introduction to the MPXV, environmental wastewater monitoring, surface environmental monitoring, virus persistence at varying temperatures, and air monitoring, thereby offering insights for the early detection and prevention of MPX.

Monkeypox virus  /  Environmental monitoring  /  Wastewater  /  Review
张加生, 张敏, 杨静, 查日胜. 环境中猴痘病毒污染监测研究进展. 现代预防医学, 2025 , 52 (20) : 3820 -3823 . DOI: 10.20043/j.cnki.MPM.202501426
Jia-sheng ZHANG, Min ZHANG, Jing YANG, Ri-sheng ZHA. Research progress on environmental contamination monitoring of Monkeypox virus[J]. Modern Preventive Medicine, 2025 , 52 (20) : 3820 -3823 . DOI: 10.20043/j.cnki.MPM.202501426
猴痘(Monkeypox,MPX)是一种由猴痘病毒(monkeypox virus, MPXV)引起的人畜共患疾病,在中非和西非流行,最近已传播到许多非流行国家和地区。2022年7月23日,在COVID-19大流行背景下,世卫组织宣布持续发生的猴痘疫情为国际关注的突发公共卫生事件。猴痘的潜伏期多为6~13天,发病早期会出现寒战、发热,可伴头痛、嗜睡、乏力、背部疼痛和肌痛等症状,发病后1~3天出现皮疹,发病至结痂脱落约2~4周[1]。患者出现前驱症状或皮疹时,就具有传染性,直至病变处痊愈、痂皮脱落[2]。尽管猴痘是一种自限性疾病,但部分患者会因肾损伤、咽炎、心肌炎和软组织感染等而需要入院治疗[3-4]。世卫组织数据显示[5],2022年1月1日-2024年10月31日,全球126个国家共报告了115 101例实验室确诊病例和2例疑似病例,死亡255例。目前猴痘病毒已在人群中传播数+年且不断演变,至今也尚无特异性抗猴痘病毒药物,因此该病备受关注。本文从猴痘病毒简介、环境污水监测、物表环境监测、不同温度下病毒持久性、空气监测等方面进行综述,为猴痘早发现早预防提供理论依据。
猴痘病毒是痘病毒科正痘病毒属的成员,是对人类致病的4种正痘病毒属之一。猴痘病毒是一种有包膜的线性双链DNA病毒,基因组大小约197kb,被包裹在直径为200~250nm多晶的哑铃形核内,病毒颗粒呈砖形或椭圆形[6]。猴痘病毒基因组有一个高度保守的中央编码区,约56~120 kb,两侧是可变区域和末端重复序列[7]。猴痘病毒的中央核心区与其他正痘病毒具有超过90%的序列同源性,特别是在位于C10L和A25R之间的开放阅读框(ORF)内。正痘病毒的物种和毒株特异性特征通常存在于基因组末端的可变区中[8]。猴痘病毒已鉴定出两个遗传进化支,即中非进化支(进化支I)和西非进化支(进化支II),进化支II有两个亚分支:IIa和IIb,其中IIb是2022年猴痘疫情中主要传播的一组病毒变种。人类感染中非进化支病死率高达10%,而感染西非进化支病死率较低,病死率低于1%[9]。一般来说毒力的差异源于开放阅读框中基因区域的缺失和基因碎片化[10]。
猴痘主要传染源为感染猴痘病毒的啮齿类动物以及灵长类动物(包括猴、人等)。传播方式可能有:(1)动物源性传播:猴痘病毒的自然宿主包括非洲中部的一些啮齿动物和灵长类动物。人类可通过直接或间接接触受感染动物的血液或其它体液,或皮肤及黏膜的病变区域,从而感染猴痘病毒[11-12];(2)人际直接接触传播:主要包括血液传播、性接触传播、飞沫传播,以及家庭成员间的密切接触传播等[13-15];(3)垂直传播:猴痘病毒可以从受感染的母亲传播给新生儿[16];(4)间接接触传播:通过接触患者使用过的毛巾、衣服、床上用品或其他与感染性皮疹或体液接触的物品发生的间接传播,其占比为2.7%~7.6%[17]。
自1970年发现首例人感染猴痘病毒病例以来,病毒主要在非洲西部和中部地区流行。2003年,美国报告了非洲以外的首例病例,截至2003年7月8日,共报告了71例猴痘病例。2022年5月英国健康安全局(UKHSA)报告了7例猴痘病例。此后,全国100多个国家和地区出现猴痘疫情,疫情蔓延至非洲外的其他国家。过去,只有在接触受感染的动物或前往猴痘流行地区后才能诊断出猴痘病毒感染,近年主要通过与人与人之间的性接触传播,以男男性行为为主(MSM)[18-21]。
污水监测是一种有效的方式,具有低成本、快速响应的优势,越来越受到关注。有研究显示,猴痘病毒可通过粪便排泄、病变身体部位的皮肤碎片、呼吸道和鼻腔、唾液、尿液等体液分泌物等排入废水中[22-23]。通过分析污水收集点污水中的传染病生物标志物,可以实时地全面监测某些地区传染病的传播情况[24]。同时,无论是有症状患者还是隐性感染者,均会将猴痘病毒颗粒排出体外,故环境污水中存在人群所有感染者体内的病毒信息。因此,环境污水监测对于猴痘的预防和控制具有重要意义,尤其是在追踪无症状感染者方面。
Ampuero等[25]一项研究显示,从3个污水处理厂采集了21个污水样品,在6个污水样品中检测到了猴痘病毒DNA。陈欣等[26]于2023年7-9月对成都市污水监测结果显示,8个样本检测出猴痘病毒DNA阳性,检出率30.8%,均为西非分支Ⅱb C.1型;各分离株基因与报道的临床阳性株非常相似,与2022年猴痘疫情暴发的基因组密切相关;各分离株序列之间也非常相似,相似性为99%以上;可以推测污水中的猴痘病毒均来自于患者或携带者的人体脱落物或排泄物。表明,污水监测是监测猴痘病毒的一种可行方法。Guzmán等[27]一项西班牙地区污水监测研究显示,312个样本中有56个显示猴痘病毒DNA阳性,病毒载量范围在2.2×103至8.7×104基因组拷贝数(gc)/L之间。提示,污水监测是监测新型病毒的一种敏感且具有成本效益的方式。Xu 等[28]一项研究显示,2023年9月5日淄博市污水检出猴痘病毒DNA,并对9月淄博市阳性废水、阳性环境样本和猴痘病例中获得的猴痘病毒基因组进行了二代测序,结果显示,这3个基因组的基因型均属于C.1谱系的IIb分支,但其基因组不同,表明可能存在猴痘隐性传播。污水监测已被证明是一种潜在有价值的早期监测工具,可用于人口较多国家的猴痘病例和当地无症状病例传播监测。
污水中猴痘病毒浓度变化与医院病例相关研究较少,研究结果尚不一致。Wolfe 等[29]于2022年6月19日-8月1日期间,每日监测9个污水厂污水样品,9个监测点均检出猴痘病毒DNA;9个监测点中有5个,在临床上报告首例病例之前或之后一天内,检出猴痘病毒DNA;在连续10天以上检出阳性污水样本的监测点,污水中猴痘病毒病毒载量与报告病例的发生率呈正相关。Bagutti等[30]一项研究显示,39份污水样品中15份检出阳性;logistic分析显示,有症状病例的数量是污水阳性的影响因素(OR=2.18,P=0.001),而每日新增病例数与污水阳性无相关性(OR=1.23,P=0.629);污水结果阳性和阴性的监测点比较,每日新增病例和有症状病例有显著差异(P<0.05)。提示,在病例数较低的情况下,污水中也可检测到猴痘病毒病毒DNA,说明了基于污水的监测系统在评估新发传染病流行方面的价值。也有研究人员呈不同观点。Gazecka等[31]于2022年7—12月每日监测波兰波兹南地区中央和左岸2个污水厂污水,中央污水厂第29、43和47周在污中检测到了猴痘病毒DNA,而左岸主要在9月中旬至10月底期间检测到了猴痘病毒DNA;7—12月,当地卫生部门共报告了22例猴痘病例,7月中旬—8月中旬住院人数最多;污水中猴痘病毒浓度与就诊人数无相关性。提示,当地猴痘流行的规模可能被低估,猴痘患者一般在出现严重皮肤疖肿的情况下才会进行临床检测,无症状和轻微症状的病例,多数人可能不去就诊,导致出现漏诊。提示,由于缺乏猴痘病毒感染的准确数据,因此很难建立准确的预测模型,来预测临床病例与污水监测数据之间的关系。
医护人员在应对猴痘疫情时,因防护不到位或职业暴露易引起猴痘病毒感染。Gould等[32]2022年5月24日-6月17日期间,采集医疗机构5个隔离室高接触区、脱卸区、医护个人防护用品,环境样品共60个,有56个(93%)呈阳性(Ct为24.7~37.4);在病房、浴室、接待室、个人防护用品表面均检测到猴痘病毒DNA;其中接待室地板1个样本中鉴定出具有活性。Nörz等[33]一项医院病房表面的环境污染调查,发现患者手直接接触的所有表面都检出猴痘病毒,两间浴室中检测到的猴痘病毒含量最高;在患者的手机、马桶座圈和椅座表面上也检测到了猴痘病毒DNA。Salvato等[34]报道一起疑似污染物传播的案例,2名医护人员现场流调(穿戴个人防护装备,未带手套),采样时佩戴了手套,并避免与患者直接身体接触,最终2名医务人员确诊猴痘病毒感染。提示,2名医护人员感染可能是通过接触患者家中、个人防护用品或标本运输箱外表面的污染物导致的。
研究显示,目前家庭物体表面猴痘病毒污染相关报道较少,家庭物表可能会导致猴痘病毒感染传播,特别是存在无症状感染者的情况下。Pfeiffer等[35]采集猴痘病毒感染者家中9个区域,30个物体表面环境样品,21个(70%) qPCR结果呈阳性,包括所有3个多孔物品(布制家具和毯子)的样本,25个无孔表面(手柄和开关等)中的17个(68%),以及1种混合物品表面(课桌椅);物表样品qPCR 检测呈阳性的,继续病毒培养均未产生阳性结果。提示,清洁或随着时间流逝可能会影响病毒载量并使病毒灭活。Morgan等[36]一项猴痘患者离家15天后,进行了有针对性的环境采样,发现存在猴痘病毒DNA污染,继续培养7个样本中分离出活病毒;2种样品表面类型比较,多孔表面(床上用品、衣服等)和无孔表面(咖啡桌面、灯开关等)之间的qPCR阳性率没有差异,但2种类型物表培养物中分离到活病毒率存在显着差异。提示,多孔表面物体可能会带来更高的猴痘病毒感染风险。Morgan等[37]另一项研究也显示,来自4个家庭的12% (22/191) 动物和25% (14/56) 环境拭子样本猴痘病毒DNA呈阳性,但没有检测到活病毒。提示,环境中存在猴痘病毒DNA污染,尽管与宠物接触的较多,但未发现无皮肤损害的动物感染猴痘病毒的迹象。
使用不同的培养基来模拟猴痘病毒生长环境,探讨猴痘病毒不同温度下的存活时间,有研究显示,特定环境下,猴痘病毒的存活时间随着温度的降低而增加。Meister等[38]研究显示,在4 ℃、22 ℃和37 ℃条件下,不锈钢圆盘培养基中含有牛血清白蛋白(BSA)或羊血的病毒溶液,监测其残留传染性,病毒初始浓度为2.72×105 TCID 50/mL,在前24小时内保持恒定,不受温度或干扰物质的影响;5天后,4 ℃下羊血和BSA的病毒滴度基本无变化,在22 ℃和37 ℃条件下,羊血和BSA的病毒滴度均有不同程度的下降,37 ℃温度下,第6天(羊血)和第7天(牛血清)均未检出活病毒,衰减时间(t1/2)分别为4.82天和5.36天;22 ℃温度下,第10天(牛血清)和第11天(羊血)均未检出活病毒,t1/2分别为7.38天和6.47天;而在4°C的温度条件下,30天内均未培养出活病毒;BSA的病毒滴度在第20天(t1/2 =26.37 d)开始出现大幅度的下降,含羊血的病毒滴度下降得更早,但在观察时间范围内下降幅度更均匀(t1/2=29.04 d)。Li等[39]一项评估猴痘病毒在不同温度和冻融循环下的稳定性研究显示,猴痘病毒滴度在3个冻融循环内保持稳定,在12个循环后病毒滴度下降了1.04 lg CCID 50/mL(12.44%);猴痘病毒在56 ℃ 40 min、70 ℃ 10 min和95 ℃ 5 min下均能有效灭活。Batéjat等[40]一项将不同分支的猴痘病毒加入培养基,不同的温度和时间下进行热灭活效果观察,结果表明,猴痘病毒在70 ℃条件下的灭活时间<5分钟,在60 ℃条件下的灭活时间<15分钟,西非和中非分支的猴痘病毒之间没有差异。这均提示,猴痘病毒的稳定性随温度的降低而升高,但由于相关报道较少,有待进一步研究。
目前猴痘病毒经呼吸飞沫传播已得到证实,但气溶胶传播相关证据有限。有报道显示,气溶胶中检测出猴痘病毒DNA,提示可能存在气溶胶传播。Hernaez等[41]采集了2家医疗机构飞沫、气溶胶样品发现,患者口罩内采集的45个飞沫样品中32个(71%)检出猴痘病毒DNA,32个阳性样本中有2个分离出活病毒;医院空气中采集的42个气溶胶样本,27个(64%)样本检测到猴痘病毒DNA,其中医院隔离室采集的2个气溶胶样本中发现了高水平的猴痘病毒 DNA (Ct=30、29,病毒载量分别为4.4×103、1.3×103vg/m3),但气溶胶样本中均未分离出活病毒。Marimuthu 等[42]一项猴痘患者居住的房间空气监测研究显示,在发病第7天空气样本中猴痘病毒DNA检出率、病毒载量(100%,4/4样本阳性,平均 10 copies/L)高于随后的天数(第8天,100%,4/4样本阳性,平均3 copies/L;第13天,83.3%,5/6样本阳性,平均1 copies/L;第21天,40%,2/5样本阳性,<1 copies/L),但从空气样本中未分离到活病毒。提示,病毒可能存在于灰尘样本中(包括活病毒),提示病变脱落可能是空气污染的潜在来源[43]。Gould等[32]采集医疗机构5个隔离室,换床前和换床期间20个空气样本,5个(25%)呈阳性;其中,一名患者更换床褥前和更换床褥期间采集的4份空气样本中,有3份(75%)呈阳性(Ct 为32.7 ~36.2),且其中1份空气样品病毒检出具有复制能力。目前猴痘病毒气溶胶传播相关研究较少,现有研究在空气气溶胶样品中检出猴痘病毒DNA,不排除猴痘病毒通过气溶胶传播的可能。
目前的证据表明,在特定环境中猴痘病毒是可存活的,并具有传染性,同时受环境因素影响(如受污染的表面、温度等),在不同环境中存活时间不同;污水监测可作为人群猴痘监测的重要补充,尤其是无症状患者监测,可获得猴痘病毒载量和序列突变数据;同时还可以监测其他传染病,特别是一些新发或重新出现的传染性疾病;猴痘病毒的存活时间随着温度的降低而增加;气溶胶中检出猴痘病毒DNA,提示可能存在气溶胶传播。总之,环境中猴痘病毒监测研究,或可为猴痘的早期预警、人群流行趋势的监测、病毒溯源调查以及制定防控政策等提供一定科学依据。
  • 吴江区科教兴卫项目(WWK202514)
  • 江苏盛泽医院神经内科临床试验机构能力提升(SLT2023028; SZJG202402)
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doi: 10.20043/j.cnki.MPM.202501426
  • 接收时间:2025-01-26
  • 首发时间:2026-10-29
  • 出版时间:2025-10-25
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  • 收稿日期:2025-01-26
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吴江区科教兴卫项目(WWK202514)
江苏盛泽医院神经内科临床试验机构能力提升(SLT2023028; SZJG202402)
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    1.苏州高新区疾病预防控制中心,江苏 苏州 215010
    2.南京医科大学附属江苏盛泽医院

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2种不同金属材料的力学参数
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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